How to treat knee meniscus

Joint arthroscopy > Knee joint > Diseases and injuries > Meniscus damage

Meniscus injury is usually characterized by the following symptoms:

feeling of acute pain in the knee joint;
restriction in movements;
swelling of the joint or effusion in it (that is, the release of a significant amount of synovial fluid).

It is also possible that there may be sudden restrictions on movement in the joint, mainly extension. This is called a joint block .

In some cases, if the meniscus in the knee joint is damaged, the patient only needs timely first aid, as well as ensuring rest for the entire knee joint. In this case, these symptoms regress, improvement, and sometimes recovery, is noted. But often damage to the meniscus in the knee joint goes unnoticed and is not treated, as a result of which the damage passes from the acute stage to the chronic stage. To treat chronic injuries, you need to resort to surgical methods, in particular arthroscopy. Knee arthroscopy is the least traumatic operation on the meniscus, the price of which is determined by how complex the meniscus injury is, as well as the complexity of the required surgical intervention.

Damage to the meniscus in the knee joint

Among internal injuries to the knee, meniscus tears and injuries are extremely common. Damage to the meniscus in the knee joint is, unfortunately, not uncommon. It is diagnosed most often in adults, while such damage rarely occurs in children. Injuries and meniscal tears are most common among athletes. In the knee joint, which is characterized by normal functional development, there are two menisci: the outer (also known as lateral) and the internal (also known as medial). Performing absolutely equivalent functions, these menisci differ in the level of mobility due to the uneven distribution of load in the joint, which causes their damage. The outer (i.e. lateral) meniscus in the knee joint is more mobile, since it is not limited by ligaments, which reduces the risk of damage. Damage to the internal meniscus is diagnosed much more often, because it is firmly connected to the internal collateral ligament of the knee joint, which causes its less pronounced mobility.

Injury or tears of the meniscus are usually a consequence of excessive loads on the knee joint when actions are performed that are not provided for by the functional structure of this joint-ligamentous apparatus, for example:

rotation with a fixed foot around a bent shin;
sharp extension in the joint;
direct blow to the knee joint;
falling with straight legs;
torsional load.

How to identify a meniscal injury

The reasons why a meniscus injury occurs can be not only falls and other mechanical impacts. Common precursors to damage are:

gout;
intoxication of the body of any etiology;
rheumatism;
age-related changes.

In addition, minor injuries to the meniscus that do not lead to a tear, but are associated only with its stretching or thinning, will eventually cause a tear. If you do not pay attention to the thinning or gradual breakdown of cartilage tissue in time, this can lead to deformation and arthrosis, which ultimately leads to disability.

Meniscus injury is a common problem that traumatologists encounter in their practice. Men are three times more likely to suffer a torn meniscus than women. The average age at which the peak of knee ligament injury occurs is 23-25 years.

At the time of injury, the victim experiences pain not only in the knee area, but along the entire length of the limb. Only after two weeks the pain will be localized in the sore knee. The main signs of a meniscus tear are:

acute pain;
hyperthermia at the site of injury, meaning the knee may become hot compared to the rest of the body;
enlargement of the knee due to severe swelling;
a loud crunching sound during flexion and extension of the joint, including without load;
severe weakness of the femoral muscle;
lumbago when trying to put pressure on the leg.

Despite the severity of pain in the knee joint, these same signs can indicate not only a meniscus tear. In the same way, ruptures of ligaments and muscles manifest themselves.

Rubbing

If the patient cannot yet use compresses, he can use rubbing. For meniscus injuries, the following formulations are most often used:

garlic tincture : 2 heads of the spicy vegetable are peeled, chopped and poured with half a liter of apple cider vinegar with a strength of 6%. The product will infuse for a week, in warmth and darkness; Dark glass containers are recommended for its preparation. Rubbing is carried out until the pain goes away completely; The tincture can be stored without loss of medicinal properties for up to six months. It is also suitable for treating bruises;
rub of essential oils : equal volumes of menthol, clove, camphor, eucalyptus oils are supplemented with the same amount of wintergreen oil and freshly squeezed aloe juice. You need to rub the sore joint 2-3 times a day, warming it after the procedure for at least half an hour;
pork fat : lard is bought at the butcher shop, 200 grams of the base are melted over very low heat, supplemented with chopped garlic and eucalyptus leaves (2 tablespoons of dried raw materials). After boiling, the ointment is infused under the lid for 2 hours, filtered through gauze and poured into a glass container. For rubbing, use twice a day.

First aid to a patient

The victim may experience severe pain from a couple of days to a week. If the severity of pain is moderate, you can do without contacting a traumatologist. To relieve pain and reduce suffering, you need:

Apply ice to the sore knee. This will relieve swelling. Cold during prolonged contact causes blood vessels to constrict, thereby reducing local hyperthermia.
You can reduce the intensity of pain with the help of non-steroidal anti-inflammatory drugs, including ibuprofen, diclofenac, analgin.
To reduce the risk of worsening the situation, it is important to ensure immobility of the injured limb using a splint. It is better if the knee is elevated in relation to the healthy leg.

When the acute period is over and the patient can see a traumatologist, the specialist will assess the extent of the damage and prescribe a course of treatment and care.

Home care

Any home therapy should be discussed with your doctor, because it is only an auxiliary component of drug treatment. Traditional medicine can only be indicated for relieving pain and swelling:

Compresses of a hypertonic solution draw out excess fluid, thereby relieving swelling. A solution is prepared from a tablespoon of salt dissolved in 250 ml of water. The cloth is soaked in salt water and applied to the injured knee.
Peppermint rubs. For this, essential oils of clove, mint, camphor and eucalyptus are taken. After mixing the ingredients, take a few drops of the product and rub it into the injury site with slow and careful movements. Menthol will create a feeling of freshness and coldness, which will alleviate the patient's condition.
Pine baths. They can improve blood flow to the injured knee and relieve pain. In addition, pine needles have a restorative effect on the body. To prepare baths, you can use pharmaceutical pine mixtures, which just need to be brewed immediately before preparing the bath. If it is not possible to find pine needles, you can use pine salt.

What are menisci?

Menisci are fibrocartilaginous structures that give the joint the necessary stability, evenly distribute body weight in the knee and act as a shock absorber.
Each knee has two menisci that look like C-shaped pads. They are located between the tibia and femur, one on the inside of the knee (medial meniscus), the other on the outside (lateral). The medial meniscus is most often affected.

Because menisci are shaped like the letter “C,” they have two so-called horns (the part where the meniscus ends)—anterior and posterior. Most ruptures occur in the dorsal horn.

Gymnastics to restore knee function

Any gymnastics is indicated only if the acute period has already ended and you can work with the knee joint without pain. As a rule, gymnastics is prescribed after wearing a plaster cast or splint for a long time. To return the knee to working capacity, you need to begin to gradually warm it up according to a certain method.

Clinics offer physical therapy sessions where, under the supervision of a specialist, patients recover from serious injuries. If a doctor has diagnosed a meniscal tear, any exercise will be postponed until the tissue has completely healed.

Exercises begin with minimal loads. First, these will be exercises for flexion and extension of the sore knee. You need to do it while sitting on a high chair. 10 lifts twice a day is enough. Gradually, the load can be increased, in accordance with the doctor’s recommendations. If you experience any pain, you should immediately report it to a specialist to adjust your rehabilitation plan.

Arthroscopic procedure

Many people are hesitant to undergo surgery because they do not know that manipulation of the meniscus of the knee joint is not so scary. Partial or complete resection is done in the most gentle way: without pain, cuts and blood, using a safe and effective regional anesthetic. Patients are concerned about whether it is possible to run after removal of the meniscus of the knee joint (watch our video on the topic) and engage in physical exercise?

In the operating room.

Let's just say that people are allowed to lead their usual lifestyle, where running, jumping, cycling, and so on are not contraindicated, but only after a thorough restoration of the operated area. There are many real examples where even football players return to the game after such an intervention, and actively take part in competitions, playing at a professional sports level.

Exercise not on an unstable platform.

It is very important for the patient’s life to undergo rehabilitation so that after surgery the meniscus of the knee joint does not change for the worse. It will be as dynamic and rich as before. Well, we already discussed the dangers of inaction at the very beginning of the article. Now, actually, let's talk about the surgical procedure itself.

Modern medical technologies allow injured cartilaginous structures to be restored minimally invasively. Thanks to this, recovery after surgery, usually a suture is placed on the meniscus, is quick and without any difficulties. For therapeutic and restorative purposes, the arthroscopy method is used. The procedure is performed using a fiber-optic endoscopic device equipped with a video device called an arthroscope.

The optical device looks like a thin probe. The probe is inserted through a puncture in the skin (diameter 5 mm) inside the joint and brought directly to the damaged object, which is visualized on the operating screen in enlarged sizes. The minimally invasive technique can also be used as a diagnostic tool if traditional diagnostic methods turn out to be insufficiently informative.
Having decided on the treatment tactics, which will depend on the type and severity of the damage, the surgeon, using an additional puncture and special instruments, begins to perform the main tasks of eliminating defects on the meniscal body. The doctor, as far as possible, will try to preserve the cartilage tissue as much as possible, sparingly removing only clearly non-viable areas.
There are two most common correction techniques: suturing the linear tear or excision of the marginal dislocated areas. In the first case, a suture will be applied using medical threads using a special technology. In the second, microsurgical instruments will be used to resect the flaps in the peripheral part, and then polish the edges of the meniscus. If free fragments are detected, the specialist removes them from the joint space.
At the end of the session, the surgical field is washed. Small skin incisions are sutured, treated with antiseptic agents and covered with a sterile dressing. No plaster needed.

In case of generalized crushing of structures or an excessively large gap, the cartilaginous layer will most likely be completely removed. In practice, such a clinic is extremely rare. As for implantation or transplantation, today the methods of implanting artificial implants and donor cartilage grafts of the knee are at an experimental stage. Therefore, such high-tech methods in modern meniscus surgery have not yet become widespread.

Treatment of the meniscus with the involvement of medicine

When fragments of a meniscus tear are displaced, as well as in other difficult situations, surgical intervention may be required. To intensively relieve inflammation, injections of corticosteroids and hormones are used directly into the knee. This allows you to instantly relieve pain and alleviate the patient’s general condition. If the tissue of the knee joint is damaged, medications will be prescribed aimed at restoring cartilage tissue. These include Alflutop. It is injected directly into the joint or intravenously. Separately, there are drugs such as Teraflex and Honda. They promote the natural restoration of cartilage tissue and increase the elasticity of the meniscus.

To support the body and help the meniscus recover after heavy loads or injuries, you need to have meat dishes in your daily diet, as well as cod, eggs, legumes and dairy products.

Advantages of arthroscopic surgery

Minimally invasive endoscopic technology is considered the gold standard for the treatment of injuries to the knee and other joints. It has multifaceted capabilities, allowing for diagnosis and surgical intervention of almost any complexity. Main advantages:

low blood loss;
low tissue trauma;
no rough postoperative scars remain;
minimal risk of complications;
quick recovery period with little pain.

During endoscopic surgery, it is possible to perform partial or complete removal of cartilage plates, apply sutures, and fix the meniscus.

The duration of the operation is on average 1-1.5 hours, which depends on the complexity of the damage and the scope of treatment. After processing the surgical field, the surgeon makes two punctures into which an arthroscope with a fixed camera is inserted. From it, an image of the joint cavity is displayed on the monitor screen. Through another puncture, manipulators are inserted - instruments for all actions during the operation. To improve visualization, a small amount of saline is placed into the cavity.

Upon reaching the meniscus, the doctor assesses the condition of the tissues and, taking into account the damage, decides on further actions - suturing, tissue resection, removal of the meniscus. After all manipulations, the joint cavity is washed with antiseptic solutions, the instruments are removed, sutures are applied to the wound and covered with a sterile bandage.