Ligaments, Cartilage & Meniscus

Dr. NIKOLAJ WOLFSON, MD, FRCSC, FACS

IN THE SAN FRANCISCO BAY AREA

Anterior Cruciate Ligament (ACL) Injuries

The anterior cruciate ligament is often injured during sports activities. Athletes who participate in high demand sports like soccer, football, and basketball are more likely to injure their anterior cruciate ligaments. Changing direction rapidly or landing from a jump incorrectly can tear the ACL. About half of all injuries to the anterior cruciate ligament occur along with damage to other structures in the knee, such as articular cartilage, meniscus, or other ligaments.

Posterior Cruciate Ligament (PCL) Injuries
The posterior cruciate ligament is often injured from a blow to the front of the knee while the knee is bent. This often occurs in motor vehicle crashes and sports-related contact. Posterior cruciate ligament tears tend to be partial tears with the potential to heal on their own.
Collateral Ligament Injuries
Injuries to the collateral ligaments are usually caused by a force that pushes the knee sideways. These are often contact injuries. Injuries to the MCL are usually caused by a direct blow to the outside of the knee, and are often sports-related. Blows to the inside of the knee that push the knee outwards may injure the lateral collateral ligament. Lateral collateral ligament tears occur less frequently than other knee injuries.
Meniscal Tears
Sudden meniscal tears often happen during sports. Tears in the meniscus can occur when twisting, cutting, pivoting, or being tackled. Meniscal tears may also occur as a result of arthritis or aging. Just an awkward twist when getting up from a chair may be enough to cause a tear, if the menisci have weakened with age.
Tendon Tears
The quadriceps and patellar tendons can be stretched and torn. Although anyone can injure these tendons, tears are more common among middle-aged people who play running or jumping sports. Falls, direct force to the front of the knee, and landing awkwardly from a jump are common causes of knee tendon injuries.
Cartilage Injury

Knee cartilage can be injured as the result of a traumatic injury, degenerative arthritis, or chronic overuse. Depending on the type of injury, the different types of cartilage may be damaged. When cartilage is damaged, often it is described as a tear of the cartilage. Typically, when someone refers to a tear in the cartilage, they are talking about an injury to the meniscus cartilage.

Words commonly used to describe an injury to the articular cartilage in the joint include:

  • Fissuring: A fissure in the articular cartilage occurs when there is a cleavage within the layer of cartilage causing a separation between the layer. Sometimes this causes no symptoms, while others it can cause a catching sensation.
  • Thinning: Cartilage thinning can occur after an injury or as an early sign of arthritis in the knee. Thin cartilage may not have as smooth an appearance as normal and may not glide as easily.
  • Flaps: Flaps in the articular cartilage occur when a portion of the cartilage layer has not adhered and can be lifted from its normal position. This can also lead to catching sensations with knee movement.
  • Defects: Cartilage defects can lead to the exposed bone within the joint. This can occur after traumatic injuries or as a result of knee arthritis.

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