Saturday, December 15, 2018

Don’t Take That Meniscus in Your Knee for Granted

I just read an article about the meniscus, that rubbery, crescent-shaped piece of cartilage that helps absorb impact between the long leg bones that meet in your knee.

Decades ago, the common medical wisdom was that the meniscus wasn’t all that important, and when it was torn, surgeons simply took it out.

Of course common medical wisdom was wrong.

Patients who had their meniscus removed often developed arthritis in their knee later. That suggested the meniscus actually played a critical role.

Now we have new, and quite sobering, details about what happens when the meniscus is extracted from the knee.

According to a new study, “extensive cell death occurs within hours during vigorous exercise.”

Researchers used a powerful microscope to observe what was happening, minute by minute, as the vigorous activity was occurring. The article says that half of the cells that create new knee cartilage were dead within four hours (I assume these cells were chondrocytes?).

Whoa. That’s really grim.

Now, an intriguing question (that the article doesn’t pose, but that occurred to me): Are people who have an injured/torn meniscus also susceptible to a certain amount of cartilage cell death? Because their meniscus isn’t working as well as it should?

For me, the bottom line is that I don’t find this study surprising. What I find more surprising is that medical savants of 40 years ago could have looked at a rubbery cushion in the knee joint and decided that it really wasn’t that significant.

Medical hubris at its finest.

3 comments:

  1. Haven't read the study but, based on your review, I do find its findings surprising. I would have thought it was reasonable that without the cushion the meniscus serves, extensive cartilage damage wherever the femur comes into contact with the tibia should occur. But it seems I either don't understand fully what part the meniscus plays in the knee or there's something quite strange happening, unrelated to the meniscus' direct purpose.

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  2. .... And this is the very reason why I choose not to go for surgery. I rather live with a torn meniscus rather than a removed meniscus.

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  3. Just like the appendix. Traditionally seen as some sort of unnecessary extra, now it is considered to be part of our body's cleansing system and immune defense.

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