Cutting Edge Issue 2 - Page 73

CARTILAGE INJURIES IN THE KNEE Quadriceps Muscle Femur Quadriceps Tendon within the joint, or is trailing frayed bits, or has splits within it (basically is not working properly) rather than facilitating joint movement it is actually blocking and disrupting it. The diagnosis of meniscal injuries is difficult as a lot of the orthopaedic tests are not terribly reliable. Probably the most useful information is gained by a combination of taking a good comprehensive case history, finding out the mechanism of injury and doing a comprehensive physical examination. If a severe meniscal injury is suspected then immediate referral to a specialist orthopaedic surgeon and MRI is the norm. Treatment can be provided by an osteopath or a physiotherapist initially and for a minor injury; however in my experience if there is a cartilage injury in most cases eventually this will lead to a referral to a surgeon. This subsequently and commonly will result in an ‘arthroscopy’ of the joint where the meniscal cartilage can be trimmed/tidied up and loose bits within the joint vacuumed out. Occasionally meniscal replacements are performed with donor tissue but this is a fairly new procedure as far as I know. Patella Cartilage Patellar Ligament Meniscus Ligament Tibia CUTTING EDGE | 71