A meniscus injury is the most common knee joint damage. This problem is often faced by athletes and workers of heavy physical labor. At the first symptoms of a violation in the functioning of the knee joint, you should consult a doctor. This will help in time to begin treatment and avoid consequences.
Functions of the knee joint meniscus
In fact, it's a cartilaginous tissue. The basis of the meniscus is 70% composed of collagen fibers. In addition, approximately 0.6% elastin and about 13% special proteins are present here. The cartilaginous lining itself consists of such sections:
- anterior horn;
- the rear horn.
Due to the fact that the cartilage is connected to the joint capsule with the tibial and femoral ligaments, this gives it mobility and high strength. There are such varieties of the meniscus:
- inner or medial cartilage;
- External (it is also called the "lateral meniscus").
Such cartilaginous tissue is of great importance for the musculoskeletal system. Its functions are as follows:
- is the stabilizer and limiter of mobility of knee joints;
- reduces friction between the femoral and tibia;
- plays the role of shock absorber.
Types of damage to the meniscus of the knee joint
All injuries can be classified according to two characteristics: the extent and type of rupture. To identify the stage of damage will help MRI. In addition, a knee injury, a meniscus tear can be of this type:
Trauma of the lateral meniscus
The main cause of this rupture is a combined injury, accompanied by a twisting of the shin. Direct injuries of this cartilaginous formation are rarely diagnosed. In addition, the lateral meniscus of the knee joint can be deformed under the influence of a rheumatic disease. However, damage to the lateral cartilaginous formation occurs 7-10 times less frequently than the internal one.
Injury of the medial knee joint meniscus
The causes of damage to this cartilaginous formation are numerous:
- a sharp change in the position of the body;
- Overweight, which exerts a strong burden on the musculoskeletal system;
- unsuccessful turn and so on.
The medial meniscus is more often traumatized in men than in women. In the zone of high risk are athletes:
- football players;
- tennis players;
- basketball players.
Injury of the knee joint meniscus - symptoms
The rupture of cartilaginous formation proceeds in acute and chronic phases. Damage to the meniscus of the knee joint symptoms can have these:
- a click caused by the erasure of the cartilaginous tissue;
- if a fragment of the meniscus is stuck between two contact surfaces, this can lead to blockage of the knee;
- pain, the intensity of which varies depending on the stage of injury;
- edema of the knee, indicating that the meniscus and ligament were simultaneously broken;
- when the outer edge of the cartilaginous lesion is affected, hemarthrosis develops.
To make sure that there is a meniscus injury, such functional tests will help:
- Symptom Baikov - the knee should be bent at right angles. After the palpation of the joint space. At the same time, the knee is passively unbent. If there was a lot of pain - it indicates a break in the meniscus.
- Landau symptom - the patient should sit with his legs crossed. If there is severe pain in the knee - this is a sign that the meniscus is injured.
- Symptom McMurray - the patient needs to lie on his back and knees bend. After this, rotational movements are carried out. The crunch and pain with such manipulations speak of violations.
- Symptom Polyakova - you need to lie on your back and raise your healthy leg up. Simultaneously it is necessary, leaning on the shoulder blades and the heel of the second leg, slightly to raise the trunk. After such an exercise in the area of rupture of the cartilaginous formation, there will be severe pain.
Degrees of damage to the meniscus
There are several degrees of violations. There are three groups of lesions, when there is a meniscus injury - the symptoms are:
- the first stage - the appearance of a small violation;
- second degree - the focus of damage increases;
- the third stage - there is an anguish.
Damage to the knee joint meniscus - treatment
With the help of functional tests, an experienced traumatologist can only prescribe a diagnosis. To identify the nature of the lesion and its severity, the doctor will recommend to the patient an additional examination. A simple X-ray is not very informative in this case, since it does not show cartilaginous formation. Damage to the horn of the medial meniscus or other disorders can be helped by such diagnostic methods:
- MRI ;
Based on the results obtained, the trauma specialist will select the optimal treatment regimen. Non-surgical therapy is more often prescribed if:
- the knee joint is not blocked;
- damage to the medial meniscus is insignificant;
- there are no clicks when driving;
- a degenerative rupture occurred in an elderly patient.
The essence of conservative treatment is to eliminate blockade of the knee joint. Such therapy is represented by the following steps:
- Puncture the contents of the joint bag.
- Introduce 10 ml of 1% Procan solution or 20 ml of 1% solution of Novocain.
- The patient should sit on a high chair so that the angle between the shank and thigh is straight.
- 15 minutes after the administration of the drug, the doctor proceeds directly to manipulation.
