Meniscus symptoms treatment. Meniscus of the knee joint - treatment of rupture and symptoms of damage, surgery for injury and rehabilitation. Treatment of the knee joint with folk remedies

Pain in the knee most often indicates that the meniscus is damaged.

The inner meniscus of the knee joint is the cartilage tissue that is most often damaged and deformed.

Pain can speak of various kinds of damage, so it is necessary to undergo a full examination, find out the cause, and only then take measures to eliminate the problem. It is also important to be aware of the symptoms of these lesions and how to deal with them.

The meniscus is called the cartilaginous layer inside the knee joint, which has the shape of a crescent and protects the joint from external and internal influences.

The main violations to which the meniscus is subject include:

• trauma
• Gap
• cartilage degeneration

Due to higher mobility, injuries most often occur in men under the age of 40-45 years.

The knee joint consists of two menisci, which are called internal and external.

Their location is arranged in such a way that they perform a kind of shock absorber role between the thigh and lower leg.

Cartilage tissue protects the joint from excessive friction during movement, softens and reduces the load. The inner meniscus, which is also called the medial, is less mobile than the outer one, but is injured more often.

Causes of damage

Damage to the meniscus can occur due to external influences on the knee joint, as well as internal disorders.

Among the reasons for external influences, it is worth highlighting:

• Injuries with dislocation;
• Blows that fall on the knee;
• Falls involving the knee
• Full extension of the knee;
• Re-injury.

If we consider internal disorders, the cause of damage can be a weakening of the cartilage tissue and various diseases that lead to a violation of the development and structure of the meniscus. It can be rheumatism, arthrosis, gout or chronic intoxication.

Chronic injury occurs when there is recurring injury to the knee joint or other part of the limb that puts more stress on the knee. An untreated or untreated primary injury may also be the cause. Without treatment, the cartilaginous tissue of the meniscus is deformed, stratified, cracks and erosion appear.

In rare cases, damage to the meniscus can occur due to excess weight, when the joint simply cannot withstand the extra pounds. Regular loads can cause damage to the meniscus or provoke disorders that lead to such a condition.

The risk group for developing meniscal disease includes:

• Athletes;
• People whose work is associated with constant, unregulated physical activity;
• People who have had diseases of the musculoskeletal system;
• People prone to injury due to their physiological characteristics, as well as with predisposing heredity.

Without timely diagnosis and treatment, damage to the internal meniscus leads to impaired movement and future disability due to the inability to walk.

Features and symptoms of damage

At an early age, meniscus injuries occur in most cases due to trauma or developmental pathology in childhood. With age, the disease occurs during the appearance of various kinds of internal disorders.

The causes of the development of meniscus damage become key in the manifestation of the symptoms of the disease.
In general, lesions have similar symptoms.

If the meniscus ruptures during an injury, symptoms appear immediately.

It all starts with pain in the knee, with an injury, it is acute and sudden.

Following it, due to damage to soft and cartilaginous tissues, rapid edema appears.

In the affected area, blood vessels are torn, which lead to the formation of redness and hemorrhagic hematomas.

Swelling and bruising occurs above the patella and soon covers the entire knee.

If there is a rupture of the meniscus, then acute, almost unbearable pain is accompanied by a violation of the mobility of the joint.

Fragments of the meniscus block movement, the joint jams, and painful sensations accompany characteristic clicks and creaks. It may be difficult to bend the leg at the knee.

The nature of pain depends on the physiological characteristics of a person, his pain threshold, as well as on the nature of the gap itself. Sometimes the pain does not even allow you to step on your foot, and in some cases it allows you to walk normally and occurs only with a heavy load.

Swelling of the joint can appear suddenly, especially if the damage is localized in the area of ​​the cruciate ligament.

Rapid edema occurs due to rupture of the lateral meniscus and dislocation forward. The outer part of the tibia, when changing position, clamps the damaged meniscus between the femur.

The development of a rapid onset of symptoms usually occurs with leg injuries.

In older people, when damage occurs due to degenerative or age-related changes, pain and all other symptoms may develop less noticeably.

The chronic course of the disease, usually even during an exacerbation, can pass without edema and redness, and the only symptom is pain, which can occur when tissue degeneration becomes irreparable.

For people over 40, it doesn't take a serious injury to cause a meniscus tear. It is quite awkward to stand on a foot or a step when going down the stairs.

Then the pain will be sudden, but will pass in just a couple of minutes and will reappear when climbing stairs or when doing physical exercises. It is more difficult to determine damage in older people, since they do not attach importance to short-term pain and consider it just a manifestation of a dislocation or bruise.

On the basis of symptoms and pain alone, it cannot be argued that the meniscus is damaged, all signs can cause bone fractures, severe bruises. Only an examination by a specialist can confirm the diagnosis and reveal the cause and consequences of any damage.

Like acute meniscal tears, degenerative tears can produce a wide variety of symptoms. Sometimes it is completely impossible to step on the foot or even move it a little because of the pain, and sometimes the pain appears only when descending the stairs, squatting.

Degenerative changes in the inner meniscus of the knee

There are several reasons for the development of degenerative changes in the internal meniscus of the knee joint. This may be due to an abnormal anatomical structure, an old injury or a disease in the body that disrupts the metabolic process and leads to degenerative changes.

The outer cartilage is deformed by trauma, while the medial meniscus only undergoes changes due to severe disorders.

It is fixed in the joint, and it is not as easy to damage it as the outer one, which performs the function of shock absorption.

