Meniscal injuries can occur acutely when there is a shear stress within the knee, often caused by a twisting mechanism of the body with the foot anchored on the ground. This is common in soccer, basketball and tennis players. Small tears in the meniscus may also occur with minimal trauma due to degenerative changes in patients over 35 years old. This might occur as a gradual onset of knee pain.
The management of meniscal tears varies depending on the severity. A large painful tear is usually treated surgically, where the meniscus is repaired or partially removed. However, Dr Ross Hauser advocates that the best option for meniscus repair is Prolotherapy. Treating all the adjacent structures along with a comprehensive rehabilitation program may be successful in helping athletes to return to sport and patients to return to pain free activity.
Chondromalacia Patella is a common cause of pain on the front of the knee, or patellofemoral joint pain. Patellofemoral articular cartilage lesions can cause chemical or mechanical irritation of the synovium of the joint, which can lead to swelling or erosion of the subchondral bone. This also results in altered biomechanics of the patella during activities such as stair climbing. Chondromalacia Patella can occur due to a single maximal load, such as falling onto the knee, or a lower magnitude repetitive load.
Danielle Steilen describes how Prolotherapy is effective in treating Chondromalacia Patella by stimulating the repair of damaged cartilage, boosting healing and improving patella tracking. Functional rehabilitation is also an important component of treatment, in order to improve motor control, strength, endurance and stability around the knee.
Corticosteroids are potent anti-inflammatory drugs which are usually administered by local injection or orally. The goal of corticosteroids is to reduce pain and inflammation sufficiently enough to begin a rehabilitation program. However, its use is controversial due to the incidence of side-effects and the concern that it may have an inhibitory effect on healing.
Prolotherapy has been said to be a much more effective treatment option than cortisone, in that it stimulates inflammation and therefore healing. As structures heal, they become more stable and this leads to a decrease in pain.