Moderate knee pain and MRI showinng torn meniscus.


Q: I recently started experiencing moderate knee pain, and I went to a local doctor. I had an MRI done, and he sent me to a sports medicine doctor. They determined I have juvenile osteoarthritis in my knee and I have a torn meniscus. I could possibly even have an injured ACL. I'm scheduled to have surgery tomorrow. The only part I'm worried about is that I'm not experiencing that much pain anymore. I don't know what to think. Help?


A:    Both ligaments ACL and PCL are very important to stabilize the knee joint backwards and forwards, the lateral ones stabilize it side to side, the menisci give cushion between femur and tibia, and the synovial fluid lubricates all the surfaces minimizing the friction during the movements, so as you can see every element is important for the correct function of the knee joint. The menisci are C-shaped wedges of fibro cartilage located between the tibia and femur, and very close related to knee ligaments and attached also to the joint capsule. They are susceptible to get injured with leg rotation movements or rotational forces applied to them, and the lesion produced can be partial or complete tear. Meniscus injuries are common in active people as you, who are involved in sporting or physical activities. Pain along with locking or buckling are common symptoms after a meniscus lesion develops. Locking usually occurs at 20-45° of joint extension. If a torn fragment has been trapped within the joint, extension may feel limited against a rubbery resistance. Joint inflammation or capsular involvement also may resemble locking. A more reliable indicator of meniscus lesion is a click, pop  or snaps after the joint unlocks, it can be or not associated with pain. A sensation of giving way may occur when the loose fragment becomes lodged for a moment in the knee joint, causing a sense of buckling. This finding should be distinguished from the sensation of giving way due to joint instability (eg, ACL tear) or buckling secondary to decreased activity of the quadriceps femoris muscle.

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