Mr Craik provides private knee consultations at Ashtead Hospital in Surrey and often diagnoses and treats patients who have developed meniscal tears and osteochondral defects.

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MENISCAL TEARS

 

The meniscus is a structure within the knee made from cartilage. There are 2 menisci in each knee. They are positioned between the top of the shin bone and bottom of the thigh bone, running around the periphery of the knee joint. They function to contour the top of the shin bone and act like shock absorbers during activities when the knee joint is carrying weight. 

 

When an injury to the knee occurs such as twisting, the meniscus can be torn. This can result in a portion of the meniscus becoming unstable and getting caught in the joint either permanently or intermittently during certain activities. Patients may experience sharp catching type pains with episodes whereby the knee will lock and they cannot fully extend the knee. The knee can also give way during these catching events. 

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Another situation when the meniscus can become injured is in the presence of knee arthritis. When knee arthritis is present the joint surfaces becomes generally worn and the meniscus tears as a consequence of this. The treatment of meniscal tears is different depending on exactly where the meniscus is torn and if knee arthritis is present.

 

Xrays do not show meniscal tears but can demonstrate if there is significant arthritis within the knee. An MRI scan can clearly show the meniscus and can help to diagnose if a tear in present.

 

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OSTEOCHONDRAL DEFECTS

 

The cartilage in the knee that lines the end of the thigh bone, top of the shin bone and under the kneecap can become injured during falls, twists and dislocations. Sometimes the joint cartilage can be damaged when it separates from the underlying bone with a small fragment of bone still attached. This is called an osteochondral defect. When there are localised defects in the joint cartilage, or very unstable fragments of cartilage and bone, then patients can experience pain with episodes of locking and giving way when loose fragments get caught in the wrong part of the knee joint.

 

Osteochondral defects can sometimes be seen on knee xrays but are best diagnosed with an MRI scan.

 

The ability of the joint cartilage to repair itself is very limited. Therefore if there are small focal cartilage defects or loose fragments of bone and cartilage in the joint then you may be offered knee surgery to help repair the damaged joint surface and to remove loose fragments from the knee. This is often performed with knee arthroscopy (key hole knee surgery).

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