Changes in the medial meniscus occur rather slowly, but are more difficult to treat.

Degenerative change in the meniscus tissue is not just a destructive process.

It can manifest itself in various disorders:

• Rupture of the meniscus itself or horns;
• detachment of fastening;
• Rupture of the ligaments of the meniscus;
• Meniscopathy due to gout, rheumatism or chronic diseases of the internal organs.

Often, degenerative change accompanies injury and involvement of soft tissues and cartilage.

Inside the cavity of the cartilage, under the influence of tissue destruction, the formation of a cystic formation occurs. Cavities filled with fluid become a frequent companion of degeneration of the internal meniscus.

Diagnostics

Diagnosing a meniscal injury based on general symptoms is almost impossible. Closed injuries are often confused with dislocations, bruises or fractures. In trauma, all symptoms are blurred due to damage to external tissues.

All complaints can be directly related to pain due to injuries, and a characteristic crack or crunch in general can indicate joint jamming, which the elderly associate with senile changes.

In patients over forty, any ailment should signal the onset of problems. Based on the symptoms, it is impossible to talk about the development of the disease, but it is possible to assume the disease, and it is simply necessary to confirm it through additional studies.

In case of injuries, examination is included in the complex of mandatory measures.

To identify damage to the meniscus of the knee joint, you can use:

• X-ray examination;
• X-ray with contrast;
• Computed tomography;
• Arthroscopic examination.

On x-rays, you can see the affected area and determine the stage of the disease. With the help of a contrast agent, it is possible to determine the exact location and presence of damage to soft tissues and cartilage.

In difficult situations, when the deformation has led to irreversible consequences or a hematoma from a bruise does not give an accurate picture, an endoscopic examination with minimal invasiveness is performed on x-rays.

Treatment and resection of the internal meniscus of the knee joint

Treatment of meniscal injuries is treated with conservative methods, as well as by surgical intervention.

Due to the late diagnosis, a surgical solution to the problem is resorted to more often. Modern technologies make it possible not only to remove the damage painlessly, but also to replace it with an artificial graft if the meniscus is completely destroyed.

Conservative treatment is sufficient in case of minor damage, small tears of the meniscus horn heal successfully on their own. In order to limit yourself to conventional therapy, it is necessary to limit the mobility of the joint for the healing period, and the symptoms in this case are removed with the help of medications.

To relieve pain and inflammation, ointments and tablets for oral use will help.

These can be anesthetics and non-steroidal anti-inflammatory drugs.

For older people, it is important to stop the process of meniscus destruction by identifying the cause of degeneration in time. Together with symptomatic treatment, the treatment of the underlying disease is prescribed in parallel.

Only by eliminating the cause can the process of destruction be stopped, and then, with the help of a specially designed therapy, the destroyed cartilage tissues can be restored.

Cardinal measures are resorted to if the size of the gap exceeds 10-12 mm, then the gap is stitched together. With the help of special needles, tight sutures are applied to the rupture area, which help tissue regeneration.

This method is used in the absence of concomitant diseases, usually after a knee injury. This method is suitable for suturing ruptures of the posterior horn of the meniscus, and with an anterior rupture, it may be difficult to insert a needle into the cavity.

Surgical method stitching can end in unpleasant consequences. The needle can damage nerve endings or blood vessels, so the procedure is prescribed only as a last resort, if there is no risk to the patient.

There is also a sutureless meniscus stapling method, which is a painless and bloodless procedure, but has a very low chance of healing on its own.

Surgical intervention or resection of the meniscus is resorted to in case of failure of conservative treatment or direct indications for the removal of the affected area.

The presence of effusion and severe pain indicates a serious degenerative change in the meniscus, so you should not delay the operation.

Meniscectomy has always been considered a safe way to repair damage, but its complication of arthritis is increasingly occurring in people who have had it. During the operation, only the damaged tissue or part of the meniscus is surgically removed, and those parts that can be saved are simply polished.

With an extensive lesion, all tissue is removed and the meniscus is replaced with an artificial prosthesis.

Rehabilitation

The period of rehabilitation after surgery depends on the volume of the intervention, the individual characteristics of the person, his age and the presence of concomitant diseases.

The program for each is selected individually. If the meniscus was completely removed, then it will take up to 7-10 days to develop the leg and walk on crutches.

In case of partial removal and polishing, rehabilitation will take up to 14 days. People with a meniscus tear take the longest to recover with the natural functioning of the leg.

Then the restriction of the load and the period of cartilage fusion may take 1-2 months.

The method of surgical treatment also affects the rehabilitation period, with band surgery, the patient needs time to heal the sutures, and with the help of arthroscopy, skin incisions are minimal and the postoperative period is reduced by at least half.

Conclusion and forecast

The chances of a full recovery depend entirely on the severity of the disease when you see a doctor.

If, in the event of an injury, the patient is given timely assistance and the damage is diagnosed in a timely manner, the chances of a full recovery increase dramatically. It is also important to take into account the age of the patient and his physical characteristics.

The presence of concomitant diseases, especially those associated with the musculoskeletal system, is of no small importance.

Damage to the meniscus in diabetes mellitus, gout or arthritis often ends in a chronic course of the disease, since the problem is not eliminated, but only suppressed for a while. Only regular examinations and compliance with all doctor's prescriptions will help to avoid disability and maintain limb mobility.

