Artificial Knee

Does my knee need surgery?

One of the most common knee injuries is damage to the meniscus — the cartilage that stabilizes and cushions the knee. Often, people assume surgery is required to improve this condition.

“Some kind of treatment is often needed for a meniscal tear,” says Dr. Dale Macdonald, Sport Specialist and Clinic Director at Elite Sport Performance in Calgary. “However, a lot can be done without resorting to surgery.”

Macdonald believes that surgery is sometimes recommended too quickly for this injury. Current research indicates that meniscal surgery may provide some short-term benefits, but in the long run, the benefits provided by surgery lessen. In some instances, meniscal surgery can also create new problems.

For example, when surgery is used to remove damaged bone or cartilage, the remaining parts of the meniscus can endure larger-than-normal mechanical loads. This can cause accelerated deterioration in the knee.

Macdonald adds that the meniscus naturally dehydrates as we age. In fact, it’s normal for adults who have no symptoms to have tiny tears in the meniscus. No treatment is required because this small degeneration creates no problem or pain.

Treatment is required, according to Macdonald, when a person’s knee is painful, swollen, catching, clicking, popping, locking or feels unstable and/or gives way. The treatment depends on the type of tear or damage, and will take into account a patient’s age, health and activity level.

Physiotherapy can be a great option for meniscus injuries. Strengthening your leg muscles provides improved stability and shock-absorption for the knee. Exercises targeted to this area can also reduce swelling, improve kneecap alignment and build strength and flexibility around the knee so the chance of re-injury is minimized.

Beyond physiotherapy, Macdonald is encouraged by new research for non-surgical management of meniscal tears. Some promising early results show that injections of platelet-rich plasma (PRP) can help certain areas of the meniscus with tissue regeneration. Stem cell injections – just now being introduced in Canada – may also prove beneficial for meniscal injuries.

“In my mind, surgery is a last resort after other methods have been tried without success,” Macdonald says. “The body has amazing self-healing properties. With a little guidance from a professional and the support of non-invasive treatments, patients can often get back to their activity in pretty short order.”