"My 56 year old mother has osteoarthritis and a cartilage tear in her knee. Is she is doing damage by not having it treated?”

When people talk about having a cartilage tear in the knee, they are most often referring to the meniscus. The knee has two menisci that absorb impact and protect against arthritis. The menisci can be injured as a result of sports or traumatic injury when we are young, or with relatively little force as we get older.

For individuals who have already developed arthritis, differentiating pain from arthritis from a torn meniscus can be difficult. Pain is the most common symptom for both and it usually localizes to the side where the injury has occurred, although it can be felt in the back of the knee or diffusely throughout the joint. After an injury, pain frequently improves significantly over a period of 2 to 3 months. Nutritional supplements (e.g. glucosamine/chondroitin sulfate) may help decrease arthritis pain. Muscle strengthening can enhance the stability primarily provided by knee ligaments. Braces can shift weight away from an injured side of the knee and provide pressure signals to the brain that can override pain signals. Both analgesic and non-steroidal anti-inflammatory medications may also be helpful, but  individuals with significant medical illnesses, especially liver or kidney disease, should consult their  physician before taking them.

Mechanical symptoms—catching or locking—usually indicate the presence of a loose flap or free cartilage fragment. It is unclear whether a loose or mobile cartilage fragment directly causes damage or progression of arthritis. However, these symptoms may keep an individual from returning to desired activities.

Symptoms that interfere with normal function may benefit from other treatments. Joint injections can be useful in providing pain relief with less risk of systemic effects. Viscosupplements, based on hyaluronic acid that lubricates fluid healthy joints, can help manage arthritis. Corticosteroids decrease inflammation and can rapidly improve pain from either arthritis or a meniscal tear. Surgery may be helpful for people whose symptoms do not get better with time or other treatments.

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