The meniscus of the knee joint is called the cartilaginous discs located between the tibia and the femur. They are crescent-shaped “pads” and provide joint stability, act as a shock absorber and increase the contact area of ​​the articular surfaces. Speaking of meniscus injuries, specialists usually mean its rupture. In this article, we will introduce you to the main causes, symptoms, varieties, methods for diagnosing and treating injuries to the meniscus of the knee joint.

Despite the large margin of safety of the menisci, such injuries are one of the most frequent problems of the knee joint and are usually observed in physically active people (youth, athletes, working individuals).

According to statistics, every year 60-70 people out of 100 thousand face such injuries, and 3-4 times more often such injuries occur in men. In persons under 30 years of age, traumatic ruptures of the meniscus usually occur, and after 40 - a violation of their integrity due to the appearance of chronic degenerative changes in them.

A bit of anatomy

There are two menisci in each knee joint:

• lateral (or external) - its shape resembles the letter C;
• medial (or internal) - has the shape of a regular semicircle.

Each of them is conditionally divided into three parts:

• anterior horn;
• body;
• back horn.

Menisci are formed from fibrous cartilage and are attached to the tibia (front and back). In addition, the inner meniscus along the outer edge is attached by the coronary ligament to the joint capsule. This triple fastening makes it more immovable (compared to the outer one). Because of this, it is the inner meniscus that is more prone to injury.

A normal meniscus consists mainly of collagen fibers. Most of them are located circularly (along), and the smaller part is radially (from the edge to the center). Between themselves, such fibers are connected by a small amount of perforating (i.e., disordered) fibers.

The meniscus is made up of:

• collagen - 60-70%;
• extracellular matrix proteins - 8-13%;
• elastin - 0.6%.

In the meniscus, a red zone is distinguished - an area with blood vessels.

Meniscus functions

Previously, scientists believed that menisci were non-functional muscle remnants. They are now known to perform a range of functions:

• contribute to a uniform distribution of the load on the surface of the joint;
• stabilize the joint
• absorb shocks during movement;
• reduce contact voltage;
• send signals to the brain about the position of the joint;
• limit the range of motion of the cartilage and reduce the likelihood of dislocations.

Causes and types of gaps

Depending on the causes of damage to the menisci, there are:

• traumatic ruptures - appear as a result of traumatic impact (awkward turn or jump, deep squat, squatting, rotational-flexion or rotational movements during sports, etc.);
• degenerative tears - appear due to chronic diseases of the joint, which lead to degenerative changes in its structures.

Depending on the location of the injury, a meniscus tear can occur:

• in the anterior horn;
• body;
• back horn.

Depending on the shape, a meniscus tear can be:

• horizontal - occurs due to cystic degeneration;
• oblique, radial, longitudinal - occurs at the border of the middle and posterior third of the meniscus;
• combined - occurs in the posterior horn.

After an MRI, specialists can judge the degree of damage to the meniscus:

• 0 - meniscus unchanged;
• I - a focal signal is recorded in the thickness of the meniscus;
• II - a linear signal is recorded in the thickness of the meniscus;
• III - an intense signal reaches the surface of the meniscus.

Symptoms

Traumatic tears

At the moment of injury (when jumping, deep squatting, etc.), the patient develops a sharp pain in the knee joint and the soft tissues of the knee swell. If the damage occurred in the red zone of the meniscus, then the blood pours into the joint cavity and leads to development, manifested by the appearance of bulging and swelling above the patella.

The intensity of pain in case of damage to the meniscus can be different. Sometimes, due to its sharpness, the victim cannot even step on his foot. And in other cases, it is felt only when performing certain movements (for example, it is felt when going down the stairs, but not when going up).

After an injury to the internal meniscus, when trying to strain the leg, the victim feels a sharp shooting pain, and flexion of the limb leads to pain along the tibial ligament. After an injury, the patella cannot be moved, and muscle weakness is determined in the area of ​​​​the anterior surface of the thigh.

If the external meniscus is damaged, the pain intensifies when trying to turn the lower leg inward. It is felt when the peroneal collateral ligament is tense and shoots along it and into the outer part of the joint. In the area of ​​the anterior part of the thigh, the patient has muscle weakness.

After a rupture of the meniscus, its detached part moves and makes it difficult to move in the knee joint. With minor injuries, sensations of difficulty in movement and painful clicks may appear, and with large injuries, blockade of the joint may occur, which is caused by the movement of a large moving fragment to the center of the joint (i.e., it seems to jam the joint). As a rule, a rupture of the posterior horn leads to limited knee flexion, and damage to the body and anterior horn makes it difficult to extend the limb.

Sometimes a meniscus tear (usually external) can be combined with. In such cases, swelling of the knee occurs faster and it is more significant than with an uncombined injury.

Degenerative tears

Usually such damage occurs in people over 40 years of age. Their appearance is not always associated with a traumatic factor, and a gap may occur after performing habitual actions (for example, after getting up from a chair, bed, armchair) or with minor physical impact (for example, regular squatting).

The patient develops swelling and pain in the knee area, which does not occur acutely. Usually, the manifestations of a degenerative meniscus end there, but in some cases they may be accompanied by blockade of the joint. Often, with such damage to the meniscus, there is a violation of the integrity of the adjacent cartilage that covers the tibia or femur.

As with traumatic injuries, the severity of pain in degenerative tears can be variable. In some cases, because of it, the patient cannot step on the foot, and in others, pain occurs only when performing a specific movement (for example, squats).

Possible Complications

Sometimes, in the absence of unbearable pain, meniscus damage is confused with the usual one. The victim may not seek help from a specialist for a long time, and pain may eventually disappear completely. Despite this relief, the meniscus remains damaged and ceases to function.

