Treatment of knee meniscus damage
Damage to the meniscus of the knee joint, symptoms and treatment is a problem for people who are not used to sitting in one place and those who are actively involved in sports. The meniscus plays a very important role in the knee joint system, and its injury can seriously affect a person’s motor abilities. Any damage to the internal meniscus of the knee joint requires emergency measures and effective treatment. Poorly healed injuries can cause the development of various joint pathologies and early human disability.
Anatomical and physiological features
The knee meniscus is a triangular cartilage-like pad that separates the femur and tibia. The main tasks of such gaskets are to absorb sharp shocks, redistribute emerging loads, reduce contact stress in the area of bone articulation and stabilize the joint. When bending a joint, more than 80% of the load is absorbed by the meniscus, and when extending the leg, up to 70% of the load.
In any knee joint there are 2 types of elements: the internal (medial) and external (lateral) meniscus. The C-shaped inner meniscus connects the tibia to the outer capsular border of the joint. The tibial ligament is fixed in its middle. Such fastening of the medial meniscus reduces its mobility, which is the reason for its more frequent damage (destruction). The external meniscus covers almost the entire upper lateral area of the tibia joint. Due to the fact that the lateral meniscus is not limited by the articular capsule in mobility, its injuries are recorded 8-9 times less often than injuries to the internal element.
How does the meniscus of the knee joint work?
Both types of menisci have the following main components in their structure: the body, as well as the anterior and posterior horn. The composition of the menisci is almost 75% formed by collagen fibers with multidirectional orientation. The interweaving and orientation of the fibers ensures very high strength of the structure. The outer end of the meniscus is composed of a thickened layer of collagen and is firmly attached to the joint capsule, while the inner end is slightly pointed and oriented into the joint cavity. Increased elasticity of the meniscus is ensured by a small amount of a specific protein (elastin). This structure makes the menisci almost 1.5 times more elastic than cartilage, which determines the functions of reliable shock-absorbing elements.
If we consider the blood flow system, the menisci have a specific character. The following zones are distinguished in them: the red area, which is in contact with the capsule and has its own circulatory network; an intermediate zone, nourished by the red zone, and a white zone, in which there are no blood vessels, and nutrition occurs as a result of the diffusion of nutritional components from the synovial fluid. In the meniscus attachment system, the following main ligaments are distinguished that strengthen the structure: the transverse ligament, which connects the menisci to each other, the frontal and dorsal femoral ligaments.
Despite the significant loads placed on the menisci, in normal condition they are able to perform their functions. Another thing is the appearance of excessive loads exceeding the strength of the fibers. Such forces usually occur when the tibia rotates abnormally at the knee, when landing after a jump from a great height, or when squatting with a large load. In general, knee meniscus injury, especially medial meniscus injury, is a fairly common occurrence, most often affecting men. The most common type is a sports injury.
Damage to the meniscus takes the form of a rupture along its body or a complete tear at the site of attachment to the capsule or bone ending. Damage to the posterior horn of the medial meniscus is considered one of the most common, but ruptures of the anterior horn and body can be observed, both in the medial and lateral element. Damage to the meniscus can be completely isolated, but is often combined with damage to other articular elements. As a rule, the lateral and cruciate ligaments and the joint capsule are affected. Almost half of the pathologies are combined with a fracture of the tibia condyles. A body rupture can occur with complete separation and movement of the torn part, or in the form of a partial rupture, when the connection between the elements is not completely broken.
In the etiology of meniscal injuries, there are 2 main mechanisms: traumatic and degenerative. The traumatic mechanism causes damage to an absolutely healthy joint at any age of a person when excessive load occurs. The most common injuries: damage to the internal meniscus - a sharp rotation of the tibia with a significant amplitude in the outer direction, and damage to the lateral meniscus - when it rotates inward.
Traumatic destruction of the medial meniscus often occurs in the longitudinal direction with destruction in its central area. A “watering can handle” lesion is considered typical, when the middle of the body is destroyed, but both horns are not destroyed. At the same time, lesions of the anterior and posterior horns are quite often observed. Transverse ruptures occur much less frequently. Rupture of the lateral fibers in an adult is not a typical lesion due to the high mobility of this meniscus. This type of injury is more common in adolescence, when the tissues are not yet strong enough.
Types of knee meniscal tears
The degenerative mechanism of joint destruction is associated with chronic processes that reduce the strength of colloidal fibers. It develops in people over 48-55 years of age. When the structure of the menisci weakens, their destruction can occur under loads that are not normally critical. The provoking reasons that trigger the degenerative mechanism are the following factors:
If an injury such as a meniscus injury occurs, symptoms depend on the extent of the injury and the involvement of other joint elements. The most characteristic symptom is pain. It can be localized at the point of rupture, and is often felt throughout the entire joint space. If the damage is not too great and the parts have not separated, then pain in the form of clicks is felt and discomfort appears.
In case of complete destruction, the torn fragment migrates into the joint and blocks its mobility. An intense painful symptom occurs.
