Old rupture of the posterior horn of the medial meniscus. Damage to the meniscus of the knee joint - what to do? Rupture of the posterior horn of the lateral meniscus treatment

Posterior horn

Treatment of a tear in the posterior horn of the lateral (outer) meniscus

The lateral meniscus is a structure in the knee joint that has a shape close to a ring. Compared to the medial meniscus, the lateral meniscus is slightly wider. The meniscus can be divided into three parts: the body of the meniscus (middle part), the anterior horn and the posterior horn. The anterior horn is attached to the internal intercondylar eminence. The posterior horn of the lateral meniscus is attached directly to the lateral intercondylar eminence.

Statistics

Rupture of the posterior horn of the lateral meniscus is an injury that is quite common among athletes, people leading an active lifestyle, as well as those whose professional activities involve heavy physical labor. According to statistics, this injury is more common than anterior cruciate ligament injury. However, approximately one third of all cases of ligament rupture are associated with a meniscus tear. In terms of frequency, damage of the “watering can handle” type is in first place. Isolated damage to the posterior horn of the meniscus accounts for about a third of all meniscus injuries.

Causes

Injury to the posterior horn of the lateral meniscus varies from patient to patient. The causes of injury largely depend on the age of the person. Thus, in young people under 35 years of age, the cause of injury is most often mechanical impact. In elderly patients, the cause of rupture of the posterior horn is most often a degenerative change in the meniscal tissue.

In women, rupture of the posterior horn of the external meniscus occurs less frequently than in men, and the rupture itself is usually organic in nature. In children and adolescents, rupture of the posterior horn also occurs, usually due to awkward movement.

Injury resulting from mechanical impact can have two possible causes: direct impact or rotation. The direct impact in this case is associated with a strong blow to the knee. The victim's foot is usually fixed at the moment of impact. Damage to the posterior horn is also possible with awkward, sharp bending of the leg at the knee joint. Age-related changes in the meniscus significantly increase the risk of injury.

The rotational mechanism of injury implies that a meniscus rupture occurs in the event of a sharp twisting (rotation) of the ankle with the foot fixed. The condyles of the tibia and femur with such rotation shift in opposite directions. The meniscus also becomes displaced while attached to the tibia. If there is excessive displacement, there is a high risk of rupture.

Symptoms

Damage to the posterior horn of the lateral meniscus manifests itself with symptoms such as pain, impaired joint mobility, and even complete blocking of the joint. The complexity of the injury in diagnostic terms is due to the fact that often a rupture of the posterior horn of the meniscus can manifest itself only with nonspecific symptoms, which are also characteristic of other injuries: damage to the ligaments or the patella.

A complete tear of the horn of the meniscus, in contrast to minor tears, often manifests itself as a blockade of the joint. The blockade is due to the fact that the torn fragment of the meniscus is displaced and restrained by the structures of the joint. A typical rupture of the posterior horn is a limitation in the ability to bend the leg at the knee.

In case of an acute, severe rupture accompanied by damage to the anterior cruciate ligament (ACL), the symptoms are pronounced: swelling appears, usually on the anterior surface of the joint, severe pain, the patient cannot step on the leg.

Conservative treatment

For small tears, non-surgical treatment is preferred. Puncture gives good results when blocking a joint - removing blood helps to “free” the joint and eliminate the blockage. Further treatment consists of undergoing a series of physiotherapeutic procedures: therapeutic exercises, electromyostimulation and massage.

Often, during conservative treatment, medications from the group of chondroprotectors are also prescribed. However, if there is serious damage to the posterior horn, then this measure will not be able to completely restore the meniscal tissue. In addition, the course of chondroprotectors often lasts more than one year, which extends the treatment over time.

Surgical treatment

For significant ruptures, surgical treatment may be prescribed. The most commonly used method is arthroscopic removal of part of the meniscus. Complete removal is not practiced, since in the absence of the meniscus the entire load falls on the knee cartilage, which leads to their rapid wear.

Rehabilitation

The rehabilitation period after meniscus surgery lasts up to 3-4 months. A set of measures during this period is aimed at reducing swelling of the knee joint, reducing pain and restoring the full range of motion in the joint. It is worth noting that full recovery is possible even if the meniscus is removed.

Front horn

Treatment of a tear in the anterior horn of the medial (internal) meniscus

The medial meniscus differs from the lateral one in its larger circumference and greater distance between the horns (approximately two times). The anterior horn of the medial meniscus is attached in the area of ​​the anterior edge of the articular part of the tibia - in the so-called intercondylar fossa. The outer surface of the meniscus is tightly connected to the articular capsule, and the inner surface is tightly connected to the medial collateral ligament.

Normally, the anterior horn of the meniscus has a smooth surface and its edges are quite thin. The blood supply to the menisci is mainly localized in the anterior and posterior horns, but the blood vessels extend only 5-7 mm from the edge of the meniscus.

Statistics

It is estimated that medial meniscus injuries account for 60 to 80 percent of all knee injuries. Rupture of the anterior horn of the medial meniscus ranks first in frequency of occurrence. Longitudinal and flap tears are more typical for this injury.

Causes

The main reason for rupture or separation of the anterior horn of the meniscus is a significant load on the knee joint, combined with fixation of the foot and rotational movement of the knee. At risk are young people leading an active lifestyle, as well as older men. Statistically, rupture occurs more often in men than in women.

Symptoms

Damage to the anterior horn of the medial meniscus is often combined with displacement of the torn part and its blocking between the internal surfaces of the joint. When the anterior horn is torn off with entrapment, symptoms such as blockade of the knee joint, knee pain and the inability to move independently appear. After treatment, the joint block is eliminated. Also, with an injury to the anterior horn of the meniscus, the patient can often slightly bend the knee, after which a blockade occurs.

