Twisted, Injured Knees Easily Treatable -- Especially in Young Patients
WebMD News Archive
Feb. 11, 2000 (Atlanta) -- For sudden knee injuries -- with signature
symptoms like locking, popping sounds, pain, and swelling -- a minimally
invasive procedure called arthroscopy is generally the best treatment,
according to a paper published in the January issue of Current Opinion in
"Someone twists the knee or lands on it 'funny,' causing bones to become
misaligned or injuring the meniscus (the knee's bumper)," lead author Tal
David, MD, an orthopaedic surgeon and sports medicine specialist at Los
Angeles' Kerlan-Jobe Orthopedic Clinic, tells WebMD. "There's clearly an
inciting incident that's caused the problem. This is the patient who says, 'I
felt a pop, and since then my knee feels like there's something grinding in
there, like something catches in there when I flex and extend it.'"
Such injuries cause painful swelling and can begin wearing away the
cartilage -- the cushioning tissue that surrounds the bony knee joint, says
David. Traditional procedures to treat these injuries have involved bone
realignment (osteotomy) or knee replacement (total knee arthroplasty), but
these are invasive procedures that mean several days' hospital stay and
Arthroscopy -- a minimally invasive procedure -- has become a popular option
because of its low cost and short recovery period. Typically, patients go home
the same day they have arthroscopic surgery and get around on crutches for up
to one week.
The procedure involves inserting a flexible tube into the joint, allowing
the surgeon to view the damage and remove or repair broken pieces of bone, a
procedure called debridement. Sometimes, surgeons drill small holes -- called
abrasion arthroplasty -- to stimulate bone marrow cells to regenerate cartilage
in small, damaged areas.
"Arthroscopy definitely has its advantages, but until now it's been
unclear to physicians exactly which patients benefited most from this
procedure," says David. "In this paper, we looked at the literature to
clarify the positive predictors of a good outcome."
"Young people who injure the knee ... do very well with
arthroscopy," says David. "The gray area will be the person over 50 who
has a little bit of arthritis who injures the knee. Their outcome is not as
predictable. Alignment is not as important with them."