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TORN MENISCUS
Tears of the meniscus, either the medial or the lateral meniscus, are the most common knee injury that may require surgery. Two things are important to remember: Many meniscus tears do NOT require surgery; and meniscus tears in older persons can occur easily without a significant traumatic event.
To explain…
Any anatomic structure, anywhere, that is injured requires blood supply to heal. The cartilage in the knee meniscus only has blood supply at the marginal edge of its periphery, adjacent to where it is attached to the tibia. Thus, most injuries to the meniscus are permanent and have no capacity to heal. However, if the tear in the meniscus is not unstable, if the torn surfaces remain naturally opposed together, and if the owner of the tear does not subject the knee to much stressful activity, the torn meniscus can be tolerated for years or forever. It will still function as a cushion for non-strenuous activities. Surgical repair or excision is not necessary. Think of it like a cushion on your sofa; the cushion may not be as firm and contoured as it was when new, but it still functions to pad the seat.
Secondly…
The meniscus cartilage is composed of roughly 65% water. With age, the cartilage loses some of its water content. As a result, it becomes somewhat brittle, less flexible, less malleable. If one stoops or twists while bearing weight on such a brittle cartilage, it might crack or split—like cooked bacon becomes brittle without its fat content and will crumble or taste crisp. Very minor mechanical force on a brittle meniscus cartilage is necessary to crack or split it.