In the case when destruction occurs in the red zone, a hematoma develops as a result of internal bleeding. The process is accompanied by swelling slightly above the kneecap. If a piece of the anterior horn comes off, the function of the joint to extend the leg is impaired, and if the posterior horn is destroyed, the function of flexing the joint is impaired. Gradually, effusion – exudate – can accumulate in the joint as a result of the inflammation process.
The presence of a meniscus tear is determined by performing certain tests to determine the following symptoms:
Basic tests for diagnosing knee meniscal tears
Symptoms of damage to the meniscus of the knee joint, most often, manifest themselves quite clearly (pain, swelling, impaired mobility), but to definitively determine the type of pathology, it is necessary to differentiate these signs from joint diseases.
The primary diagnosis is made based on the results of examination and testing. The next step to clarify the pathology is radiography and ultrasound of the knee joint. However, it should be borne in mind that x-rays do not provide a clear picture of meniscus damage, but help to establish the involvement of bone tissue in the process. An accurate diagnosis is made based on the results of computed tomography and MRI.
As a more reliable method, WHO recommends MRI. In particular, damage to the meniscus according to Stoller is established using this method. When the Stoller classification is used, the grades and damage to the meniscus are classified as follows:
The treatment regimen for a damaged meniscus is determined by the type and extent of the damage. For small lesions, conservative therapy can be used, but the most common method is surgery. Only a doctor can decide which method to use after receiving the results of ultrasound and MRI.
Conservative therapy aims to eliminate the blockade of the joint. For this purpose, fluid is removed from the joint cavity by puncture and Procaine is administered. An important stage of treatment is moving the meniscus back into place. If the procedure is carried out correctly, the blockade of the joint is removed. Further treatment includes the following procedures: UHF exposure, physical therapy according to an individual program, therapeutic massage, administration of chondroprotectors for cartilage restoration (Glucosamine, Chondroitin, Rumalon). If necessary, medications are used to relieve pain and relieve inflammation.
Surgery is performed in the following circumstances:
Surgery for a torn meniscus of the knee joint
The following technologies can be used as surgical interventions: meniscectomy (complete or partial removal);
Meniscus damage is a common, but quite dangerous, injury. If such a pathology occurs, it is necessary to provide first aid and call an ambulance. Only a doctor can determine how to treat the damage.
A crack in the meniscus of the knee joint is a fairly serious pathology that occurs most often in professional athletes and dancers. But sometimes an injury can occur in a person who has nothing to do with professional sports, and even in an elderly person.
The meniscus plays an important shock-absorbing function in the knee joint, which allows us to move without injuring the bones of the whole body. Everyone should know why damage to the meniscus of the knee joint occurs, what are the symptoms and treatment of the disease, since with such a pathology irreversible changes in the joint can occur, so the pathology must be treated as soon as the first symptoms appear.
Anatomy of the knee joint
Menisci are cartilage plates or pads that are located in the knee joints. They do not allow the joints to fray and fall out, limiting their movement on both sides. There is one pair of menisci in each knee, and the plates are divided into external and internal.
The lateral or external meniscus is rarely injured, since it is quite dense and mobile and can withstand severe injuries and stress. The medial meniscus of the knee joint is most often injured, as it is located between the joint capsule and the tibia and takes on most of the load. At the same time, it is quite thin and motionless.
The menisci consist of a living part in which blood vessels are located, it has a reddish tint, and a non-living part that is white. The location of the crack or tear in the meniscus of the knee joint plays an important role; if the living area is damaged, it will most likely heal quickly and without complications. More often, damage to the posterior horn of the medial meniscus occurs; this pathology requires timely treatment.
The main cause of a torn meniscus is trauma. The disease most often occurs in young active people aged 23 to 45 years. Elderly people who have a history of degenerative and inflammatory joint diseases, for example, arthrosis, arthritis, suffer from the pathology less often. In childhood, a meniscus tear occurs extremely rarely, since in children the cartilage tissue is quite mobile and not rough.
It is worth noting that even at a young age, the risk of injury greatly increases if a person leads a passive lifestyle and moves very little. The fact is that joints and muscles need to constantly work; if a person sits all day, then stagnant processes form in the tissues, they are not supplied with nutrition and degenerative changes occur. The latter often lead to inflammation and serious injury.
In the following cases, a tear of the knee meniscus may occur:
Often a meniscus fracture is also accompanied by ligament rupture, condyle fracture, joint subluxation and other pathologies. Such cases are considered very dangerous and require urgent hospitalization and, most often, surgical intervention.
Meniscus injuries are divided into three main types. Depending on how exactly the cartilage plate is damaged, the treatment plan and even the prognosis for the future will depend. In each case, you must undergo an examination and consult a doctor, otherwise there is a risk of developing a number of complications.
The following types of meniscus injuries are distinguished:
The easiest way to treat a crack is in the part where the blood vessels are located. Cartilage tissue is quickly restored and the person returns to normal life. In other cases, surgery and long-term rehabilitation are required, and such injuries do not always go away without leaving a trace for the patient.