Subsequently, the destruction of the articular surfaces occurs, leading to the development of a severe complication - (deforming arthrosis). This dangerous disease in the future may become an indication for knee arthroplasty.

In case of a knee injury, the following symptoms are the reason for a mandatory visit to the doctor:

• even mild pain in the knee when moving up the stairs;
• the appearance of a crunch or click when bending the leg;
• episodes of knee jamming;
• swelling;
• sensation of interference with movements in the knee joint;
• the impossibility of deep squatting.

If at least one of the above signs appears, you should contact an orthopedist or traumatologist.

First aid

For any knee injury, the victim should be given first aid:

1. Immediately abandon any load on the knee joint and subsequently use crutches for movement.
2. To reduce pain, swelling and stop bleeding, apply a cold compress to the area of ​​injury or wrap the leg with a cotton cloth and apply ice to it (be sure to remove it every 15-20 minutes for 2 minutes to prevent frostbite).
3. Give the victim to take an anesthetic drug in the form of tablets (Analgin, Ketanol, Nimesulide, Ibuprofen, etc.) or perform an intramuscular injection.
4. Give the leg an elevated position.
5. Do not postpone the visit to the doctor and help the victim get to a medical institution or trauma center.

Diagnostics

After questioning and examining the patient, the doctor conducts a series of tests that allow, with an accuracy of 95%, to establish the presence of meniscus damage:

• rotational Steiman tests;
• detection of a symptom of extension according to the tests of Roche and Baikov;
• mediolateral test to identify the symptom of compression.

The following additional examination methods allow to accurately establish the presence of a meniscus rupture:

• MRI of the knee joint (accuracy up to 95%);
• Ultrasound (sometimes used);
• radiography (less informative).

The informational value of radiography in the study of cartilage tissue is small, but it is always prescribed if a meniscus rupture is suspected to exclude the presence of other injuries (ligament tears, fractures, etc.).

Sometimes diagnostic arthroscopy is performed to confirm the diagnosis.

Treatment

The treatment of meniscal injuries is determined by the severity of the injury. Small tears or degenerative changes can be repaired conservatively, while significant tears and blockades of the knee joint require surgery.

Conservative therapy

The patient is advised to provide the injured limb with maximum rest. To ensure the immobility of the joint, an elastic bandage is applied to the area of ​​injury, and when in bed, an elevated position of the leg is recommended. In the first days after the injury, cold should be applied to the area of ​​injury. When moving, the patient must use crutches.

To eliminate pain and inflammation, antibacterial and are prescribed. After stopping the acute period, the patient is recommended a rehabilitation program that provides the most complete restoration of the functions of the knee joint.

Surgery

Previously, with a severe injury to the meniscus, an operation was performed to completely remove it. Such interventions were considered harmless, since the role of these cartilage pads was underestimated. However, after such radical surgery, 75% of patients developed arthritis, and 15 years later, arthrosis. Since 1980, such interventions have been found to be completely ineffective. By the same time, it became technically possible to perform such a minimally invasive and effective operation as arthroscopy.

Such a surgical intervention is performed through two small punctures (up to 0.7 cm) using an arthroscope, which consists of an optical device connected to a video camera that displays an image on a monitor. The device itself is inserted into one of the punctures, and instruments for the operation are inserted through the other.

Arthroscopy is performed in an aquatic environment. This surgical technique allows to achieve good therapeutic and cosmetic results and significantly reduces the time of rehabilitation of the patient after the injury. With the help of an arthroscope, the surgeon can reach the most distant parts of the joint. To eliminate damage to the meniscus, the specialist installs special fasteners (anchors) on it or sutures it. Sometimes, with a significant displacement of the meniscus during the operation, its partial removal is performed (i.e., its detached section is cut off).

If during arthroscopy the doctor detects chondromalacia (cartilage damage), then the patient may be recommended intra-articular administration of special drugs after surgery. For this can be used: Dyuralan, Ostenil, Fermaton, etc.

The success of arthroscopic interventions for meniscus ruptures largely depends on the severity of the injury, the location of the injury, the age of the patient, and the presence of degenerative changes in the tissues. A greater likelihood of good results is observed in young patients, and a smaller one in patients over 40 years of age or in the presence of severe meniscal damage, its horizontal dissection or displacement.

As a rule, such a surgical intervention lasts about 2 hours. Already on the first day after arthroscopy, the patient can walk on crutches, stepping on the operated leg, and after 2-3 days he walks with a cane. Full recovery takes about 2 weeks. Professional athletes can return to training and their usual loads after 3 weeks.

In some cases, with significant damage to the meniscus and the complete loss of its functionality, the patient may be recommended a surgical operation such as meniscus transplantation. Frozen (donor and cadaveric) or irradiated menisci are used as a transplant. According to statistics, better results from such interventions are observed when using frozen donor menisci. There are also transplants made of artificial materials.

Content

While running or playing basketball with a sharp load, the meniscus of the knee can tear. Such an injury is a common occurrence in our time, during which degenerative changes in the joint can also occur, which are associated with wear and tear. The meniscus of the knee joint is also called the Achilles tendon, the rupture of which can be treated surgically or conservatively, depending on the degree of damage.

What is the meniscus of the knee

The strong and thick cartilaginous lining on the bone that is part of the structure of the knee is called the meniscus. Its direct purpose lies in the good sliding of the bone articular structure when moving under tension. In other words, the meniscus of the knee joint is a shock-absorbing part that excludes injuries to the bones, preventing them from dispersing at rest or in motion.

