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Q. I recently
underwent arthroscopic surgery on my knee for a torn cartilage. The
surgeon removed half of the cartilage. My pain is gone but I wonder if
anything else could have been done rather than removing the torn
cartilage. Also, is there anything that could or should be put back in its
place?
A. Each knee has two menisci. These C-shaped rubbery type shock absorbers
are on the medial (medial meniscus) and lateral (lateral meniscus) side of
the knee. If you develop a “cartilage tear” the treatment depends on the
size, type, and location of your tear and whether there are other factors
in your knee such as ligament tears or arthritis. Sometimes it is correct
to remove a piece of the cartilage and other times it can be repaired, and
that is best determined by your surgeon at the time of surgery when they
directly visualize your cartilage or meniscal tear through the
arthroscope.
If the meniscus is repaired and saved the recovery is usually longer but
in the long run it is better for your knee. Age is also a factor. The
younger you are, the more likely your meniscal tear can heal, and efforts
should be made to try to save it. Also, if you are young and have had your
entire meniscus removed and you are having symptoms, there are some new
alternatives. A donor meniscus from a cadaver (meniscal allograft) can be
transplanted into your knee. This is a relatively new but promising
technique and the long term effects are not known for certain but it seems
to be an excellent alternative in select situations.
If all or even part of your meniscus has been removed then you have lost
some shock absorption in your knee so it becomes even more important to
build up the external shock absorbers around your knee which means
strength training and muscle building, especially your quadriceps muscle
on the front of your thigh. Also, you can also reduce the stresses placed
on your knee joint by keeping your weight down and avoiding higher impact
activities such as running. |