A meniscus tear usually occurs with a sudden movement or impact and is accompanied by sharp pain and sometimes a crunching sound, which is difficult to miss. But such symptoms are also accompanied by other injuries of the knee joint, so in any case, the patient should first be examined by a traumatologist.
When a meniscus is cracked or torn, the following symptoms appear:
The symptoms of a torn meniscus are not always clear. Swelling, pain and lameness accompany almost all knee injuries and even inflammatory and degenerative diseases. In each case, an individual approach to the problem and adequate treatment are required.
Only a qualified specialist can correctly diagnose the disease and prescribe adequate treatment, so immediately after an injury you should not delay, you must immediately take the patient to the emergency room. It is best to immobilize the limb, since knee injuries are often accompanied by a condyle fracture.
Ultrasound of the knee joint
In the hospital, the doctor examines the patient, asks questions about how the injury occurred, what kind of pain is bothering him and in what place. During palpation, the doctor usually observes the mobility of the joint; when the meniscus is torn off, its displacement is felt. An experienced specialist can make a preliminary diagnosis at the first examination.
To confirm the pathology and to identify the location of the rupture, it is necessary to undergo a series of examinations:
Often one ultrasound examination is enough, but to clarify some points, the doctor may also refer you for a tomography. Laboratory tests are always carried out before surgery, and with conservative treatment they help to identify the presence of an inflammatory process.
Many patients suffering from knee pain are interested in how to treat meniscus. After passing all the necessary tests, the doctor prescribes treatment for the meniscus of the knee joint. Depending on the severity of the injury, conservative or surgical treatment may be chosen.
If a crack or rupture of the meniscus appears, conservative treatment is usually effective, but in more severe cases, especially with complex injuries of the knee joint, surgery must be performed. If a patient refuses surgery when it is required, it can result in lifelong knee impairment.
Treatment without surgery is usually complex and long-term. The patient is prescribed a number of drugs that relieve the symptoms of the disease and restore cartilage tissue. Also, if necessary, the doctor can perform a number of manipulations, for example, realign the meniscus if it has shifted.
The knee meniscus is treated using therapeutic immobilization to stabilize the knee and allow it to recover quickly. To do this, apply a plaster cast, or special orthoses and splints can be used at the discretion of the specialist.
The following medications are also prescribed:
It is important to note that in each case it is necessary to individually select the dosage of medications, which only a doctor can do. Self-medication often leads to serious disorders in the body, because all medications have their contraindications and side effects.
Surgery on the meniscus of the knee joint is indicated in cases where it is completely torn and there is no way to reduce it. It is important to understand that the sooner the patient consults a doctor and the sooner the operation is performed, the fewer complications there will be in the future.
When treating meniscus, the following types of surgical intervention are used:
Knee arthroscopy
Before the operation, the patient must undergo tests for contraindications and undergo an examination by specialists. So, in case of poor blood clotting, serious heart problems and other pathologies, surgical intervention may be refused.
With any treatment, conservative or surgical, after meniscus fusion, the patient is prescribed a course of rehabilitation. This is necessary to restore the function of the joint, normalize motor activity, and prevent degenerative disorders.
First of all, the patient is prescribed a course of physiotherapy. Physiotherapy perfectly relieves pain, reduces inflammation and restores blood circulation in tissues, which is especially important in cases where the patient wore a plaster cast and moved little.
A course of therapeutic massage is also mandatory. It also improves blood circulation in tissues, as a result, cartilage tissue receives more nutrition and recovers faster.
Therapeutic exercise allows you to strengthen muscles and develop joints, get rid of stagnant processes, and also improve blood circulation. Exercise therapy is the most important stage of recovery; exercises must be approached with special attention, exercises must be performed every day and correctly.
During the rehabilitation period, it is also recommended to continue taking chondroprotectors, even if nothing bothers you anymore. These products will help completely restore cartilage and prevent degenerative changes in the joint. If you stop treatment too early, arthrosis and arthritis may develop in the future.
In general, within a month after the start of treatment, patients begin to move normally and can live at a normal pace, go to work or school, and do their usual activities. But you need to do the exercises and take chondroprotectors for at least another 4-5 months.
The meniscus is a strong and rather thick cartilage pad installed on one of the bones that is part of the joint structure. The direct purpose is to improve the quality of sliding of the articular bone structure when the joint moves under varying degrees of stress, that is, during physical activity. In other words, the meniscus is a shock-absorbing part that eliminates mechanical or other types of bone trauma. Plus, it firmly connects the structure, stabilizing all components of the joints, preventing them from moving apart during movement or at rest.
As part of the human skeleton, the menisci are located between the acromion of the scapula and the clavicle (acromioclavicular joint), the sternum and clavicle (sternoclavicular joint), the temporal bone and mandible (temporomandibular joint), in the hip joint and the meniscus of the knee joint.
