LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

Meniscus

How to Prevent Osteoarthritis After Injury

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knee osteoarthritis symptoms
Knee arthritis and steroid injections

The more astute of us are rightfully concerned with developing arthritis as we age. Luckily, this is not a foregone conclusion.

Most people incorrectly think that injury to a joint is the only major factor that leads to the later development of arthritis in that joint. While any injury to a joint is an important player, there are other factors at play.

(I also have patients who state that his or her left knee pain is just from old age.  At this point I ask how much older it is than the other knee…)

For arthritis of the spine related to disc degeneration, we have known for a long time that a lifestyle that is pro-heart disease will also increase your risk for disc degeneration and spinal arthritis. The reason for this is simple—discs do not have their own blood supply. Instead, they are fed indirectly by small blood vessels. If these small blood vessels become filled with plaque, they can no longer deliver needed nutrients to the discs. With normal use, these discs will break down because they can’t meet the demands of daily life.

The surfaces of your joints are not too much different. Poor blood vessel health will lower the ability of your joint surfaces to get the nutrients they need to respond to day to day demands.

This means that a lifestyle that is designed to protect your heart will also protect your joints. Pretty cool. NOT killing two birds with one stone, so to speak.

This particular study may give us even more insight into how we can protect our joints. In it, researchers looked at the ability of different types of fats (specifically saturated fats, omega 3 and omega 6 fatty acids) to protect against damage to the medial meniscus of the knees of mice.

They found that saturated fats and omega 6 fatty acids did not protect against the later development of osteoarthritis and even increased the amount of arthritis that resulted, they increased extra bone formation around the joint (a hallmark of osteoarthritis) and increased scar formation.

Let me put this more plainly: The dietary choices you make WILL absolutely increase the damage to your joints that occurs with an injury, leading to more osteoarthritis in your joints years later.

Luckily, the omega 3 fatty acids were a different story.

The omega 3 fatty acids were able to enhance wound repair as well as lower the risk of later development of arthritis. Pretty cool that diet can play this powerful of a role.

In case you need a refresher on which fats to avoid, here’s some help:

  • The main source of saturated fats include fats contained in our society’s poorly raised livestock.
  • Omega 6 fatty acids are found in certain oils like corn, sunflower, soybean and peanut oils.
  • Omega 3 fatty acids are found in nuts, seeds (such as flax), wild caught fish and game, certain grains (salba, quinoa as examples) and grass fed beef.

Just by making smart dietary choices combined with maintaining an ideal body weight and staying active you can go a long way towards protecting your joints for years to come.

Is would also seem that, just in case all the other things that they are good for has not been enough, fish oils supplements would play a role in preventing osteoarthritis, especially after injury.

Osteoarthritis is NOT something that has to happen to your joints. Think about that the next time you reach for that bag of chips…

 

Do You Need Surgery for a Torn Cartilage in Knee?

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Your MRI shows that you have a tear in the medial meniscus of your knee and you have resigned yourself to the fact that surgery is the only fix.

The belief has always been that the posterior horn (the back half) of the medial meniscus (the shock absorbing pad on the inside part of your knee) does not have a very good blood supply. For this reason, any tears that occur are not going to heal on their own. This means surgery is your only option.

I’ve never been one to believe in dogma.

From an anecdotal standpoint, I have had more than my share of patients with documented medial meniscus tears that do perfectly fine without surgery. I still remember one of my early ones. This particular patient was on track for surgery, but just did not have the time off of work needed for the surgery and recovery. So he waited. In the meantime, we treated his knee, thinking that anything we could do to restore balance to the knee prior to surgery would be a good thing. Turns out, he did really well and never had the surgery. Later, he even forgot which knee it was that used to bother him.

Over the years, I have seen patients with meniscal tears do very well. Typically, the patient that responds best is closer to an ideal weight and more active. Patients who don’t fit this mold don’t do as well and seem to be more likely to end up in surgery.

Of course, my personal experiences do have some backing in the medical literature. For example:

In case all this isn’t enough to sway your decision away from surgery, pay attention to this particular study.

In it, researchers looked at the outcome of patients with medial meniscus tears who had surgery and compared these outcomes to those who didn’t have surgery and instead did rehab for his or her torn cartilage. They were evaluated using the WOMAC scoring (0-100, with higher numbers equating to more severe symptoms). Here’s what they found:

  • At 6 months the surgical WOMAC score was 20.9 points.
  • At 6 months, the rehab group score was 18.5 (yes–better, if ony slightly).
  • At 6 months, 30% of those in the rehab group ended up having surgery.
  • On the flip side, 6% of the surgical group had not undergone surgery.
  • At 12 months the situation did not change from the 6 month scores.
  • Adverse events did not differ in the groups.

Overall, there was no difference in long term outcomes between the surgical and non-surgical groups. Although 30% of the non-surgical patients ended up with surgery, this seems to match up with what we see in our office–some patients (overweight, sedentary) just don’t seem to do as well.

Either way, it seems clear that, if you discover that you have a torn medial meniscus and you are told you have to have surgery, it’s a very good chance that this just is not true.