If the internal meniscus is damaged, the blockade is eliminated in four steps:
- The traumatologist conducts traction of the foot. This procedure can be performed either with hands or with the help of a dense tissue that covers the leg.
- The doctor deflects the shin in the opposite direction from the restrained meniscus. During such manipulation, the joint space increases. As a result, the meniscus can even become in its original position.
- The doctor performs rotational movements of the shin, turning it outward or inward.
- Free flexion and extension of the knee joint are performed.
More often after such manipulations the blockade is eliminated. In this case, the doctor applies a gypsum longure, extending from the fingers to the upper third of the thigh. Keep the patient this bandage for 5-6 weeks. If, after the first manipulation, you can not get rid of the blockade, it should be repeated. The maximum number of such procedures is 3 times. All of them should be conducted by an experienced trauma doctor.
After this, the doctor gives the patient a conservative treatment. He knows what to do with a meniscus injury, so he will recommend the most effective procedures. More often the therapy includes the following manipulations:
- exercise therapy;
- ultra-high-frequency therapy;
- taking medicines.
The hondoprotectors have proved effective. These drugs restore cartilaginous tissue. Such medicines can prescribe:
Bandage on knee with a meniscus injury
This medical knee is made of elastic fabric. He has a delicate texture, so you can wear a bandage under your clothes. Since the knee joint has no seams, it does not rub. Bandages are differentiated according to the pressure exerted on the leg:
- Knee joints of the 1st compression class are used when a minor knee joint meniscus injury is diagnosed. The pressure applied to them is 22 mm Hg. Such a bandage prevents the tearing of the meniscus.
- Knee pads 2 class of compression - appointed in the post-operation period. They stimulate the functioning of the lymphatic and circulatory systems, speeding up the recovery process.
Meniscal injury - operation
Surgical intervention is recommended in such cases:
- there was damage to the joint and such a violation is accompanied by bleeding;
- a complete meniscus rupture was diagnosed;
- the cartilaginous body is flattened;
- there was a separation of the horn;
- conservative therapy did not give the desired result.
Eliminates damage to the internal meniscus of the knee with the help of such technologies:
- arthroscopy - stitched off elements;
- meniskectomy - partial or complete removal of cartilaginous formation;
- transplantation - replacement of destroyed tissues.
Meniscal injury - recovery
Rehabilitation in the postoperative period is represented by exercise therapy and physiotherapy. Its duration depends on what is the injury of the meniscus and what surgical technology was used to eliminate it. The purpose of this restoration:
- Remove contractures that have occurred after the knee meniscus has been damaged.
- Restore the joint and normalize the gait.
- Strengthen the muscles that stabilize the knee.
LFK with a meniscus injury
There is a whole complex of rehabilitation exercises. They must be carried out under the guidance of an experienced specialist. He knows what is fraught with a trauma or a break in the meniscus. In addition, he knows what load is permissible at this or that stage of recovery. So, exercise therapy in the trauma of the knee joint meniscus during the postoperative period is represented by general development exercises, which are aimed at all muscle groups. At a late stage, exercise therapy is represented by the following complex:
- walking in the opposite direction on the treadmill (running in slow mode);
- exercises on the gym ball;
- jumping on one leg;
- employment on a stationary bike;
- "A foot press" and so on.
Massage of the knee joint after a meniscus injury
This procedure is used in both conservative therapy and postoperative period. If a knee joint meniscus injury is diagnosed, treatment with massage helps to achieve this result:
- reduction of swelling of tissues;
- restoration of muscle tone;
- lowering of pain sensitivity;
- improvement of blood circulation in tissues.
At the first stage the massage is represented by stroking and gentle kneading. This procedure lasts no more than 3 minutes. Later, more intensive manipulations are connected, for example, circular and rectilinear grinding. Such exercises are conducted for 4-5 minutes. Complete the massage with alternating active and passive leg movements. At the same time, electrostimulation of the hip can be used.
Injury of the knee joint meniscus - consequences
If you identify the problem in time and start correcting it in time, you can avoid serious complications. The old trauma of the knee joint meniscus is an insidious injury. It can lead to such consequences:
- Provoke the development of arthrosis .
- To create mechanical instability of the knee joint. At any time during the movement, blockade may occur.
- Lead to rupture of ligaments and even fracture of bones.
If the meniscus injury is taken under the doctor's control in time, the patient will recover in a short period of time. Yes, and surgical intervention often occurs without complications. However, in all patients over the age of forty, the chance of developing negative consequences increases. This is due to the fact that at this age the ligamentous apparatus is weakened. An experienced traumatologist will help to cope with this problem.