When injuries occur, the pads and ligaments tear, causing joint components to lose stability and integrity. They may diverge or even dislocation or bone fractures may occur.
The knee meniscus is often at risk of injury. Factual evidence is provided by statistics on the number of falls and mechanical injuries of the lower extremities. Meniscus tears are the result of physical vertical loads and sudden falls. Knee plate injuries are common in athletes, miners and loaders. Ballerinas and older people join this group.
What is a meniscus and why is it needed in a joint? The explanation is simple: it is a strong elastic lining between the bones that does not allow the bones to wear out and diverges, allowing them to slide on top of each other without damage. Thanks to the pad, a person easily and painlessly walks, runs and jumps, and also performs circular and flexion-extension movements. For the legs, this is a very important detail, because they are constantly in motion and are constantly exposed to stress.
The knee joint consists of the femur, tibia and patella. Their epiphyses are covered with a layer of cartilage. The joint is secured by muscles and tendons. What is the meniscus of the knee joint? These are mobile and elastic round (crescent-shaped) plates of connective tissue nature located inside the joint space. Between them are the cruciate tendons. The structure of the knee joints includes two types of meniscus: external (lateral) and internal (medial). Information about the meniscus of the knee joint and what it is from an anatomical point of view is briefly presented.
Important! The lateral meniscus is more mobile than the medial one and is less likely to rupture. The internal meniscus hardly moves due to the collateral ligament, so it is susceptible to injury.
The meniscus, more precisely the knee menisci (lateral and medial), can be subject to deformation during movement, as a result of braking of the tibia. In addition, the menisci equally distribute the vertical load over the entire surface of the joint, which contributes to excellent shock absorption during jumping, running and sharp turns. They protect the cartilaginous plates from abrasion and injury.
Connective tissue pads fit tightly to the tibia, on which the process of flexion, extension and rotation depends. The mobility of the menisci allows the joint to freely perform the most extreme movements without injuring the epiphyses of the bones. The knee, bending, moves the menisci back, and straightening, directs them forward. Rotation of the knee joint causes the intra-articular spacers to rotate, they follow the condyles of the femur. Lateral rotation of the knee pulls the lateral meniscus forward toward the lateral condyle of the bone, and internal rotation pulls the meniscus backward. Thus, biomechanical movements of the menisci occur, with free movement of the knee joints. When injured, biomechanics are disrupted, and the meniscus in the knee cannot maintain the integrity of the joint, limiting its movement.
Mechanical shocks in the knee area lead to meniscus rupture. As for the rupture zone, its depth and scale, all this directly depends on the force of the impact and on the area of injury (lateral, medial part of the knee, cup or back of the leg), as well as on the type of joint movement during the impact (rotation, flexion or joint extension). The type of injury depends on the impact surface that the knee (or knees) hit.
And so, the main causes of injury to the intra-articular menisci include:
Attention! Repeated trauma to the knee joint and meniscus (impact, contusion, compression and open or closed bruises) contributes to the development of chronic meniscitis.
Concomitant chronic diseases such as rheumatism, diabetes, hormonal imbalance and cancer lead to destruction of the meniscus and its complete rupture. The entire set of pathological processes listed above leads to deforming arthrosis and disability.
According to statistics, athletes (namely football players) and elderly people more often suffer from meniscus pathology. First of all, the meniscus of the knee is damaged, the symptoms of which are joint immobility and severe pain (read about the features of treating the meniscus at home). Re-injury to a limb that has been rehabilitated and has been in good condition for many years is aggravated by a blow and a sharp rotation of the knee inward or outward. This fact immediately leads to a meniscus tear.
In addition to these factors, there is a list of provoking causes of meniscal injury, such as:
Trauma to the medial plates occurs during extension movements, and damage to the lateral meniscus occurs during internal rotation of the leg.
According to the location and degree of damage to the meniscus, injuries differ from each other, so traumatologists have divided the tears into certain types of tears of the internal and external menisci.
Types of damage to cartilage pads:
According to injury statistics, 40% of them are injuries to the meniscus of the knee joint, the treatment of which requires immediate assistance. When the meniscus is pinched, the function of the joint is blocked. Treatment consists of closed reduction of the meniscus; if reduction cannot be achieved, rapid surgery is recommended.
Partial damage (tear of some parts of the meniscus)
About 50% of patients who go to the emergency room suffer from a partial meniscus tear. Often the crack damages the posterior horn, less often the middle, and even less often the anterior horn. Cracks have longitudinal, oblique, transverse, horizontal and internal appearance.
Complete rupture of the connective tissue plate
A complete tear involves the separation of the entire meniscus from its attachment site. There is also a tear in the form of a “watering can handle,” when the torn part is held behind the body of the plate.
On what basis is a knee meniscus injury diagnosed? Symptoms are the main evidence of this disease. But there is no need to confuse meniscus injury with other diseases of the knee joint such as fractures, joint degeneration, synovitis, bursitis and arthrosis. Instrumental studies will help in differential diagnosis: X-ray, MRI and computed tomography.