Thanks to such a pad, a person can painlessly and easily walk, jump, run, perform bends, unbends and circular movements of the legs. The meniscus itself is elastic and mobile sickle-shaped plates of a connective nature that are located inside the knee. The structure of the knee joint includes the medial (inner) and outer (lateral) plates.

Where is the meniscus of the knee

The epiphyses of the knee joint, which consists of the patella, tibia and femur, are covered with a layer of cartilage. It is connected by tendons and muscles. The meniscus of the knee joint is inside it. The medial plate is characterized by slight mobility. Its posterior horn is connected to the lateral surface of the ligament attached to the tibia. The medial meniscus on the other side (anterior horn) is fixed in several ways:

• three ligaments to the tibia;
• two ligaments to cruciate anterior junction;
• one ligament to the tibia.

The lateral meniscus of the knee is located close to its outer zone. This part of the knee joint is very mobile, so its injury is rare. The anterior horn of the lateral plate is attached to the medial cartilage and tibia by two ligaments. Sometimes fastening is carried out to the large femur with one ligament. The blood supply to both plates is limited, since the blood vessels are located only in the region of the anterior and posterior horns.

Causes of meniscus problems

Primary damage to the meniscus can occur due to a fall on the rib of the patella, a sharp blow to the knee with a heavy object, or an injury accompanied by a sharp rotation of the lower leg. This leads to a rupture of collagen fibers and the inability of the knee joint to fulfill its purpose. Repeated bruising is a secondary cause of meniscal problems.

As a result of gout, microtrauma, rheumatism, degenerative changes in the meniscus are formed. The plate ceases to perform its functions, becoming a foreign body for the body, destroying the articular surface. An untreated injury eventually turns into arthrosis, and then disability occurs when a person can move only with the help of crutches. A meniscus injury can be caused due to:

• age-related changes;
• oncological diseases, diabetes;
• metabolic disorders, blood supply, innervation;
• degenerative or destructive process in the bone apparatus;
• complications after surgery;
• improper rotation of the joint;
• jumping/falling from a height;
• a sharp rise in weight;
• regular vertical loads;
• hit with a blunt object.

Rupture of the meniscus of the knee joint

Cartilage damage often occurs in dancers and athletes, but ordinary people often find themselves in unpleasant situations. As a rule, men aged 20-40 turn to a traumatologist. Cartilage in children is highly extensible and more plastic, so injuries among younger people are very rare. A rupture of the meniscus of the knee joint occurs for the following reasons:

• standing work;
• chronic intoxication of the body;
• arthrosis, arthritis;
• old knee injury.

Symptoms of a torn meniscus in the knee

After the meniscus in the knee is damaged, the victim feels a sharp pain in the joint. The leg becomes edematous, and if the rupture occurs in the area with blood vessels, then hemarthrosis develops (accumulation of blood inside). With a small tear, the main symptoms of a torn meniscus of the knee are painful clicks inside the knee, but the patient can move around on his own. With severe damage, the joint is completely blocked, becomes immobile. Sometimes ruptures are accompanied only by pain syndromes when descending the stairs.

How does the meniscus hurt?

Joint damage is immediately manifested by pain. At first, it is sharp and does not allow a person to move. Then the knee gradually adapts to the injury, the pain weakens, and then completely disappears. The meniscus hurts during an intense load that exceeds the strength of the structure or during exercise. If a person spends on his feet all day, then in the evening the knee pain always increases. The degree of the disease can be determined by the nature of pain:

meniscus treatment

It is impossible to do without medical assistance in case of damage to the knee cartilage. How to treat a meniscus? There are different methods of therapy - from non-traditional to surgical. Which meniscus treatment to choose is a personal matter for everyone, but with a strong rupture or complete separation of the plate, one cannot refuse the operation. If the cartilage is pinched, you need to contact a chiropractor or traumatologist. The doctor will perform a reposition, thanks to which the patient will forget about his problem for a long time. In other cases, non-surgical sparing treatment with drugs is recommended.

Treatment of a torn meniscus of the knee joint without surgery

Experts say that if the injury is ignored, the likelihood of developing chronic pathology is high. This eventually leads to the destruction of cartilage tissue, degeneration of adjacent cartilage and even bone tissue. As a result of damage to the meniscus, arthrosis develops, which leads to disability. Treatment of a rupture of the meniscus of the knee joint without surgery is anesthesia, applying an elastic bandage to the injured leg, ingesting anti-inflammatory drugs, physiotherapy, removing the blockade of the joint, using creams and ointments for pain relief.

Medical treatment

Therapy depends on the signs, because there are patchy, degenerative, horizontal, radial cartilage lesions. Basically, drug treatment includes taking anti-inflammatory drugs in the form of capsules, tablets or ointments: Ibuprofen, Ketorolac, Diclofenac, Indomethacin. When choosing medicines, doctors take into account interactions with other medicines and contraindications. This is especially important for older patients. For edema, intra-articular injections of corticosteroids are used: Prednisolone, Dexamethasone and others.

Physiotherapy

The defeat of the connective cartilage is accompanied by pain, swelling, muscle spasms. Physiotherapy helps speed up the recovery process. Procedures can reduce pain, eliminate muscle atrophy, remove swelling, and tone muscles. Physiotherapy refers to passive rehabilitation, that is, there are no efforts on the part of the patient during therapeutic treatment. Physiotherapeutic procedures include a wide variety of manipulations:

• magnetotherapy;
• exposure to ultrasound;
• massotherapy;
• hydrotherapy;
• electromyostimulation;
• aerotherapy;
• UHF therapy;
• hirudotherapy and others.

