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Differentiating knee arthritis from meniscal degeneration

Knee arthritis is a chronic gradual onset 'worsening over the years' knee pain that may affect either the front of the knee (patellofemoral joint) or the sides of the knee (medial or lateral compartment). The pain is classically described as dull aching, worse after sitting for prolonged periods and gets better with mobility.

Patients who get osteoarthritis due to wear and tear and degeneration of the articular cartilage (lining cartilage of the joint) also get similar wear and tear in the meniscus (cartilage cushions in the knee joint).

Due to this wear and tear in meniscus, they are weakened and are susceptible to tear due to forces put on them during normal day to day activities rather than sporting injuries (commonly seen in young adult).

Patients presenting with acute exacerbation of knee pain on the background of chronic arthritic pain along with locking or clicking in the knee often localised to the inside part of the knee are most likely to have degenerative meniscal tears.


While meniscal tears rarely heal up by themselves, they do tend to settle down after the initial exacerbation of pain and the treatment for these is most often conservative. This includes:


Ice pack application

Crepe bandage support/ compression tubular bandage support, and

Graduated gentle physiotherapy

If symptoms do not settle down by 3 months, an MRI may be indicated to look for significant meniscal tears.

IF these are identified on MRI scan, a day care knee arthroscopy (keyhole surgery) may help relieve symptoms by doing a partial meniscectomy (taking out the torn flapping part of meniscus).

It is very important to understand that the keyhole surgery will only relieve symptoms secondary to meniscal tear and will not do much to the chronic background arthritic pain.

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