Dear Paul: I have been playing golf for 30 years. I am noticing that when I strike the ball, the inside of my right knee hurts.

I recently had an MRI that shows I have torn cartilage on the inside of my knee. I am 55 years old and wonder if it is too late for me to get this fixed. Do people my age have surgery to repair cartilage? -- S.S., College Station

Dear S.S.: The cartilage inside the knee is called the meniscus. People your age have that procedure done all the time.

It is very important to get it repaired because if you don't and you have a bone-on-bone relationship within the knee, it could lead to a total knee replacement later in life.

Twenty years ago, when knee cartilage was torn it often resulted in the entire cartilage being removed. But that was found to be excessive.

Today, the least amount of cartilage necessary is removed in order to create a good working surface within the knee.

In the past 10 years, some meniscus injuries have been surgically repaired.

The meniscus has three sections.

One of the sections is well supplied by blood and can be repaired well.

There is a middle section of the meniscus that has some blood flow but not a great deal.

And there is one section of the meniscus that has no significant blood flow. That section of the meniscus is very difficult to surgically repair and is usually removed.

The purpose of the meniscus is to distribute the load on the knee surfaces. The meniscus is also a shock absorber. It produces stability in the knee. It also helps in creating joint awareness due to nerve receptors within the knee.

There are more than 1 million meniscus surgeries performed every year. Sixty-one out of every 100 thousand athletes will have a meniscus injury.

The usual mechanisms of injury to older athletes are planting a leg in a stress phase of exercise.

If you are right handed, while playing golf the stress on the inside of the knee is the greatest when you make contact with the ball.

Sometimes pain can be alleviated by changing the shoe spikes so that your traction in the right shoe is reduced. That will reduce some of the rotational stress force on the knee.

The most common symptoms for a cartilage injury in the knee are pain, swelling and, in some cases, an audible snap or catch.

In some other cases, if the knee is bearing weight, it will feel as if it is giving way.

Meniscus injuries can be easily diagnosed using a physical examination or an MRI. The procedure for repair is usually outpatient.

In many cases physical therapy can begin within days of the surgery. The physical therapy program is designed to:

* Reduce swelling.

* Restore motion.

* Restore strength.

The usual time for rehab is three to six weeks. At the end of six weeks, the person's range of motion, strength and function should be within 15 percent of normal.

When a meniscus is repaired, as opposed to partially removed, the post-op period is usually extended.

There is restricted weight bearing for three to six weeks. Rehab is slower because of the need to avoid weight bearing initially.

Meniscus repair is important because failing to do something about it can lead to premature total knee replacement.

Paul V. Bonarrigo is director of the Sports and Back Clinic in Bryan.