An injured knee can do more damage than you think
Dr. Nader Darwich and Rashid Al Qubasi
Consultant Orthopaedic Surgeon Dr. Nader Darwich explains how the meniscus supports the knee and requires immediate attention in case of injury
The meniscus is a piece of cartilage in the knee that cushions and stabilises the joint and protects the bones from wear and tear. But all it takes is a good twist of the knee to tear the meniscus. The symptoms of a meniscus tear can include a sharp pain in the knee, swelling, a popping sensation, difficulty bending and straightening the leg, and in some cases, a piece of the shredded cartilage breaks loose and catches in the knee joint, causing it to get "stuck" or "locked up".
Dr. Nader Darwich, Consultant Orthopaedic Surgeon specialised in knee and sports at
Burjeel Hospital for Advanced Surgery, Dubai, says: "It is crucial to save an important
component such as the meniscus in an injured knee instead of just removing it as repairing
it can give more life to the knee. Extremely significant for the function and survival of the
knee, when a meniscus is torn or moderately damaged a lot of people choose to remove the
damaged part but we repair it."
He further added: "The meniscus acts as a shock absorber and plays a vital role in the stability, lubrication and position of the knee. By removing the meniscus, there will be a wear and tear of the cartilage that leads to osteoarthritis of the knee. Not many institutions do this and just shave the meniscus and remove it. Therefore, it is vital for us to change our attitude to preserve the meniscus for the future of the knee and bring about awareness on the importance of its function and not sacrifice it."
Meniscus tears are common, especially in young people who do a lot of aggressive sports like football, volleyball and soccer. This can happen when a person changes direction suddenly while running, and often occur at the same time as other knee injuries, like an anterior cruciate ligament (ACL) injury. Meniscus tears are a special risk for older athletes, since the meniscus weakens with age. More than 40 per cent of people 65 or older have them. Eighty-five per cent to 90 per cent of people who get the surgery for a meniscus tear, the short-term results are excellent. But in the long-term, people who have a large meniscal injury that is unrepairable may be at a higher risk of developing knee arthritis.
Um Saif, a 22-year-old Emirati patient of Dr. Nader, had torn his lateral meniscus four years ago while playing football. It was identified as a bucket handle tear, the worst case of a meniscus. He said, "I went to four doctors who told me there was nothing wrong, but Dr. Nader took up the case immediately. My knee was jammed, it would lock and unlock. I would go to the shopping mall for a walk and leave in a wheelchair. After surgery, I recovered fully with the help of physiotherapy within a year and today I can play sports."
He added: "My experience with Dr. Nader was the best as he immediately knew the issue."
Rashid Butti Al Qubasi, an Emirati UAE Representative International Champion Endurance runner who also became the first Emirati athlete to represent his nation in a combative sport at the 2008 Summer Olympics in Beijing said: "I was experiencing excruciating pain in my knees. Dr. Nader was very familiar with my condition. I had a knee surgery ACL reconstruction. After two months, I was back at the field and was the first Arab and GCC national to ever win the XDubai Spartan Race, which was held for the first time in Bahrain on April 1, 2016, at age 41. This was the most amazing moment in the history of the UAE and the Arab sporting world. Like me, Dr. Nader has operated on many other players in the UAE national team. Today, I am also a coach for the Abu Dhabi police team. I had a speedy recovery, because I followed Dr. Nader's schedule and instructions that helped me heal quickly."
Meniscus tears are tough to prevent since they are usually the result of an accident. But some precautions might lower the risks of a knee injury such as:
- Keep your thigh muscles strong with regular exercises.
- Warm up with light activities before taking part
- Give your body time to rest between workouts. Fatigued muscles can increase your risk of injury.
- Make sure your shoes have enough support and fit correctly.
- Maintain flexibility.
- Never abruptly increase the intensity of your workout. Make changes slowly.
To diagnose a meniscus tear, a doctor will give you a thorough exam and would want to hear details about how you got your injury. X-rays may be necessary, to rule out broken bones and other problems. You may also need an MRI scan, which allows a more detailed evaluation of the knee cartilage. Treatment for meniscal tears depends on the size and location of the tear. Other factors which influence treatment include age, activity level and related injuries. Thankfully, not all meniscal tears require surgery. If your knee is not locking up, is stable, and symptoms resolve, nonsurgical treatments can be performed.
If a tear is large, unstable, or causing locking symptoms, surgery may be required and you can often go home the same day. You may require a brace afterward for protection if a repair is performed. Full recovery from surgery may take 4 to 6 weeks, depending on the type of procedure performed as well as other factors.