THE HEALTH | MARCH-APRIL , 2023
| Column |
BONE TO PICK
THE meniscus is the substance in the knee that acts as a cushion between the thigh and leg bones . That ’ s the meniscus described in a nutshell . The menisci are a complex structure that plays a vital role in the knee joint .
So where exactly is the meniscus positioned ? First , there are two menisci . They are both attached to the articular surface of the tibia ( the leg bone ) in the knee . The medial meniscus is on the inner part of the knee , and the lateral is on the outer .
Both menisci have their distinctive shapes . The lateral meniscus is shaped more like a circle and covers a larger surface area , whereas the medial meniscus is more C-shaped .
The menisci play an integral role in contributing to the knee joint ’ s stability and transmitting forces through it . The end of the femur bone that makes up the upper part of the knee is somewhat hemispheric in shape , while the upper part of the tibia is generally a flat surface .
One can imagine a round object rolling and gliding on a flat surface isn ’ t all that stable . This is where the menisci come into play . They act to increase and improve contact between the femur and tibia cartilage surfaces .
THE SYMPTOMS
Because the meniscus is more elastic than the cartilage around the tibia and femur bones , it better absorbs forces through the knee . The meniscus shape increases joint congruity , and the meniscus composition that improves shock absorption plays an essential role in transmitting forces .
In cases where the meniscus is lost due to injury , there is a significant increase in peak pressure between the femur and tibia bones . It , in turn , will lead to faster wear of the cartilage surfaces and , eventually , knee osteoarthritis .
Injury to the meniscus can occur as either a result of an acute injury like a fall or a sports injury as well as a more chronic / longstanding issue .
Very often , in an acute trauma like a sports injury , the patient tends to have an Anterior Cruciate Ligament ( ACL ) tear with a concomitant injury to the lateral meniscus . In contrast , chronic injuries tend to involve the
Softening the blow – the role of the meniscus
The menisci contribute to the knee joint ’ s stability and transmitting forces through it medial meniscus .
So , what kind of symptoms might one experience when there is an injury to the meniscus ? As stated above , meniscus injury can occur concomitantly with other injuries to structures in and around the knee , like the cartilage and ligaments .
While meniscus injury presents with only pain in most cases , one must consider that other structures may also be injured and contribute to other symptoms .
AN ESSENTIAL KNEE STABILISER
Occasionally , the meniscus might get displaced and jammed between the gliding femur and tibia bones in cases of a more severe tear . It then leads to the knee being locked into a particular position . This condition is termed a locked knee .
As mentioned above , the menisci are
While meniscus injury presents with only pain in most cases , one must consider that other structures may also be injured and contribute to other symptoms . ”
an essential knee stabiliser apart from their role in transmitting forces . They become primary stabilisers of the knee when there is an impaired function of the knee ligaments .
So , while pain is still the main
Dr Jonas Fernandez is an Orthopaedic Surgeon at Putrajaya Hospital . He is also a member of the Malaysian Arthroscopy Society ( MAS ). symptom of meniscus injury , the symptom of knee instability should also be considered . To be more precise , conditions called ramp lesions , and root tears contribute to most cases of instability in cases of meniscus injury .
Meniscus injuries can be diagnosed from a patient ’ s history and examination . Magnetic Resonance Imaging ( MRI ) will offer an excellent indicator of the exact location and pattern of the meniscus tear and detect other concomitant injuries .
Treatment usually starts with a period of physiotherapy but often requires surgery to address the tears . Minimally invasive surgery using an arthroscope is the mainstay of treatment .
Special sutures are used to repair them . However , in more complex tears , repair may not be suitable . In such cases , the meniscus will be trimmed .
Whenever possible , it is integral that the meniscus is repaired and preserved because , as we have read above , they soften the blow to the knee . – The Health