Symptoms of knee meniscus injury are as follows:
Recommended! Immediately after a meniscus injury, apply a heating pad with ice in the area of impact and give an injection of an analgesic, and, if possible, immobilize the joint until the ambulance arrives.
Diagnosis is based on external examination and instrumental examination of the injured limb. A meniscal injury can be diagnosed by performing an X-ray of the knee joint (to rule out fractures and bone fractures), ultrasound, MRI, computed tomography and endoscopic arthroscopy.
To confirm a rupture of the meniscus of the knee joint, special tests or manipulations are used, which are confirmed by symptoms according to the author: Landau, Baikov, Perelman, McMurray, Shteiman, Chaklin and Polyakov, as well as by the main symptom - knee “blockade”.
Treatment of knee meniscus is divided into conservative and surgical methods, but the entire treatment process depends on the severity. In some cases, surgery is started immediately, or joint blockade is removed, immobilization, administration of non-steroidal drugs and chondroprotectors is performed (this includes treatment of the meniscus without surgery).
If the meniscus is displaced or pinched, the traumatologist realigns the meniscus and places a cast for 3 weeks or a month. During this time, drug therapy is prescribed for the treatment of the meniscus, which consists of prescribing:
In the case when the pathology is accompanied by crushing of the meniscus, its complete ruptures, displacement, profuse hemorrhage and separation of the cruciate ligaments, horns and body of the meniscus, urgent joint surgery is required.
An effective treatment method is arthroscopy. Using this surgical technology, restoration, partial or complete removal of the platinum is performed, as well as meniscal transplantation. An artificial or donor meniscus takes root quickly; cases of rejection are rare. After surgery on the meniscus, treatment is medicinal (the regimen corresponds to the above). Rehabilitation of the limb occurs within 4 months, and sometimes restoration of physiological and biomechanical functions lasts up to six months. Rehabilitation depends on the age, general condition of the body, the immune system and concomitant diseases of the patient.
Drug and post-operative therapy is complemented by non-traditional recipes for the treatment of joints of the lower extremities.
Some time-tested recipes for local use:
Damage to the meniscus is a serious pathology, because the menisci are the main component of shock absorption and strength of the knee joints. Our movement and full life depend on it. In case of injury, you do not need to resort to self-medication with folk remedies, but quickly call an ambulance. Only traumatologists can determine the extent of damage and prescribe effective treatment. Otherwise, patients with meniscus tears will end up in a wheelchair, so do not neglect useful information: “knee meniscus symptoms and treatment.”
from Knee Joint November 17, 2015 0 13,335 views
Impaired movement functions can be caused by damage to the meniscus of the knee joint, the symptoms and treatment of which we will discuss in detail. This cartilage acts as a shock absorber and stabilizes the movable joint of the bones. It has the shape of a crescent, its outlines may be slightly curved during movement.
Anatomy of the menisci in the joint
There are two such cartilages in the knee joint:
The meniscus consists of a body, behind and in front of which there are protruding formations - horns. When the joint flexes and extends, both structures slide along the top of the tibia, thereby cushioning the movement, reducing stress on the bones and protecting them.
The outer (lateral) one is more mobile and therefore less likely to be damaged as a result of mechanical action. The internal (medial) meniscus is held in a static position by the lateral internal ligament of the knee joint, which makes it more susceptible to injury.
Among the possible injuries to the knee joint, the meniscus is the most commonly injured. Rupture of cartilage tissue and the onset of symptoms can be triggered by combined or indirect knee injury. This is usually caused by either sudden movements or mechanical damage, for example, hitting the knee on a hard object.
Damage to the internal meniscus also includes the consequences of gout, rheumatism, and chronic intoxication, which lead to pathological changes in the cartilage tissue of the joint.
Similar reasons can lead to various particular types of cartilage damage in the joint. They are also treated differently. This is determined, for example, by the direction and force of the blow.
Violation of the integrity of the meniscus is divided into the following types:
There are combined injuries, when several of the above injuries occur simultaneously. An aggravating circumstance is possible displacement due to injury.
All cartilage damage and symptoms experienced in the knee are due to tissue tearing. However, much depends on the type of rupture; symptoms and treatment will differ.
What are the signs that indicate that a meniscus injury has occurred? All symptoms of damage to the knee joint are divided according to the time of appearance and duration into acute and chronic.
Acute ones make themselves felt immediately after receiving damage. These include:
Diagnosis of disorders is difficult, since the signs of manifestation are similar to a regular bruise or sprain. But an incorrect diagnosis and, as a consequence, conservative treatment - fixation of the joint in order to provide rest for the injured limb - can only aggravate the situation. At first, these measures will make the patient feel better, but they will not solve the problem. Under the influence of increased load or a new blow, even a minor one, the pain in the knee will return. And then we will talk about chronic symptoms of damage to the internal meniscus:
For preliminary diagnosis, the doctor palpates the joint space of the injured knee. If the pain intensifies, additional studies should be performed to accurately determine the nature of the injury.
