Meniscal Deficiency
In each of the knees, two discs of cartilage act as shock absorbers and help keep the knees stable. A single disk of this cartilage is called a meniscus. If the meniscus becomes torn or injured, patients may need to have part or all of it removed in a procedure called meniscectomy.
While this procedure can relieve symptoms of a torn or injured meniscus, it can also cause problems in the future. Meniscal deficiency resulting from surgery can cause or speed up the development of chondromalacia and/or osteoarthritis, conditions that break down the cartilage in the joints.
Symptoms
- Decreased activity
- Loss of function in the knee
- Pain in the knee
Prevention
- Preventing meniscal tears is the best way to avoid meniscectomy and the meniscal deficiency that can result from it.
- Meniscal tears can be caused by an awkward twisting of the knee or physical impact, which often occur during sports.
- Degenerative meniscus tears can happen during everyday activity in older people and are caused by aged and worn cartilage.
- Taking care not to twist the knee can help prevent meniscal tears.
Risk factors
- Age
- Joint degeneration
- Partial or total meniscectomy
Diagnosis
- Medical history and symptom review. The healthcare provider will review the patient’s symptoms and medical history, including any treatments that he or she may have needed for past knee problems.
- Physical examination. The healthcare provider will examine the patient’s gait, or the way he or she walks, for any limping or abnormalities. The healthcare provider will also examine the alignment of the lower extremities, inspect the knee for surgical marks or liquid buildup, and test range of motion.
- Imaging tests. The healthcare provider will use X-rays and MRIs to examine the knee for abnormalities, evaluate any implants from prior surgery and check for the development of osteoporosis or chondromalacia.
Treatment
- Conservative management. Before any surgical treatment is prescribed, the health care provider will try many different conservative options to address symptoms, including activity modification, weight loss, medication, physical therapy, braces and injections.
- Surgical management. When conservative measures fail, meniscal allograft transplantation or arthroscopy may be performed to address the symptoms of meniscal deficiency.
Follow-up care
- After surgery, the healthcare provider may prescribe a knee conditioning program to strengthen the muscles that support the knee, reduce stress on the knee joint, help the knee absorb shock, restore range of motion and prevent future injury.