The knee joint is the commonest joint to be injured with playing sports, the bones of the knee are covered with cartilage to allow smooth movement. There is medial & lateral meniscus (cushions) – that function as shock absorbers. It has two internal cruciate ligaments (ACL & PCL) and two external collateral ligament (MCL & LCL) that provide stability.
Severe injuries to the knee joint requires a review from a Knee specialist to ascertain early and accurate diagnosis of the injury and initiation of early treatment. Dr Gautam Tawari is a UK fellowship trained and a Royal college of surgeons accredited Sports and Knee arthroscopy surgeon. He undertakes arthroscopic ACL/PCL surgery, Meniscal repairs, Knee Cartilage surgery and Stem cell treatment in the knee joint.
He follows an advanced rehabilitation protocol to ascertain his patients get back to sports quicker and more confidently.
Anterior cruciate ligament is one of the major ligaments of the knee that connects the femur (thigh bone) to the tibia (shin bone) and helps stabilise the knee joint. It prevents excessive forward movement of the the tibia in relation to the femur and also limits excessive rotational movements of the knee. A tear of this ligament results in feeling of lack of control of the knee on movement.
An ACL injury most commonly occurs during sports that involve twisting or overextending your knee, sudden directional change or slowing down while running, landing from a jump incorrectly or direct blow to the side of the knee, such as during a football tackle.
Anterior cruciate ligament reconstruction is a very common and a very successful procedure. It is indicated in patients wishing to return to an active lifestyle especially those wishing to play sports involving running and twisting. Reconstruction of the ligament tightens the knee and restores stability. The commonest form of reconstruction is by using patients own hamstring tendons to replace the injured ACL.
The procedure is performed under general anesthesia and is arthroscopic (keyhole). A hamstring tendon graft is prepared and is pulled through the predrilled holes in the tibia and femur. The new tendon is fixed into the bone with screws while the ligament heals into the bone.
Rehabilitation begins in 1 week and a physiotherapist provides specific exercises to strengthen and restore knee movement. Competitive sports are avoided for 5 to 6 months to allow the new graft to incorporate into the knee joint.
Menisci are two C-shape cartilage pieces present inside the knee joint, often referred as cushions. They stabilise the knee joint and act as “shock absorbers”. Meniscus tear is the commonest knee injury in athletes, especially those involved in contact sports. A sudden bend or twist of the knee cause the meniscus to tear. Elderly people are more prone to degenerative meniscal tears as the meniscal tissue wears out and weakens with age.
Torn meniscus causes pain, swelling, stiffness, catching or locking sensation of the knee. The knee is unable to move through its complete range of motion.
The treatment depends on the type, size and location of tear as well as age and activity level of the patient. Knee arthroscopy is often required for meniscal tears. Surgery is performed using arthroscope (pencil like camera) which enables to visualise and treatment is carried out with special instruments.
The arthroscopic treatment options include excision of damaged part of meniscus (partial meniscectomy), meniscus repair or meniscus replacement. During meniscectomy, small instruments called shavers or scissors may be used to remove the torn meniscus. In arthroscopic meniscus repair the torn meniscus is pinned or sutured to its rim.
Meniscus replacement or transplantation involves replacement of a torn cartilage with the cartilage obtained from a donor or a cultured patch obtained from laboratory. It is considered as a treatment option in very young patients with loss of meniscus.