Special diagnostic methods:
An X-ray examination is prescribed before treatment for any damage or pain. Depending on the specific circumstances, an axial, direct or lateral photograph is taken.
For complex symptoms, contrast arthroradiography is prescribed - an x-ray with a preliminary injection into the joint cavity of a substance that reacts to radiation. This allows you to evaluate the outline of the cartilaginous body and identify unhealthy gas accumulation, if any. The gas is not visible on a regular x-ray.
The most accurate diagnostic method is magnetic resonance imaging. This is a step forward compared to radiography, since it becomes possible to reproduce the projection of the meniscus in any plane. Along the way, you can examine the bone and muscle components of the joint. You can learn more about MRI in this article.
When the first symptoms of meniscus damage in the knee joint appear, treatment will show good results if diagnosed in time. The course is prescribed by the doctor after a thorough examination and based on the test results. Depending on the specific situation and the severity of the disorders, the treatment scenario can be conservative or surgical. Let's consider both options.
The conservative path provides a therapeutic, non-surgical effect on the damaged bone joint. If radiography shows minor radial tears or disruption of the integrity of the posterior horn of the cartilaginous body, there is no reason for surgical intervention.
What will be the appointments in this case?
Surgical treatment of a damaged joint is prescribed if examination shows a large-scale meniscus tear. Also, prompt surgical intervention requires clicking sounds when bending the leg, blockades that appear, and stiffness in movement.
What operations are performed?
After the operation, it is not recommended to subject the knee joint to stress for some time - do not run, do not lift heavy objects, do not make sharp lunges on the injured leg.
Modern medicine recognizes a complete meniscectomy as an ineffective and even harmful operation; in recent years it has been abandoned in favor of partial removal of the meniscus. The reason is that the lack of cartilage tissue has a detrimental effect on the functioning of the joint and, ultimately, can lead to arthritis and irreparable pathological changes.
This manipulation is performed arthroscopically: surgical instruments are inserted through small incisions. Thus, the operation is not open, healing is faster, and the process is not so painful for the patient. The purpose of the operation is to remove the irreparably damaged part of the cartilage and straighten the inner edge.
The best prevention of damage is to be careful in your movements. Comfortable shoes are of great importance, especially when playing sports: an inaccurate lunge can seriously damage the knee and leave it out of action for a long time.
For more reliable protection of the joint, it is advisable to wear knee pads during training - this not burdensome precaution significantly reduces the risk of damage to the meniscus.
Among all human joints, the meniscus is considered the largest and most complex. As a connective cartilage in the knee joint, it acts as a shock absorber during movement and provides stabilizing functions. Being under heavy daily stress, the meniscus is most often susceptible to injury.
Depending on the degree of damage to the meniscus of the knee joint, treatment takes a long time, sometimes surgical intervention is required. Sharp pain in the knee, restriction of free movement, this is only a small part of the troubles that such an injury brings.
Such injuries can be associated with damage or rupture of ligaments, fractures, and bone displacements. Therefore, any knee injury requires immediate qualified medical attention.
A torn meniscus of the knee joint is one of the most common types of injuries, since this part of the leg is subjected to high physical stress every day.
Modern man lives in an active rhythm of life. Sports, heavy physical work, unintentional falls and injuries lead to an increasing number of victims being diagnosed with an internal or medial meniscus tear. According to statistics, about seventy percent of all injured people have a medial tear. The lateral meniscus accounts for twenty percent, and only five percent is a rupture of two menisci at once.
The meniscus is a cartilaginous connective tissue that acts as a shock absorber. If no changes occur in these tissues, then the movement of the leg and the knee joint itself occurs freely. But when a person moves, the meniscus contracts, returning to its original shape when the knee is extended.
Each knee joint has two menisci:
The knee joint is well supplied with blood, so both the medial and lateral menisci receive adequate nutrition. It is thanks to this that minor injuries quickly resolve and treatment does not last long.
X-ray allows you to evaluate the thickness of the meniscus of the knee joint
However, with a torn meniscus, the treatment process is more complex and lengthy, so recovery and rehabilitation can take several months.
Modern doctors distinguish several types of meniscal tears:
Modern surgeons and orthopedists note that a meniscus tear can be in the acute or chronic stage of the disease. Based on this, treatment is prescribed.
A meniscus tear can have different localization and be complete or incomplete
In addition to these two indicators, there are degrees of gap:
Often similar problems can occur in older people. Cartilage tissue loses elasticity with age and undergoes degeneration. Even in the absence of knee injuries, older people experience pain when walking or doing minor physical activity. Gait may be impaired and there may be swelling around the knee joint. In such cases, it is necessary to provide the patient with complete rest, apply a cold compress to the knee and immediately seek medical help.
As a rule, tissue rupture occurs during a fall or impact. Symptoms are typical for any injury and therefore difficult to distinguish. Often, the patient may mistake them for the consequences of an ordinary bruise or sprain. However, after 10-12 days, the signs of the disease become pronounced and recognizable.
