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What is the difference between a knee meniscal cartilage and knee articular cartilage ?

Meniscal cartilages are “C” shaped fibrocartilages that sit between the femoral and tibial joint articular surfaces. They help decrease contact stress load and act to make the joint more congruent. As we age the meniscal cartilages are prone to degenerative tears, some of which can be repaired. The articular cartilage is a firm gel-like substance that covers the femoral and tibial bone ends. With osteoarthritis the articular cartilages thins, and becomes soft and degenerate. Eventually the articular cartilage becomes so thin it wears down to the underlying bone plate, known as “bone on bone”
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What is an arthroscopy? Can all surgery be done through an arthroscope?

An arthroscopy is a surgical procedure to treat intra-articular knee conditions such as meniscal tears, loose bodies and articular cartilage injury. Some procedures can also be undertaken via an arthroscope, such as Anterior Cruciate Ligament Reconstruction. Some procedures, such as knee replacement, cannot be undertaken with an arthroscope.
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When can I drive after surgery?

In general, after major knee surgery patients should not drive for six weeks. After minor knee surgery, 2 weeks is typical. The key factor is only driving when it is safe to do so. Each state has different transport laws.
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If I have an arthroscopy, can you always fix the problems at the same time?

At the majority of knee arthroscopies, the intra-articular pathology is dwelt with at the same time, including meniscal tears, loose bodies etc.  Some procedures such cartilage transplants require a delay to grow the cells. It is best to discuss your case with your surgeon prior to surgery.
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How much physiotherapy and rehabilitation will I require after my procedure?

Most anterior cruciate ligament reconstructions require 9-12 sessions of physiotherapy over 8 months. Knee arthroscopy patient’s physiotherapy requirements can vary enormously depending on what procedure was undertaken, with some requiring no rehabilitation. It is best to speak with your surgeon.  After knee replacement, between 2-6 sessions is common.
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Will I need crutches after my procedure?

Most arthroscopy patients will not require crutches, except for meniscal repairs for marrow stimulation procedures. ACL reconstructions and knee replacement patients will require crutches after surgery.
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Who is suitable for articular cartilage transplant?

Please download the KSMC brochure on Cartilage Transplant
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Why do meniscal cartilages tear?

Please download the KSMC brochure on meniscal tears.
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If I tear my meniscal cartilage will it stop me from returning to sport?

If you undergo a successful meniscal repair then the majority of patients can return to sport. If you suffer a large degenerative non-repairable meniscal tear, a significant proportion of patients may be unable to or decide not to return to heavy impact loading sport. Typically these patients have osteoarthritis injunction with a meniscal tear.
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How do I prevent knee osteoarthritis?

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What symptoms should I expect with knee osteoarthritis?

Early

  • Mild ache or pain with running or walking for long periods
  • Some stiffness or swelling
  • Ache at night if active during the day

Late

  • Pain with any activity
  • Pain that interferes with sleep
  • Marked swelling or change in leg shape
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What are the risk factors for knee osteoarthritis ?

Being Overweight
  • Linked to Knee > Hip > Hand Arthritis
  • 7 x risk
  • Animal studies high fat diet can lead to osteoarthritis
Heredity – Family History
  • Increase polyarthritic OA in families
Trauma
  • Ligament & meniscal injury
Repetitive use
  • Occupational
  • Power athletes
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What should I expect after Knee Replacement?

Knee replacement patients will find their pain levels much improved. They should be able to play gentle doubles tennis, golf and bowls. Most patients can walk for 1-1.5 hours without difficulty. However knee replacements do not feel or function like the knee you were born with. Some patients notice occasional clicking, stiffness or mild aching after knee replacement. These feeling can improve with time. A very small number of patients rate their knee replacement outcome as only fair do to excessive aching or stiffness. Most patients rate their replacement as good to excellent.
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Why should I consider ACL reconstruction?

ACL reconstruction is considered for the following groups of patients:

  1. Young patients with acute ACL tear who participate in pivoting sports.
  2. Patients with an ACL tear and repairable meniscus.
  3. Patients with a chronic ACL tear and symptoms of instability.
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Will ACL reconstruction stop later knee osteoarthritis (OA)?

When you tear your ACL, your risk of OA is 15 times higher than normal in that knee. By reconstruction your ACL, you chance of a meniscal injury is less, but it is unknown if this leads to less knee OA long-term. It is a controversial topic amongst knee surgeons. One problem is that controlled long term follow-up studies are very difficult to undertake.
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What is difference between meniscal repair and menisectomy?

With meniscal repair, your surgeon will place sutures or meniscal repair devices across the tear. The suture/ devices approximate the tear edges till your natural healing process spans the tear and allows tissue healing. This will restore the normal meniscal function and decrease the chance of later knee OA. With menisectomy, the torn portion of the meniscus is remove. This does not restore the normal meniscal function. Only meniscal tears in the vascular portion of the meniscus are typically repairable.
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