[Click! Health] Protecting Knee Joint Health from Outdoor Activity Impact: Here's How

Intense Exercise and Repetitive Impact
Frequent ACL Tears and Meniscus Injuries

Combine Weight Control and Strength Training
Walk Briskly for 40-50 Minutes Daily
Avoid Squatting Posture

Structure of the knee cruciate ligament and meniscus. [Source=Gangdong Kyung Hee University Hospital]

[Asia Economy Reporter Lee Gwan-ju] The knee is one of the most frequently injured joints in the human body. The causes vary widely, from degenerative arthritis due to aging to sports injuries sustained while enjoying leisure activities or sports. In the case of sports injuries, anterior cruciate ligament (ACL) tears caused by intense activities such as basketball, soccer, and skiing, and meniscus injuries caused by repetitive impact movements in golf and tennis are representative examples.

The knee is structured with the femur (thigh bone) resting like a millstone on the tibia (shin bone) below. Supporting this structure are the anterior and posterior cruciate ligaments, the medial and lateral collateral ligaments, and the menisci. The cruciate ligaments provide stability when the knee rotates, while the cartilage cushions the impact of weight-bearing. The problem is that the knee is much less stable compared to other joints. Although the cruciate ligaments prevent excessive twisting of the knee, they are limited by their short length of only 3 cm, and despite its name, the meniscus is thin like a crescent moon, making it prone to damage from repeated loading.

Sports injuries mainly involve ACL tears. Meniscus injuries often occur simultaneously, and if only the ACL is repaired while the damaged cartilage is neglected, further tearing and complications may arise later. In other words, when the ACL is torn, accurately diagnosing and treating the accompanying meniscus injury increases the success rate of surgery. Meniscus injuries mainly occur in the medial meniscus (ramp area), which is referred to as ramp lesions.

Professor Sanghak Lee of the Department of Orthopedics at Gangdong Kyung Hee University Hospital is examining a knee.
[Photo by Gangdong Kyung Hee University Hospital]

A torn cruciate ligament is treated not by simple suturing but by reconstruction surgery, which involves drilling holes in the bone to attach a tendon graft. The tendon graft can be either an autograft, taken from the patient's own tendon, or an allograft, which is commercially prepared. Meniscus injuries are treated either by removing the non-functional cartilage or by suturing the torn area. The balance between removal and repair must be carefully considered based on the patient's age and joint usage. Removing cartilage in patients who should have it repaired can lead to early degeneration, while overly aggressive suturing in cases better suited for removal can cause symptom recurrence. Particularly, non-functional cartilage is better removed as it can cause inflammation and worsen symptoms.

Consistent rehabilitation after cruciate ligament surgery is crucial. Many patients require revision surgery due to re-tearing of the reconstructed ligament, but steady rehabilitation can reduce the risk of re-injury. Above all, maintaining a healthy knee joint requires weight management combined with strength training. Experts recommend brisk walking for 40 to 50 minutes daily. Obesity places additional stress on the cartilage, so maintaining an appropriate weight is essential. After middle age, it is advisable to avoid strenuous exercises or postures that strain the joints. Avoiding squatting postures, steering clear of steep hiking trails, and considering the use of walking sticks are also recommended.

Professor Lee Sang-hak of the Department of Orthopedics at Kangdong Kyung Hee University Hospital emphasized, "Surprisingly, many patients neglect ACL injuries because they do not experience problems in daily life. However, if the ligament does not function properly, the load shifts to the meniscus and articular cartilage, causing internal damage to progress." He added, "To avoid suffering from degenerative arthritis as you age, if symptoms persist for more than 2 to 3 months after middle age, it is recommended to get an accurate diagnosis from a knee specialist."