. Mr. Fergus Paterson is a consultant orthopaedic surgeon with a special interest in disorders of the knee joint Profile & CV Why Mister, not Doctor? Private Consulting Rooms _____ The Bupa Cromwell Hospital Cromwell Road London SW5 0TU (Map) Secretary email: drfawzia@pamrpaterson .wanadoo.co.uk Tel: +44 (0)20 7460 2000 Sec: +44 (0)7765 833 567 App: +44 (0)20 7460 5700 Fax: +44 (0)20 7460 5709 _____ The Lister Hospital Chelsea Bridge Road London SW1W 8RH (Map) Secretary email: drfawzia@pamrpaterson .wanadoo.co.uk App: + 44 (0)20 7730 8298 Fax: + 44 (0)20 7259 9218 ______ © Fergus Paterson 2003/4/5
Seasonal cause of knee ligament injuries .. The Meniscus . Anterior Cruciate Ligament Best viewed at 800x600 resolution on IE5 or Netscape 4.6	. A torn cartilage (meniscus) is probably the commonest reason for a young adult to seek help from a Knee Surgeon, and the commonest operation performed in this group is keyhole surgery (arthroscopy). It is not only sportsmen (and women) who tear a meniscus, but certain occupations carry a risk eg plumbers, electricians, carpet layers and even enthusiastic gardeners! Meniscal tears cause pain and often a sense of mechanical interference e.g. locking. Each knee has two menisci [click here for picture] which function rather like shock-absorbers protecting the joint from impact forces; it therefore follows that removal of an entire meniscus can predispose to degenerative arthritis years later. Localisation of the pain may provide a useful clue as to which meniscus has been torn. Xrays are of little help in confirming the diagnosis as only the bones will show up, but an MRI scan will show both the menisci and other soft tissues including ligaments. The only sure way to clinch the diagnosis of a torn meniscus is by arthroscopy, this has the added advantage of allowing the surgeon to deal with the lesion under the same anaesthetic. Ligament injuries are the second commonest reason for knee surgery in this group. The knee is held together by four main ligaments any one or combination of which may be damaged by twisting forces applied during vigorous sport. Injuries vary from a simple sprain (stretching) taking a few weeks to resolve, to a complete rupture which may require surgical repair if permanent instability is to be prevented. The most important ligament of all is the Anterior Cruciate (ACL) which lies in a pivotal position at the centre of the joint controlling rotation. Unfortunately a ruptured ACL will not heal by itself and renders the knee liable to give way with turning movements causing sudden pain followed by swelling. In the longer term an untreated ACL rupture is associated with an increased incidence of meniscal tears and osteoarthritis. It is therefore often necessary to consider surgical reconstruction particularly in athletes.
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