So, among the typical symptoms that can be observed when meniscal tissue ruptures:
If you have any symptoms, it is better not to delay contacting a specialist.
An overly active lifestyle, sudden movements, awkward turns of the leg, and falls can cause unpleasant pain in the knee joint. This serves as a signal of possible injury or meniscus tear. The medial (internal) meniscus is most often damaged. In this case, the symptoms are as follows:
Symptoms cannot always be detected visually. If you have the slightest pain or discomfort in the knee joint, you should visit a traumatologist or orthopedist. A professional will make a more accurate diagnosis after a thorough examination with mandatory tomography or radiography of the knee joint. A tear of the outer meniscus causes severe pain, unlike a tear of the internal or medial meniscus, which does not always cause discomfort.
Such injuries occur during heavy physical exertion and falls. Elderly people, due to decreased elasticity of connective tissues, can also be considered a risk group. And the first symptoms are sharp and severe pain in the knee. If the meniscus tear is serious, then a swelling and hematoma appears at the site of the bruise.
Modern medicine diagnoses two types of meniscus. This:
X-ray of the knee joint
It is impossible to determine on your own what type of meniscus. This should be done by a professional orthopedist using visual inspection, palpation and further examination with an MRI or X-ray machine.
Age-related changes in the knee joint place quite a large load on the cartilage tissue. Usually this picture is observed in people after forty years. Moreover, men are susceptible to this injury more often than women. Sometimes a person may step on their foot incorrectly or sit down incorrectly, and this already causes a meniscus tear, which is diagnosed as degenerative or chronic.
There are certain symptoms of damage to each type of meniscus. So, the following signs are characteristic of damage to the lateral (outer) meniscus:
Meniscus: left - front view
For damage to the medial or internal meniscus, the signs are a little similar, but the pain is much stronger. In this case, the following symptoms are characteristic:
Under no circumstances should you make a diagnosis yourself. The effectiveness of the treatment that the attending physician can prescribe depends on this. The only thing that can be done for the victim to relieve some of the pain is to apply a bandage with an elastic bandage or apply a cold compress. All other actions and method of treatment are chosen by the attending physician.
The menisci provide reliable protection of the joint from damage, creating a shock-absorbing cushion between its tissues. In addition, they regulate mobility and reduce friction. Damage to meniscus tissue entails a number of unpleasant symptoms, pain, and even limited mobility. Joint diseases are an extremely unpleasant thing and have a negative impact on a person’s quality of life. That is why, at the first signs of an onset of illness, you should seek help from a medical institution.
Among the most common diseases of the knee joint are meniscus injuries. Thus, a tear or complete rupture of tissue can occur as a result of injury: a sharp glancing blow, an unsuccessful fall, dislocation, etc. If we are dealing with repeated joint injuries (bruises and sprains), which are often found in a sports environment, then among the most popular diseases are chronic inflammatory processes and associated joint diseases.
One of these diseases is miniscopathy, which occurs as a result of frequent mechanical damage to tissues, increased load on the knee joint, etc. In addition, meniscopathy can be acquired against the background of such ailments as gout, rheumatism, and some inflammatory and infectious diseases. Also, degenerative changes in the meniscus sometimes develop with prolonged intoxication of the body.
As a result of a blow, stretching or an unsuccessful fall, the connective tissues are torn, the meniscus ruptures, after which it ceases to cope with the functions assigned to it by nature.
After the functions of the tissue are completely lost, it turns into a body that is unnecessary and foreign to the body, slowly but surely destroying the surface of the joint with each subsequent movement. Thus, an injury once received turns into deforming arthrosis, threatening the patient with a wheelchair.
Those at risk for such an unpleasant and insidious disease are:
A sharply increasing load on the knee joint, just like a blow to the knee area, can lead to an acute meniscus injury. Depending on which area was affected, we can observe either a rupture of the internal or external meniscus, left or right knee joint. There are also combined injuries, in the case of a sharp blow that falls on the knee area and results in an inversion of the tibia outward or inward.
So we can distinguish the following types of meniscus injuries:
A meniscus tear can be either longitudinal or transverse in nature. At the moment of tissue tearing, sometimes the patient notices a very noticeable cracking sound, which precedes a wave-like and very intense pain.
If the patient complains about symptoms characteristic of meniscal diseases, the doctor must carry out a series of diagnostic procedures to establish an accurate diagnosis. Scheduled events include:
In this case, x-ray examination is ineffective, because the meniscal tissue is completely transparent to the x-ray beam. Also, the doctor performs manipulations to alleviate the patient’s condition by fixing (immobilizing) the limb and intramuscular injection of painkillers.
Any knee injury, including a torn meniscus, requires immediate and professional treatment. If a person with such an injury ignores a visit to the doctor, then treatment of the disease threatens to become longer and more complex. The symptoms should alert the victim, as the consequences can be very serious.
