Torn Cartilage
Cartilage tears such as the meniscus
are one of the most common knee problems, because it is subject to many stresses and has limited blood supply. It is therefore
unable to undergo a normal healing process. Tears not associated with an ACL injury generally do not heal as well as those
incurred during such an injury. With age, the meniscus also begins to deteriorate and can develop small tears even without
injury. When a sudden impact, excessive wear, and/or the degenerative effects of aging damage this cartilage, it begins to move
uncomfortably inside the knee joint - causing the same type of discomfort as a stone in a shoe. Often times the torn meniscus
can become caught between the bones of the joint and cause pain and swelling, making movement impossible.
At the Sanders Clinic, initial recommendations are not surgical provided the knee is not locked and able to come to full
extension. A significant number of patients are able to avoid arthroscopic surgery with a proper Reconditioning Program.
Anti-inflammatory medications such as Celebrex, or Advil are started. Nutritional supplements
for articular support are added to the program and an exercise plan is instituted utilizing a Step Box for both legs.
This simple device is used for the performance of closed chain knee extension exercises on both legs, beginning with four sets of 25 reps
of two-inch excursions each day then increasing until 50 reps can be performed. The same routine is then continued with a four-inch excursion.
After the same goal is reached, the excursion is increased to six, then eight inches. Patients must do at least four sets per day on each leg. The
patient may start to work in the stationary bike and/or the Stairmaster, as well as continue with the Step Box at increasingly longer excursions
through the end of the second week. Additionally in the second week, programs of jogging, swimming, and specific sport-related activities are begun,
if a specific sport is not already in progress. Athletes may continue to participate in their desired sport.
In those patients who do not have significant arthritis, yet are not responsive to these measures, torn edges of the cartilage can be
arthroscopically removed and the cartilage reshaped within the knee. This minimally invasive procedure
allows immediate movement of the knee and provides excellent results.
