KNEE-CARTILAGE INJURY(Meniscus Injury)
DESCRIPTIONA knee-cartilage injury is damage to cartilage in the knee at the top of the lower leg bone (tibia). Knee-cartilage injuries frequently accompany dislocations of the kneecap or ligament sprains in the knee. This is sometimes a vaguely diagnosed knee injury that resists conservative treatment. The cartilage at the top of the tibia that normally cushions the force to the knee, the knee joint, the ligaments that lend stability to the knee, and the soft tissue that includes nerves, synovial membranes, periosteum (covering of the bone), blood vessels, lymph vessels, and bursae of the knee joint are involved.
Appropriate health care includes:
Surgery to remove the damaged meniscus. This is usually done with arthroscopy, which is visual examination of a joint using an arthroscope, a fiber-optic instrument with a lighted tip.
Self-care during recovery following surgery.
Physical therapy and rehabilitation after surgery.
SIGNS & SYMPTOMSPain and tenderness in the child's knee, especially when bearing weight.
Locking of the knee joint.
"Giving way" of the knee.
"Water" on the knee (sometimes).
CAUSESA direct blow to the child's knee.
Prolonged overuse of an injured knee.
Twisting or violent muscle contraction.
Contact sports, especially football; obesity; poor nutrition; previous knee injury; poor muscle conditioning.
PREVENTING COMPLICATIONS OR RECURRENCEYour child should do the following: engage in vigorous pre-sport strengthening and conditioning; avoid concrete or asphalt surfaces and other rigid surfaces for continuous conditioning exercises; warm up adequately and tape a previously injured knee before practice or competition.
MEDICAL TESTSYour own observation of symptoms; medical history and physical exam by a doctor; X-rays of the child's knee to rule out fracture; arthroscopy for knee injuries that have some, but not all, signs of cartilage injury (this instrument is also used for surgery on the knee).
Prolonged disability, knee instability, and pain without surgery.
Arthritic changes in later years whether surgery was performed or not.
Proneness to repeated knee injury.
Postoperative complications, including bleeding into the child's knee joint, surgical-wound infection, and slow healing.
Surgery is the only definitive treatment for knee-cartilage injuries. With surgery, expect complete healing if no complications occur. Allow 6 weeks for full recovery from surgery.
HOME CAREInstructions for your child during the postoperative phase:
Walk on crutches until your surgeon instructs otherwise.
After the cast is removed, use an electric heating pad, heat lamp, or a warm compress to relieve incisional pain.
Take whirlpool treatments, if available.
Wrap the injured knee with an elasticized bandage between treatments.
Massage gently and often to provide comfort and decrease swelling.
On follow-up visits, your surgeon may aspirate fluid that has accumulated in the knee joint.
MEDICATIONFor minor discomfort, use non-prescription medicines such as aspirin, acetaminophen, or ibuprofen.
Your doctor may prescribe stronger medicine for pain, if needed.
Your child can return gradually to full activity as the range of motion and strength in the injured leg becomes equal to the normal leg.
DIET & FLUIDS
Increase the child's fiber and fluid intake to prevent constipation that may result from decreased activity.
OK TO GO TO SCHOOL?Yes, when condition and sense of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of a knee-cartilage injury.
Any of the following occurs after surgery: increased pain, swelling, redness, drainage, or bleeding in the surgical area; signs of infection (headache, muscle aches, dizziness, or a general ill feeling, and fever); nausea or vomiting.