Tonight let's tackle an infliction of the knee, namely the Meniscus tear. Oh and watch out, this one is slightly interactive with a quiz or three embedded to make sure you are paying attention.
A strict definition is as follows: Injury to the meniscus occurs when its structural integrity is compromised and the fibrocartilage that makes up the meniscus tears, breaks, cracks, ruptures, or splits.0 In Mozzarc terms (read simple terms), it's role can be thought of as a shock absorber between the Shinbone and the Thigh Bone.It comprises of a rubbery cartilage.1
The meniscus acts as a biological equivalent of a shock absorber, who wants a bumpy and even painful ride if we can alleviate it?
WHAT IS A TORN MENISCUS, HOW DOES THIS HAPPEN?
Well this can be easily seen in the following diagram 1. A tear can rip into this cartilage or a "Bucket and Handle' typetear can take place. How does this happen? Most commonly when it is under pressure and you suddenly twist your knee while bearing weight on it.
ETIOLOGY
There are essentially 3 types of sub classifications. 2.5
1) Mensical tear Mensical tears are caused by a combination of axial loading and rotational forces that create a shearing force on the meniscus.
2) Acute Tear Usually secondary to trauma affecting younger active individuals.Most commonly are vertical-longitudinal tears with peak incidence being 21- 30 years of age.
3) Degenerative Tear Secondary to age-related cumulative stress and desiccation/deterioration. Constitute 30% of all meniscus tears with peak incidence of 41-50 years of age in men and 61-70 in woman [sic].These may or may not be associated with trauma, unlike acute tears.
WHAT THEN IS THE DIFFERENCE BETWEEN ACL INJURY AND A MENISCUS TEAR?
Well tonight I’m strictly covering the meniscus but there are a few key differences between the two injuries.
1- Different muscle group invoked 2- One is much more painful. QUIZ TIME can you guess which one is more painful?
I too would’ve chosen ACL, it’s actually the meniscus tear.2 You will barely be able to stand if you tear the meniscus.
DID YOU KNOW?
Ok another POP QUIZ...which sport results in the most tears?
One of the most popular sports in the world, Basketball can be a major cause, why? Because the sport involves a lot of quick turning in the opposite direction while running thus a classic set up for such tears. As the popularity of this sport has increased, so too the incidence of this injury.3 Wrestling, skiing, baseball and and course football/soccer all feature heavily as sports with a higher incidence of meniscus related injuries. Interestingly baseball ranks higher than skiing in terms of meniscus injuries. There are approx 9.2 million skiers in the US but 15.2 million people that actively play baseball. 4,5
Males out number females three to one.2
The popularity of Basketball has contributed significantly to an increase in meniscus tears and thus is also a contributing factor to an increase incidence of OA specially amongst athletes, sports people and younger folk.2
HOW DO I KNOW IF I HAVE TORN IT?
Well here are some symptoms:
A popping sensation
Swelling or stiffness
Pain, especially when twisting or rotating your knee
Difficulty straightening your knee fully
Feeling as though your knee is locked in place when you try to move it
Feeling of your knee giving way
WHAT ARE SOME OF THE TREATMENTS FOR THIS SORT OF INJURY?
According to the Mayo Clinic, there is a real chance that minuscule tears can lead to an increase in the chance of developing OA.Many people are afraid of surgery or in some instances simply cannot afford it. The repercussions of leaving such an injury can be dire.Complications involving the knee joint and surrounding area can arise. The joint and the bone now rubbing together without the adequate or compromised action of the meniscus can lead to arthritis and of course an increase in pain. Again, what is prescribed for this pain? Those nasty Opioids of course.The more advanced such injuries are, the more the chance of further damage.
MOZZARC, THIS INFO IS ALL WELL AND GOOD BUT HOW CAN PAR HELP?
Firstly look at how desperate we are for a solution, when a specialist can’t prescribe much and suggests, and I quote from Mont (Thanks Mont): “grin and bear it”, it shows what we already know as knowledgeable PAR investors; there is NOTHING out there that currently can help, you have to rest, let it heal on its own accord and take pain killers if you are in pain. In just my express opinion, iPPS will alleviate the pain, subside the inflammation and possibly speed up the recovery like we have seen in the MOA as published in regards to OA and its action on the same. At a micro level we have seen that IPPS can act to increase the blood flow in the damaged area. What is the effect of this? This allows such micro organisms like macrophages to get into the area and start earlier on the healing magic. Well of course this whole area needs to be investigated separately to OA but inherent in the MOA that we have seen in terms of both the potential disease modifying action along with the inflammatory action, there is a chance that the typical 6 to 8 week recovery time could be sped up. At the same time the chance, or at least degree of required arthroscopy MAY be reduced. Finally the associated pain may also be reduced without any severe side effects.
JUST HOW BIG IS THIS?
Around 200,000 cases per year in the USA and millions more world wide 7. Certainly much more investigation and possibly trials need to be set up specifically in this area for one to draw any scientific conclusions but certainly another potential avenue for PAR to one day explore.
STOP PRESS
Just learnt this fact as I looked up one final reference for this article, let's make it another interactive QUIZ for you....
What is the most complicated joint in the human body? I myself prob would've guessed either the neck or some area of the spine...wrong wrong Mozzie...
The knee joint is the largest and most complicated joint in the human body.6
Ok last one..what percentage of sports injuries involve the knee? A) 4% B) 17% C) 28%
Answer? Hey, whaddya mean this is a typical Mozz rigged quiz? Answer is a massive 40%!
DISCALIMERS
I always recommend doing your own research. I'm not a doc or employed in the medical field. It's a personal and complex area and your health care professional should always be consulted if you believe you may have a tear and/or are in pain. Always better to address such situations early. Yes I think there is real potential here for us to help, it’s just another condition we may one day address! Potential in the future? Yeah you bet.
(20min delay)