Meniscus is a specialized connective tissue present in the knee joint. There are two menisci in the knee joint: the lateral meniscus and medial meniscus. They are interposed between the joint surfaces of femur and tibia, and are C-shaped structures with a triangular cross section. Meniscus plays a vital role in the knee joint function. It acts as a shock absorber for the knee and also helps in joint stability, lubrication and nutrition.

These terms are interchangeably used in many sports injuries. A sprain refers to an injury in a ligament. Sprains are graded according to the severity. A sprain may range from a minor bruise of the ligament to a complete tear (discontinuity) of the ligament. So it is very important to quantify the severity of ligament injury by clinical and radiological methods. A strain refers to an injury to the muscle-tendon unit.

Arthritis is a condition characterized by widespread damage to the moving surfaces of the joints. There are many varieties of arthritis.

When the joint damage is due to age related wear and tear, it is called Osteoarthritis. When the wear and tear is due to some injury like joint fractures, then it is called secondary osteoarthritis. Arthroscopy has a limited role in the management of osteoarthritis per se. Arthroscopic joint washout (Lavage) has only short term benefit and no therapeutic benefit in the long term. However, degenerative meniscus tear which are responsible for frequent exacerbations, locking and effusions can be treated by arthroscopy. The knee joint has two compartments - inner and outer. Usually, the inner compartment is worn out and the outer compartment is well preserved and the leg develops a bow leg deformity. A corrective bony procedure called High Tibial Osteotomy is done to correct the alignment and redistribute the load. This procedure is effective in those under 50.

This group of arthritis is caused by disorders that attack the body's own tissue (autoimmune) e.g., rheumatoid arthritis, psoriatic arthritis. The treatment is mainly with medicines. Surgery may be required for clearing the joint, correcting the deformity and in severe cases, joint replacement.

This form of arthritis is caused by the deposition of uric acid crystals in the joint. The treatment is usually with medicines.

This is an infection of the joint caused by bacteria and characterized by high fever, severe joint pain and swelling. It is a surgical emergency. The pus is drained thoroughly and the joint is washed. A continuous joint irrigation and drainage is given for a few days, followed by prolonged antibiotic therapy for up to 6 weeks.

Osteotomy basically means cutting the bone. In surgical terms, it refers to correcting a deformity of a limb or bone by realigning a part of the bone.

In cases of Osteoarthritis, the inner compartment of the joint is worn out commonly. This results in a bow-leg deformity. With the development of the deformity, the inner compartment is further loaded, resulting in a vicious cycle. To stop this, a corrective bony procedure is carried out so that the limb becomes straight and more load is transmitted to the relatively well preserved outer (lateral) compartment. This procedure is carried out on the upper end of the leg bone (tibia) to straighten the limb and hence it is called high tibial osteotomy ( HTO ). This procedure gives good results if only one compartment is affected and the age of the patient is below 50 yrs

Knees with neglected ligament injuries undergo degeneration and can have arthritis much earlier. With arthritis, the limb goes into misalignment (commonly bowing). In this situation, the problem is doubled, with an instability and arthritis with misalignment. The treatment involves simultaneous ligament reconstruction - to stabilize the knee and High tibial osteotomy - to correct the misalignment.

The ends of two bones which form a joint are covered by smooth tissue known as cartilage. This tissue is damaged by various diseases or injury, which in turn produces pain. Eventually the cartilage is totally worn out and the bone ends rub against each other causing severe pain and disability. In joint replacement surgery, the damaged surface of the joint is removed and replaced with an artificial joint called Prosthesis.

Osteoarthritis is the commonest cause of damage requiring joint replacement. Other causes are rheumatoid arthritis, fracture involving the joint causing arthritis, poor blood supply (avascular necrosis) and various childhood problems causing delayed arthritis.

There are two types of hip replacement; the traditional total hip replacement and the newer surface replacement. In traditional hip replacement, the diseased ball along with the top part of the thigh bone and the surface of the socket are removed and replaced with artificial components. These can be fixed either with a type of glue known as bone cement or without any such material and the bone is allowed to incorporate the specially made components. In surface replacement, which is meant for younger patients, very minimal bone is removed from the thigh bone.

This is the commonest joint replacement done in India. Here the diseased ends of the thigh and leg bones and sometimes the surface of the knee cap are replaced. The components are made of alloys and poly ethylene.

Coming soon...

Chronic ACL insufficiency can lead to osteoarthritis due to repeated instability episodes. Each time the knee slips, the abnormal movement in the joint surfaces lead to cartilage injury, which progressively leads to Arthritis.