Treatment directly depends on the type of meniscus injury. The external meniscus is treated conservatively; the medial (internal) meniscus will require surgical intervention.
Each case of such injuries is considered separately, therefore the treatment method is chosen individually by the attending physician. The following factors must be taken into account:
Modern medicine uses not only the surgical method of treating meniscal tears. There are also more gentle, conservative methods. Treatment of a knee meniscus tear is a long and complex process that usually takes place in several stages:
A tear of the internal or external meniscus requires different treatments. It is advisable not to put any weight on the injured leg. To relieve swelling a little, it is necessary to lay the victim down, raising his leg slightly above body level.
If a meniscus tear is not proven, but its stretching is diagnosed, a plaster cast is applied. If a rupture occurs, surgical treatment is required, after which a number of medications are prescribed that have analgesic and regenerative effects. Usually these are non-steroidal anti-inflammatory drugs and chondroprotectors (diclofenac, ibuprofen, meloxicam, ostenil and others).
During surgery, part of the meniscus may be removed. It is performed using the arthroscopy method. This is a method that does not involve resection. If the injury is more serious, then the same method is used, but with less penetration into the knee capsule and joint capsule. Modern technologies have made it possible to actively introduce the endoscopic method. So, with the help of special equipment and an optical tube (arthroscope), surgical intervention is carried out.
The modern method of arthroscopy has brought a number of advantages to orthopedic surgery, namely:
Orthopedists conduct a preliminary examination of victims using the same technology using an arthroscope. The built-in camera transmits all data to the computer monitor.
A similar method is used when treatment of the external, lateral meniscus is required. As a rule, such damage does not result in pinching of cartilage tissue. The method boils down to the fact that the patient stops active sports and is freed from heavy physical work.
The same applies to the treatment of this type of meniscus in older people. Typically, a cartilage tear does not exceed three millimeters and can heal without medical intervention. In addition to changing the lifestyle, the patient is prescribed medication and a course of physiotherapy.
This is a relatively new method that is used by modern medicine at a time when treatment of a medial meniscus tear is required. This method is used for various types of similar injuries and even in the treatment of internal meniscus damage. Healing and rehabilitation are much faster and less painful.
After treatment has been carried out, patients complain of frequent aching pain in the knee joint. This is due to the fact that a hematoma can form inside the meniscus and joint, so the attending physician prescribes painkillers that restore blood circulation and a mandatory course of therapeutic exercises to strengthen the muscles of the knee joint.
The damaged knee joint must be cast with the knee bent. The plaster is removed after approximately three weeks, after which a rehabilitation course is prescribed.
The rehabilitation period is extremely important for the complete restoration of the functions of the meniscus and for returning to a full life. Ignoring such activities can have unfortunate consequences. Damage to the meniscus of the knee joint is a complex injury, and ignoring the recommendations of the attending physician can lead to recurrence of the injury.
People who have had part or all of their meniscus removed will need to become familiar with crutches and use them for a week. Slight swelling or possible hematoma are consequences of treatment. Massage, compresses, physiotherapy, physical therapy will help quickly remove these consequences of injury. Strict adherence to the recommendations and prescriptions of the treating orthopedist or traumatologist will help to avoid troubles in the future.
If the patient has undergone arthroscopy or sutureless surgery, the rehabilitation process is a little faster. But under no circumstances should you load the meniscus after surgery. There are many ways to relieve pain symptoms and unpleasant consequences after surgery using folk remedies. However, you should not self-medicate here either. Any step or method of rehabilitation must be agreed upon with a doctor. The average rehabilitation course lasts no more than six weeks, after which you can return to a full life and sports.
Despite successful treatment, you will have to take care of your knee and remember the injury for the rest of your life. To eliminate adverse consequences, it is necessary to reconsider your diet and lifestyle. In addition, most orthopedists recommend activating the protective functions of your own body.
This can be done with the help of simple exercises that were carried out in the physical therapy room. As a rule, such exercises help strengthen the musculoskeletal system and the quadriceps femoris muscle. A simple exercise in which, while lying on your back, slowly raise and lower your straight legs alternately, will help reduce the possibility of recurrence of the injury.
Don't forget about nutrition. Now your daily diet should include foods high in:
The healthy sports nutrition market offers a large selection of biological supplements that contain the necessary set of microelements responsible for the condition of the meniscus, ligaments and joints. It is advisable to exclude alcohol from the diet, as it washes calcium and collagen from the body.
After an injury to the medial or lateral meniscus and treatment, mandatory rehabilitation is required. It represents a whole range of measures and exercises and includes:
If all the prescriptions and recommendations of the attending physician are followed, there are no negative consequences, only sometimes minor pain may be observed during physical activity, fast walking, or when weather conditions change.
The rehabilitation period has several stages.
After treatment and rehabilitation, it is important to constantly monitor the level of physical activity to avoid new injury. Repeated surgery will complicate the recovery process. When playing sports, you must use compression knee pads.