Torn or Damaged Cartilage

After I play basketball, my left knee swells considerably. With ice and rest it mostly goes away, but the swelling comes right back when I play again. What causes this? Is there anything I can do about it?

Dr. Brian J. Cole:

It's a distinct possibility that you have damage to the meniscal or articular cartilage in your knee. This cartilage serves as a cushion between the bones and a stabilizing platform for the joint. Each of your knees has two half-moon shaped wedges of meniscal cartilage that helps to protect the articular cartilage.

Your knees are designed to withstand the pressures of a lifetime of walking, running, sitting, and standing. Notice that I didn't mention basketball! This sport is really hard on the knee, and can disturb the joint's delicate balance. Twisting and torquing can cause the meniscus to tear or it can aggravate small areas where the articular cartilage may be missing or damaged. This might produce symptoms of swelling and dull pain. Since the injury is not as traumatic as a ligament tear, the symptoms will often subside until activity is resumed.

Treatment Options:

Since you're already icing and resting the joint after activity and the problem isn't going away, your next step is to talk to a sports medicine physician. As part of a thorough examination, your doctor will order an X-ray of the knee and may obtain an MRI to confirm his/her diagnosis.

In many cases, if the problem is a meniscus tear, your physician might recommend arthroscopic surgery to "trim out" or possibly repair the torn portion of the meniscus. This is an outpatient procedure. If part of the meniscus is removed, you'll be able to walk immediately after surgery. Four to six weeks of postoperative rehabilitation will be required before you are physically ready to return to basketball. If the meniscus is repaired, then the postoperative recovery is possibly going to be more restrictive in terms of early walking and returning to sports can take between four and six months. If the problem is in the articular cartilage, then the treatment options are very complex and must be evaluated by an orthopedic specialist interested in articular cartilage problems in active people.

For more information about Dr. Cole and the Sports Medicine physicians of Midwest Orthopaedics at Rush, call 877 MD BONES or contact us through this Web site.

This information is not intended as a substitute for the professional advice of your physician, nor to be a complete description of every aspect of a condition, nor a complete list of possible side effects of any medication. Decisions concerning your treatment should be based on your own health care provider's evaluation of your personal health history and current condition. Consult your physician before following any of the suggestions on this Web site. All articles on this Web site represent the personal opinions of the individual authors and should not be construed as official policy of Midwest Orthopaedics at Rush.