Surgery to remove the meniscus of the knee

An operation is scheduled on the meniscus for partial removal or stitching of the cartilage. Sometimes surgery happens for an organ transplant, where part of the cartilage disc is removed and replaced with an implant. After such a manipulation, artificial or donor cartilage take root without problems. The disadvantage of this procedure is not very fast recovery - about 3-4 months.

Most operations to remove the meniscus of the knee joint are performed using arthroscopy. The surgeon during the intervention sees all the structures inside the knee. Using this method, you can identify many problems in the knee joint, remove fluid from its cavity. The procedure lasts no more than 2 hours. After manipulations using arthroscopic technique, the patient can fully move.

Treatment of the meniscus with folk remedies

The patient has the right to independently choose methods of treatment of the affected knee joint. In case of injury, warm compresses can be applied to the affected limb. They are made from honey and 96% alcohol in a ratio of 1:1. The mass melted by steam is distributed over the diseased surface, then covered with cellophane and a warm cloth on top. Keep the compress is required daily for 2 hours. The course of treatment is one month. Treatment of the meniscus with folk remedies includes other procedures:

1. A burdock leaf will help relieve pain in the affected area. A freshly harvested plant must be applied at night in the form of a compress.
2. Onion juice will help to remove discomfort after first aid. It is required to chop 2 onions and 2 garlic, pour the mass with 6% apple cider vinegar (500 ml). The mixture must be insisted for a week, then rubbed into the knee 2 times / day. Massage movements should last at least 10 minutes.
3. An important role in the rehabilitation of the elements of the knee joint is played by constant exercises with a rubber ball, which must be placed under the knee and squeezed for several minutes.
4. Regardless of the mechanism of damage, the appearance of edema and pain can be quickly removed with coniferous baths. For cooking, you need 500 g of needles, filled with 2 liters of water. The product is boiled for half an hour, filtered and poured into a warm bath. The procedure is carried out every other day for 30 minutes.
5. With increased pain, a necessary condition is not to straighten or bend your legs. To do this, it is recommended to fix the knee during exercise with an elastic bandage until complete healing.

Cost of meniscus surgery

The cost of surgical intervention depends on the level of the clinic, the pricing policy of the medical institution, the volume of planned manipulations, and the quality of the graft. In Moscow clinics, the price for an MRI of the knee joint starts from 5,000 rubles. The cost of surgery on the meniscus (torn off) varies from 6,000 to 80,000 rubles. The price in Israeli clinics for surgery starts at $20,000.

Video: Meniscus surgery

Attention! The information provided in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment, based on the individual characteristics of a particular patient.

The meniscus, or cartilage lining, located inside the knee joint, can be damaged even with a mild side impact. Especially often he is injured during sports training, for example, dismounting from a projectile or skating. Damage to the inner meniscus is diagnosed 7 times more often than the outer one. Treatment is usually conservative - immobilization, physiotherapy. If it fails, surgery is performed.

What is a meniscus

The meniscus is a cartilaginous plate that increases the conformity (congruence) of the articular surfaces of the femur and tibia. These knee structures are strong and flexible at the same time. When flexing and unbending the joint, they change shape, adjusting to the movement that occurs when walking. But the menisci differ somewhat in mobility. The inner is attached to the medial lateral ligament, which somewhat limits its mobility. This causes more frequent injury to the inner meniscus compared to the outer one.

Cartilaginous pads along the edges are fused with the articular capsule. Due to its vessels, their blood supply with nutrients, fluid, oxygen occurs. There are no arteries in the inner parts of the menisci. They receive nutrients from changes in osmotic pressure.

Meniscus functions

The menisci are a buffer between the bones of the thighs and lower legs. When moving, they do not touch each other, are not microtrauma. The menisci contribute to the optimal displacement of the femur and tibia relative to each other, but at the same time limit the range of motion. As a result, the resulting loads are correctly distributed, there is no premature wear of the structures of the knee.

Types of damage

The menisci are not flexible enough to stretch - they tear when injured. The gaps are incomplete, complete, transverse, longitudinal, fragmented, patchwork. During injury, the cartilage lining simply breaks, but in severe cases, its parts are displaced, damaging nearby soft tissues. In trauma practice, there are such:

• complete separation. Usually, the anterior and posterior horns are torn off, as well as the body in the area located near the joint capsule;
• rupture of the inner part of the body, anterior, away from the joint capsule;

• simultaneous damage to the inner zone of the meniscus and its area located near the joint capsule.

Damage to the cartilage lining () can occur as a result of constant exposure to traumatic factors on the knee joint or due to the destructive-degenerative process taking place in it. The outer meniscus is sometimes destroyed as a result.

Rupture severity

When determining the therapeutic tactics, the traumatologist must take into account the type of damage and its severity. A minor injury to the meniscus often does not require surgical intervention, and if it is crushed, the fragments are displaced, an operation is necessary. There are 3 degrees of severity of rupture of the cartilage lining of the knee:

• 1 degree of severity. Clinically, the injury is moderate, weak;
• 2 degrees of severity. The leading symptoms of damage are severe pain, the severity of which gradually decreases, swelling, hematoma;
• 3 severity. The rupture is characterized by acute pain, extensive swelling, hematoma, inability to lean on the foot.

