A potentially interesting development has recently been announced in the treatment of one of the most common knee injuries. Utilising the still burgeoning technology of stem cell research, the practice of harvesting stem cells from patients’ bone marrow and using them to knit together tears in the meniscus area has been trialled at Liverpool and Bristol universities – with encouraging results.
The menisci are the C-shaped discs of tough, rubbery cartilage which act as shock absorbers around the knee. Each knee has two of them: one at the outer edge of the knee and one at the inner edge, and they undergo a lot of stress throughout the day as they balance and evenly distribute weight and force and provide stability across the knees.
When a tear of the meniscus occurs, it can therefore cause significant problems. It’s usually caused by twisting or turning quickly, often with the foot being planted while the knee is bent. As time goes on, the cartilage becomes less supple and pliable, increasing the risk of meniscus damage.
How will you know when you’ve suffered a meniscal tear?
One word: pain. And lots of swelling. In minor cases, the swelling will get worse over the first three days before receding, but flare up again whenever you flex your knee. There’ll be prolonged stiffness of the knee after a week or two, which will fade away. The meniscus has a limited blood supply, meaning the tear – no matter how minor – can be incapable of healing itself, and the pain can come and go for years if left untreated.
In more extreme cases, when the tear is large, a piece of the torn meniscus can lodge in the hinge mechanism of the knee. This can cause anything from irregular catching and popping in the knee to a prolonged locking of the knee, which will typically require surgery to correct.
How a meniscus tear is treated
Your knee specialist will want to know about your regular physical activities, any past injuries in the knee area and what you were doing when the pain began. This will be followed by a physical exam which will involve X-rays and/or MRIs and checks for tenderness, range of motion and stability in both knees.
Treatments for a meniscus tear can range from a simple course of RICE (rest, isolation, compression and elevation), icepack treatment and anti-inflammatory medications to surgical procedures to repair or remove part of the meniscus. Rehabilitation programmes usually concentrate on maintaining muscle strength in the quads, hamstrings, calves and hips.
Previously, the menisci were routinely removed when torn, but now we know how important their contribution is to a healthy knee, so the aim is to repair if possible. If the ‘stem cell bandage’ trial continues to produce such encouraging results, we could see a new and more effective alternative to surgery and reduce the chances of developing debilitating symptoms such as osteoarthritis in later life.