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MEN AND THEIR KNEE PROBLEMS: THE LOWDOWN ON KNEE INJURY
Although there are many different types of soft tissue injury to the knee (such as damage to any of the cruciate ligaments), there is considerable clinical evidence to suggest that the deterioration of the meniscus plays a key role in increased risk of injury to all functional parts of the knee joint. It was only a few years ago that the meniscus was regarded as a superfluous tissue remnant, so when it was torn, the medical impulse was to remove it surgically. The resultant abnormal motion in the joint and consequent deterioration of otherwise healthy knee tissue, due to augmented impact forces previously controlled by the meniscus, have served as sober reminders of the importance of the meniscus in knee health.
Damage to cartilage and erosion of bone surfaces no longer insulated by the meniscus was observed by specialists within three weeks of surgical removal. The current medical disposition is to repair the torn meniscus wherever possible by suturing and other techniques. Despite a measure of success, however, it is clear that prevention still stands as the best cure.
If you are active in sport, do not play on sore or swollen knees. A minor tear of the meniscus can almost always be healed if the injury is recognised early enough and your lay-off is accompanied by an adequate program of physiotherapy and muscle conditioning.
If the tear is acute, arthroscopic surgery is often recommended by specialists. Where the tear is to the peripheral 30 per cent of the meniscus, blood supply to the area is plentiful, so that even some acute tears may be treated without surgical intervention. In those cases in which surgical intervention is definitely required, the prognosis for full recovery is good, given the sufficiency of blood to the peripheral meniscus.
Unfortunately, an acute tear to the inner zone of the meniscus provides a less optimistic prognosis, as blood supply to the region is insufficient to maximise the healing process. Recovery, at least full recovery and a return to active sport, is difficult in the case of such tears, though orthopaedic surgeons are expanding their arsenal of new techniques for surgical intervention into this region of the meniscus, including techniques for increased blood nourishment to meniscal tissue.
It is important to be aware of recovery times if you do choose to undergo surgery. If the meniscus can be surgically repaired, you should anticipate at least four weeks in a hinged knee brace and you will be allowed to put only minimum weight on the joint for the same period and perhaps longer. During the four-week recuperation period, you should expect to engage in a regimen of carefully controlled range of motion exercises and partial knee bends, along with other tensing exercises to keep the thighs (and especially the quadracep muscles) from excessive atrophy.
Once the four-week period of conditioning is completed and the knee brace is off, patients usually commence a cycling program, water workouts, elastic-cord exercises, and additional physiotherapy. Depending upon the severity of the injury and your level of fitness, it is likely to take anywhere from twelve to fourteen weeks for full recovery following surgery. Should the meniscus prove to be irreparable and require partial removal, the recommended recovery program is more aggressive, commencing a day or so after surgery.
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