A rupture of any severity requires seeking medical attention. Due to improper fusion of cartilage tissues, the knee joint will not be able to fully function.

Possible causes of injury

In chronic diseases of the joint, the meniscus is slowly destroyed, thinned, thickened. It is easily injured even with a slight fall on a slippery surface. Cartilage destruction occurs with chronic intoxication.

The meniscus is often torn during rotation of the bent leg at the time of exposure to loads, for example, when playing hockey, skiing. It is damaged during the rotation of the lower leg, falling on straight legs, a directed blow to the knee.

Rupture symptoms

At the time of injury to the meniscus, there is a sharp pain that spreads to the entire leg. It is clearly localized in the knee only after a few hours.

Cartilage rupture is also characterized by the following symptoms:

• swelling, an increase in the size of the injured knee compared to a healthy one;
• reddening of the skin in the meniscus area, an increase in local temperature;
• difficulties with .

The rupture is often accompanied by hemorrhage into the joint cavity, the accumulation of pathological exudate in it. If a section of cartilage is torn off during an injury, then a blockade of the knee occurs - the range of motion in it is significantly limited.

Which doctor to contact

A traumatologist deals with the treatment of meniscal tears, and the surgical operation is performed by an orthopedic surgeon. It is not uncommon for a person to be unable to relate knee pain to a fall that occurred 2-3 weeks ago. Therefore, it will not be a mistake to contact an orthopedist or a general practitioner - a general practitioner.

Injury diagnosis

In the acute period, diagnosis is somewhat difficult due to the similarity of the symptoms of meniscus damage with signs, muscles, tendons. It is most informative 2 weeks after the injury, when only specific clinical manifestations persist. The grounds for making a diagnosis at this stage are local pain, congestion, limitation of mobility and the results of functional tests (Landy, Baykova, Roche).

Ultrasound procedure

CT scan

With the help of CT, the condition of the bone, cartilage tissues of the knee, ligamentous-tendon apparatus is assessed. An instrumental study is carried out to identify damage to the muscles, large and small blood vessels, nerve trunks associated with meniscus ruptures, as well as to establish the stage of gouty, rheumatoid arthritis,.

Magnetic resonance imaging

There is a classification (according to Stoller) of the degree of meniscus changes, which are well visualized in the pictures. Also, the shape of the cartilaginous plates is informative for establishing the diagnosis. Normally, they resemble a butterfly in the obtained images. When the menisci are injured, their shape changes.

First aid

During a rupture of the meniscus, pain is so acute that the victim cannot lean on the foot. He needs help getting to bed, laying down, lifting the injured leg by placing a roller or pillow under the shin. Do not try to straighten a blocked joint, as this can cause even more damage. It is necessary to fix the joint with a splint, removable or apply an elastic bandage that does not squeeze the skin too much.

To stop inflammatory edema, eliminate pain should be applied every hour for 10 minutes to the knee, wrapped in a dense cloth. As you can use any - Ketorol, Nise, Nurofen tablets.

Treatment of the meniscus of the knee joint

If the joint is blocked, its mobility is severely limited, then the doctor eliminates the blockade under local anesthesia. If (bleeding into the joint) or accumulation of exudate is detected, a puncture is performed to extract the effusion. The injured knee is then immobilized in a semi-flexed position with a plaster splint for up to 3 weeks.

Medical treatment

For the relief of acute pain, intramuscular administration of NSAIDs is practiced - Ortofen, Ketorolac. With their inefficiency, they are used with (Diprospan, Triamcinolone, Dexamethasone) and anesthetics (Novocaine, Lidocaine). Moderate pain can be eliminated by taking NSAIDs - Ibuprofen, Diclofenac, Ketoprofen, Etoricoxib, Indomethacin. During the rehabilitation period, local application to the knee and gels helps to get rid of mild discomfort:

• NSAIDs -, Finalgel, Dolgit, Artrosilene;
• - Kapsikam, Finalgon, Viprosal, Apizartron, Nyatoks.

Patients can also be prescribed drugs to improve blood circulation, group B. Therapeutic regimens include (Struktum, Artra,) to accelerate the regeneration of cartilage tissues.

Surgery

The most frequently performed is a minimally invasive operation, after which long-term rehabilitation is not required. Through several punctures, surgical instruments and a device equipped with a video camera are inserted into the joint cavity. From it, the image is sent to the monitor of the device to control the progress of the surgical intervention. The doctor sews together the torn fragments of the meniscus, and then treats the joint cavity with antiseptic solutions.

With a serious injury, the surgeon completely or partially removes the meniscus. The operation is performed both endoscopically (arthroscopy) and openly (arthrotomy).

Physiotherapy

During the rehabilitation period, patients are shown 10-15 sessions of UHF therapy. Carrying out these physiotherapy procedures helps to improve blood circulation in the knee joint, accelerate the recovery of menisci.

With moderate residual pain and swelling, electrophoresis or ultraphonophoresis with novocaine, B vitamins, chondroprotectors, less often with glucocorticosteroids is used. Applications with ozocerite or paraffin, acupuncture, massage are also used.

Folk remedies and recipes

Means prepared are used after the fusion of meniscus fragments, the restoration of all functions of the knee. They are used to eliminate mild pains that occasionally appear during a sharp change in weather, after hypothermia or increased physical activity.

Burdock leaf compress

Two large fresh leaves of burdock are soaked for 5 minutes in hot water, dried and rubbed until a thick slurry is formed. Add a tablespoon of vegetable oil (preferably linseed) and thick honey, a couple of drops of essential oils of rosemary and juniper. The mass is applied to the knee, fixed with plastic wrap, woolen cloth, gauze or elastic bandage. The duration of the procedure is 1-2 hours.

