Just as the ball leaves your racquet, you feel the pain in your knee as you land awkwardly on your right foot. You hear a loud “pop” and the next thing you know, you’re laying on the ground with your knee throbbing. Was it the meniscus? The cartilage? A ligament? Or, all of the above? One thing’s for sure – it’s time to see a doctor for that injury.
Here are three of the most common knee injuries that can land you in an orthopaedic surgeon’s office – and what can be done about them!
#1 Meniscus tear
Playing contact sports will surely put you at a higher risk of tearing your meniscus – the thin, fibrous tissue that provides cushioning between your thighbone and shinbone. However, you certainly don’t have to be an athlete to experience this type of injury; all it takes is a sudden twist, or getting up from a squat the wrong way.
“The meniscus is a disc-like, shock-absorbing structure that sits between the thigh and shin bone,” explains DR ALAN CHEUNG, consultant orthopaedic surgeon at International Orthopaedic Clinic here in Singapore . “Twisting movements during sports can create enough force to tear the meniscus, resulting in pain, tenderness and a locking sensation.”
A small meniscal tear can sometimes be left alone, says Dr Cheung. But, larger tears can be either repaired or removed through keyhole surgery. Both methods are minimally invasive and have good results, he says. Surgery usually takes under an hour and most patients can go home on the same day.
#2 Articular cartilage injury
While a meniscal tear is a more common injury in the knee, the smooth tissue that cushions the ends of the bones, called articular cartilage, can be damaged, too.
“Our knees are like the wheels of a car. The smooth cartilage lining of the knee is like a rubber tyre on a wheel. Through the passage of time, car tyres, like knee cartilage, can wear out and need replacing,” explains Dr Cheung.
Because cartilage doesn’t have a blood supply like other types of tissue, it doesn’t heal when damaged. So, leaving a cartilage injury untreated may lead to osteoarthritis over time.
Dr Cheung says that, for more localised cartilage injuries, the simplest option is a procedure called ‘microfracture’, where small holes are drilled into the bone under the missing cartilage. This allows for cartilage healing to take place.
Dr Cheung says that when a large area of joint has been worn away, then realignment of the joint or knee replacement are possible solutions to relieve pain and restore quality of life.
#3 ACL tear
Bones are connected to other bones by ligaments – short bands of tough connective tissue. As one of the four main ligaments that stabilise the knee, the anterior cruciate ligament (ACL) is very commonly torn during sporting activities that involve tackling, jumping, stopping suddenly or quickly changing direction. Typical symptoms of this type of knee injury include immediate pain, knee instability and swelling.
“When the swelling subsides in several weeks, the athlete may experience instability or a feeling of giving way when trying to change direction suddenly while playing a sport,” says Dr Cheung.
At this early stage, he usually recommends that the patient see a physiotherapist to strengthen the knee. But, if the knee remains unstable and an ACL tear is confirmed on an MRI scan, then surgery is likely necessary.
Dr Cheung says that ACL reconstruction is the standard surgical procedure for a symptomatic ACL-deficient knee. During surgery, a tissue graft – usually made up of hamstring tendons – is used to replace the torn ligament.
After ACL reconstruction surgery, you’ll be able to get up and walk with crutches straight away. In fact, many patients even go home the same day. As for recovery time, Dr Cheung says that it normally takes nine to 12 months of physiotherapy and rehabilitation to get a patient back to playing sports.
He adds, “It’s worth seeing a good physiotherapist on the recommendation of your surgeon, and underging rehab before considering surgery. This allows your knee to regain full range of movement and strength, and allow the bone bruising to settle. Some doctors have also argued that ACL reconstruction is associated with a lower risk of early arthritis (degenerative change).”
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