Knee locking is a sign that immediate treatment is needed

Published 8:53 am Friday, November 27, 2009

EF asks: Dear Dr. Patel, I am a 32-year-old male who was recently diagnosed with a cartilage tear in the knee. I have a medial meniscus tear in my left knee. My knee keeps swelling and locking as well. I injured my knee while playing basketball. My family doctor referred me to an orthopedic surgeon for possible surgery evaluation. I am a bit nervous and was wondering, Do I really need the surgery?

Dr. Patel writes: The knee has a major cartilage called the meniscus. There are two menisci in the knee (medial and lateral). The meniscus is a C-shaped cartilage that helps to distribute stress evenly across the knee. The blood supply of the meniscus comes from the periphery. The central two-thirds of the meniscus has a poor blood supply.

If the meniscus is torn, it may need to be addressed. Many patients as they get older may develop a tear that is degenerative in nature. This means that the tear occurred over time from wear and tear. Depending on the age of the patient, sometimes nothing more has to be done. Because the blood supply is tenuous to the meniscus, it usually does not heal on its own.

A tear in your situation does need to be addressed surgically. The fact that you are having locking of the knee is a not a good sign to treat this condition conservatively. Depending on the pattern of the tear, a repair of your meniscus should be attempted. If the tear is in the outer third area of the meniscus, then a repair may be feasible. The decision to repair would be made during the surgery. If a repair cannot be performed then only the portion of the meniscus that is torn should be removed arthroscopically. Hope this helps ease your worries.

Dr. Manish Patel has extensive training in treating shoulder, elbow and knee injuries, and performing arthroscopic surgery. He is the principal medical practitioner in the offices of Southampton Orthopaedic and Sports Medicine Center, on the campus of Southampton Memorial Hospital. Submit questions about sports medicine, injuries and treatment for this column to, or call Patel at 562-7301.