Honey compress

In a mortar, a teaspoon of gum turpentine is mixed with the same amount of Kalanchoe juice. In small portions, 50 g of thick honey and low-fat sour cream are gradually introduced. The mixture is applied to the knee, insulated with a film and a thick cloth, a medical bandage is fixed with a bandage, and held for about an hour. After washing off the residue, rub a moisturizer into the skin.

Consequences of meniscus injury

Fully cartilaginous knee pads are restored in children and adolescents. In adults, even after competent conservative or surgical treatment, areas with fibrous tissues form in the area of ​​​​ruptures. Since they are deprived of any functional activity, the work of the joint may be disrupted. This is manifested by mild discomfort when descending or climbing stairs, after lifting weights, hypothermia. Some stiffness of movements at the end of the working day may also be felt.

Rupture of the meniscus is a prerequisite for the development of gonarthrosis. This is what is called, which has not yet been completely cured.

Prevention of cartilage damage

The best prevention of meniscus damage is the exclusion of traumatic situations. During sports training, it is necessary to use elastic ones that do not restrict movement, but at the same time reliably protect the knee in case of falls and bumps. In the presence of degenerative-dystrophic, all medical recommendations regarding the treatment and prevention of relapses should be followed.

Problems with the meniscus of the knee joint are often found in patients experiencing constant stress on the legs. Tears, infringements, minor microtraumas are found not only in athletes.

The meniscus is a natural shock absorber, without which the knee joint cannot fully function. Let's figure out why the meniscus is injured, how to treat it without surgery at home. Correct methods of therapy will prevent the transition of the pathology of the knee joint into a chronic form.

general information

Many have heard the phrases “meniscus rupture”, “meniscus injury”, but few people know what role cartilage formation plays and what it looks like. The interarticular pad in the form of a crescent limits the mobility of the knee joint, acts as a shock absorber. The meniscus prevents injury by stretching and contracting during movement.

The formation is located in the knee joint, between the thigh and lower leg. A person has not one meniscus, but two - external and internal. The main problems arise with the cartilage lining located inside the elements of the joint.

Causes of meniscus injury

The main factor is excessive load on the lower limbs. Athletes, ballet dancers, persons performing hard physical work are at risk. The main category of patients with meniscus injuries are men aged 18–40 years.

The second reason is degenerative-dystrophic changes in the aging process. After 50 years, the condition of the joints worsens, tissue elasticity is lost, and the production of synovial fluid decreases. Problems with the cartilage lining in the knee joint often develop against the background of arthrosis.

Note! Up to 14 years, the meniscus tissues are elastic, the risk of rupture is minimal. Traumatologists rarely encounter damage to an important part of the knee joint in childhood.

Kinds

Doctors distinguish several forms of damage to the meniscus of the knee:

• pinching;
• separation;
• partial rupture of the meniscus of the knee joint.

Most patients are diagnosed with partial tissue damage, often turning into a chronic form. Meniscus tear occurs less frequently, requires serious intervention and quick, competent actions in the treatment.

Signs and symptoms

Symptoms depend on the degree of cartilage damage:

• microtrauma. Pinching, small tears, bruises of the meniscus often haunt professional athletes. Pain is mild, joint mobility is preserved. Sometimes there are clicks in the knee, tingling, short-term numbness, thigh muscles weaken. The problem often becomes chronic;
• partial break. Soreness increases with pressure on the damaged area, movements cause discomfort, limb mobility is limited. The affected area swells. It is difficult for the patient to walk up the stairs, the legs sometimes go numb. Lack of treatment (improper therapy) leads to atrophy of the muscles of the lower leg and thigh;
• cartilage ruptures. Dangerous injury requiring surgical treatment. Without urgent surgery, the patient runs the risk of severe complications. After surgery, rehabilitation is carried out, a complex of physiotherapy procedures. The younger the victim, the sooner the function of the knee is restored.

On the page, read about how to treat coxarthrosis of the hip joint.

When is surgery needed?

Surgery on the meniscus and surgical treatment is required for partial or complete detachment of the meniscus. The patient experiences excruciating pain, the tissues swell, it is impossible to move.

The decision to operate is made by the orthopedic surgeon. The patient's task is to seek help in time so that an infection does not join the meniscus injury. Refusal of surgical intervention in the presence of indications, replacement of competent therapy with untested methods worsens the condition of the diseased joint, activates the inflammatory process in the knee joint.

The doctor partially or completely removes the detached part of the cartilage lining. To restore the function of a natural shock absorber in case of ruptures, the doctor will suggest such an option for surgical intervention as suturing. Before the operation, the orthopedic surgeon takes into account contraindications, the general condition of the patient, the degree of damage to the cartilage tissue.

Prevention measures

• take precautions when playing sports, hazardous work, heavy physical exertion, take care of your legs, wear protective equipment;
• maintain a weight that is appropriate for your age and height;
• eat right, eat more vitamin meals, use foods with components that are beneficial for the health of cartilage and bone tissue;
• dose the load on the joints, do not overwork, but do not forget about physical activity.

Treatment without surgery at home for meniscal injuries is allowed for minor injuries. Coordinate all actions with your doctor, use proven home methods, effective drugs. If the doctor insists on surgical treatment for a meniscus tear, heed the advice of a specialist.

Video. TV show "Live Healthy" about the meniscus of the knee joint: