What is meniscus
The meniscus is a dense semicircular spacer between the condyles of the tibia and femur. The menisci in the knee provide adherence to the articular surfaces and fill the lateral cavities of the joint. They act as a kind of seal, soften the pressure on the cartilage and stabilize the movement of the joint under heavy loads.
The menisci are made up of collagen and complex proteins and have a tendon-like consistency. They are highly elastic and wear-resistant, and take part in the nutrition and lubrication of the joint.
Damage to intra-articular structures
During arthroscopic surgery, the surgeon can damage any structure of the knee joint. Most often this occurs when a sharp trocar is used, insufficient expansion of the joint space, poor visibility, or the doctor attempts to perform “blind” manipulations.
During arthroscopy the following may be affected:
- menisci;
- articular cartilage;
- cruciate ligaments;
- joint capsule.
Damage to intrasynovial structures is very dangerous and can have serious consequences. It can provoke leakage of irrigation fluid, deformation of the menisci or intra-articular ligaments, the development of deforming osteoarthritis in the postoperative period, etc. Naturally, in the future all this will lead to impairment of the functions of the knee joint.
If the surgeon notices an injury to the ligaments, menisci or joint capsule in time, he can immediately eliminate it. Unfortunately, this is not always possible.
What are the dangers of meniscus injuries?
During training or at home, a person falls on his kneecap or the knee is subjected to a strong blow, for example in football. The meniscus ruptures or tears. If the body already has disorders, for example, the endocrine system suffers, or there is a history of gout or rheumatoid arthritis, recovery will not occur. A damaged meniscus ceases to perform its functions and does not alleviate pressure on the joint. This creates the preconditions for knee arthrosis.
With an injured meniscus, the cartilage layer is not able to smooth out dynamic loads on the knee joint. The joints begin to deform, friction of the cartilage causes pain. The situation is aggravated if a person is overweight.
Meniscus injury is the first step to knee arthrosis
How is the disease diagnosed?
Due to the fact that when the meniscus of the knee joint is inflamed, the symptoms resemble various pathologies, the most accurate diagnosis is necessary. The doctor examines the patient, palpates the joint, asks questions about lifestyle, past injuries, and gives a referral for hardware tests. Radiography is still in demand. Although it does not show cartilage, it allows you to act by excluding other ailments, such as tendonitis and bursitis. To get a clear picture, the patient is referred to:
- Ultrasound;
- arthroscopy;
- tomography
The second method has proven itself especially well. Using a miniature device - an arthroscope - it is possible to “look” into the middle of the joint and assess its condition. But that's not all of its capabilities. Using an arthroscope, medications are administered and surgery is performed on the meniscus, removing damage.
How to recognize a meniscal injury
The blow to the knee is very painful, but after a few hours the pain subsides. Alarming symptoms indicating a meniscus tear appear later, when a person has long forgotten about the injury. Pay attention to these signs:
- acute pain in the knee that spreads to the outside of the kneecap;
- local increase in body temperature - redness of the skin in the knee area;
- swelling and swelling of the knee joint;
- difficulty going down stairs;
- pain during dynamic movements - when jumping or running;
- a specific click when bending the knee.
The above symptoms are characteristic of various diseases of the musculoskeletal system, including bruises and subluxations of the ankle or knee. Therefore, you should not diagnose yourself: go to an orthopedist and get diagnosed.
What is a meniscus tear and what does it mean? Answers to all questions are in the video:
Causes of inflammation
Possible causes of inflammation of the knee menisci:
- meniscus damage caused by uncoordinated movements or injuries during unsuccessful jumps and squats;
- constant heavy stress on the legs and knees associated with heavy physical labor, sports or due to obesity;
- disruption of the blood supply to cartilage tissue, which causes degenerative changes in it.
The number 1 reason is still injuries. With any injury to the knee joint, it is the meniscus that is primarily affected.
How is a meniscus injury treated?
Injuries to the meniscus can be different: the tendon can be partially torn or completely torn, separated from the joint capsule longitudinally or transversely. The problem can be eliminated conservatively or surgically, but only after the inflammation has subsided.
After a severe knee injury, it is important to rest the leg, cool the affected area and secure the joint with an elastic bandage. If the patient is transported to the hospital in a horizontal position, the leg is placed above the chest to prevent swelling of the knee.
To make a diagnosis, MRI or CT is prescribed, sometimes together with arthroscopy. If the meniscus is displaced, a cast is applied for 20 days, and a course of restorative therapy is also prescribed.
For meniscus injuries, the following is prescribed:
- non-steroidal anti-inflammatory drugs;
- chondroprotectors to stimulate cartilage tissue and improve the structure of synovial fluid;
- rubbing agents with anti-inflammatory, analgesic and antipyretic effects;
- collagen, for example in food (strengthens tissue trophism and nourishes the meniscus).
Most often, meniscal injuries are treated with medication.
Treatment
Depending on the degree of damage, conservative and surgical treatment is possible.
To relieve pain, a “joint blockade” injection in the form of an anesthetic is used. This helps relieve pain, but not for long. Some patients manage to unblock the joint on their own, through some movements. As a rule, a migrating meniscal fragment re-blocks the joint.
For mild cases of the disease, when the meniscus is not completely torn off, drug treatment may be used. In some situations, blood accumulates in the joint (hemarthrosis), but most often fluid accumulates there. If there are a large number of accumulations, a puncture is required to remove them.
When swelling swells, cooling bandages are applied. For general drug treatment, NSAIDs are prescribed in the form of ointment or cream for topical use or tablets for oral administration, as well as hormones and chondroprotectors.
During treatment, the patient requires rest and the possibility of fixing the joint. For this purpose, a plaster cast, tapes or bandage are used.
If the meniscus or part of it is completely torn off and moves freely in the joint, surgical intervention is required. Arthroscopy is often sufficient. But sometimes they resort to a complete menisectomy followed by installation of an implant.
Does physiotherapy help with meniscus injuries?
If the clinical picture allows the injury to be treated conservatively, drug therapy is supplemented with physiotherapeutic procedures. Laser, shock wave, ultrasound and magnetic therapy help speed up recovery.
If the patient is not allergic to bee products, he may be offered bee stinging under the supervision of a specialist. The principle is this: on the first day, one bee is planted on the sore spot, on the second - three, on the third - 5. The maximum number of bees is 9. Many patients say that after just one or two stings the healing effect is impressive.
For meniscus injuries, compresses of honey and alcohol are often made
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.
In what cases is surgery necessary?
Unfortunately, conservative treatment does not always help. If, after several weeks after a knee injury, the pain does not go away, the joint bends with difficulty, the doctor suggests surgery. Surgical intervention is also indicated in the following conditions:
- if the result of a meniscus injury is hemorrhage inside the articular cavity;
- if the meniscus is severely deformed - torn or radically displaced;
- if the meniscus has separated from the joint capsule.
Most often, damaged menisci are sutured; in severe cases, they are replaced with artificial analogues. The operation is as complex as joint replacement for gonarthrosis, and requires a long recovery - at least four months. After meniscus replacement, the pain goes away almost immediately. Training on an exercise bike, swimming in the pool, proper nutrition and therapeutic exercises help speed up recovery.
A meniscus injury can cause no less discomfort than arthrosis of the knee joint. Moreover, it often leads to degenerative-dystrophic changes in the knee joint. Therefore, be especially careful if you are injured. Don’t let the situation take its course: see a specialist.
Diagnostics
The clinical picture of meniscopathy is similar to most other pathologies of the knee joint, so there is a need for a long-term differential diagnosis by a traumatologist. Diagnostic measures include:
- General inspection. The preliminary onset of the disease, its causes are assessed, and an anamnesis is collected.
- Physical examination and tests. The condition of the injury is determined by palpation, and tests are performed to assess possible limitation of movements.
- X-ray. The condition of the bone structures is assessed and serious injuries are excluded.
- CT and ultrasound. Needed to determine the main diagnosis.
- Arthroscopy. A diagnostic and treatment method that allows minimally invasive surgery to cure most pathologies of the knee joint and its structures.
In addition, you will need: a general blood and urine test, biochemical studies, C-reactive protein, rheumatic tests. Only a specialist will be able to make an accurate and correct diagnosis, as well as prescribe treatment.
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.