With an injury to the anterior horn of the medial meniscus, the following symptoms may also occur:

• Feeling of pain inside the joint,
• Increased pain when trying to bend the leg at the knee,
• Flabbiness of the thigh muscles,
• Sensation of “lumbago” when the knee joint is tense,
• Pain in the area where the meniscus and ligament attach.

Kinds

It is customary to distinguish three types of rupture:

• Rupture of the immediate anterior horn (complete or partial).
• A meniscal tear with degenerative changes.
• Rupture of the ligament that secures the meniscus.

Conservative treatment

For minor meniscus injuries, conservative treatment is sufficient. In the first stages, the injured limb is fixed using a splint. A puncture of the joint can also be performed to get rid of the blood accumulated in the cavity and remove the blockage of the joint. The patient is advised to rest and the load on the leg should be limited. Subsequently, a course of physiotherapy, physical therapy, massage sessions and electrical myostimulation is recommended.

Surgical treatment

If there is a complete rupture of the anterior horn of the internal meniscus, surgical treatment is recommended. A meniscectomy is performed, that is, an operation to remove the torn fragment. Today, open surgery is almost never performed, as is complete removal of the meniscus. Instead, stitching or fragmentary removal is performed using arthroscopy. Due to the low invasiveness of the arthroscopic method, trauma to the knee joint and the rehabilitation period are significantly reduced. Performing such a procedure allows you to preserve functionally significant elements of the meniscus, which prevents the development of arthrosis and osteoporosis and allows the patient to quickly return to normal life.

In young patients, it is possible to undergo arthroscopic suturing of the meniscus. In this case, a rupture of the anterior horn of the meniscus is an indication for such suturing, since the anterior horn has a good blood supply, and its restoration occurs faster and more fully.

Rehabilitation

Arthroscopy can significantly reduce recovery time after a meniscus injury. After just a few days, it becomes possible to put a load on the limb, develop the knee joint and return to the usual rhythm of life. The essence of rehabilitation is to get rid of pain and restore mobility to the knee joint.

Good afternoon

I am 42 years old. I live in Kurgan. Pain in the left knee joint periodically occurred for approximately 2 years. Recently, pain with sudden movements has become daily. I asked for a consultation at the Ilizarov Medical Center. They did an MRI. Diagnosis: Rupture of the posterior horn of the medial meniscus. Synovitis. DOA 1st degree, Chondromalacia patella 2nd degree. Increased fluid in the joint cavity. The medial meniscus has a heterogeneous structure, with the presence of a linear horizontal section of hyperintense signal at the level of the posterior horn with transition to the lower articular surface. Lateral meniscus of heterogeneous structure. The doctor immediately said that only surgery was recommended for me, there were no other options. I would like to know your opinion. Thank you.

Answer to the question:

Hello! Damage to the meniscus of the knee joint leads to pain, disturbances in walking, and instability of body position. Further destruction of these cartilaginous formations contributes to the progression of arthrosis of the knee joint and leads to long-term disability or even disability.

If part of the meniscus is torn, conservative treatment is possible, but it usually helps only in the initial stage of the disease. If the disease lasts for a long time, surgery is indicated. A torn meniscus will not “heal” on its own, and the disease will only progress over time.

At the Russian Research Center "WTO" named after. acad. The Ilizarov Department, where arthroscopic treatment of knee meniscal injuries is carried out, has existed for many years. This is a federal level institution, it is well equipped, and the doctors have extensive experience in performing such procedures. Therefore, you should not refuse the operation due to possible doubts about the professionalism of the center’s staff.

If the horn of the meniscus is damaged during arthroscopy, it can either be “sutured” to the intact part or removed. This depends on the severity of the damage. In any case, this is a low-traumatic intervention. Removing a small portion of the meniscus results in only minimal reduction of the contact surface of the knee joint, and therefore the recovery time after such surgery is short.

The operation is indicated for pain in the knee, repeated blockades (“jamming”) of the joint, limited mobility in it, ineffectiveness of drug treatment and exercise therapy. It is also prescribed for a tear longer than 1.5 cm.

After the operation, a bandage is applied and the knee can be bent immediately. In the first 2–3 days, it is recommended to use a cane or crutch; by the 10th day, full load on the joint is allowed. The duration of hospital stay is 3–4 days, the ability to work is restored in about a month.

In young patients, doctors often choose the most gentle methods, that is, they do not remove the torn part of the meniscus, but sew it on. Therefore, in the future, the function of the joint is completely restored.

Another important argument in favor of the operation in your case is economic efficiency. In the future, long courses of chondroprotectors and other expensive drugs will not be needed. You will not have to go on sick leave if pain in the joint worsens, and in the future you will not need endoprosthetics.

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Menisci are very important structural units of the knee joint. They are curved strips of fibrous cartilage that sit between the bones of a joint. The shape resembles a crescent with elongated edges. It is customary to divide them into zones: the body of the meniscus (middle part); the elongated end parts are the posterior and anterior horns of the meniscus.

There are two menisci in the knee joint: medial (inner) and lateral (outer). Their ends are attached to the tibia. The medial one is located in the inner part of the knee and is connected to the internal collateral ligament. In addition, along the outer edge it is connected to the capsule of the knee joint, through which partial blood circulation is ensured.

The cartilaginous portion of the meniscus adjacent to the capsule contains a significant number of capillaries and is supplied with blood. This part of the medial meniscus is called the red zone.

The middle region (intermediate zone) contains a small number of vessels and is very poorly supplied with blood. Finally, the inner region (white zone) has no circulatory system at all.

The lateral meniscus is located on the outer area of ​​the knee. It is more mobile than the medial one, and its damage occurs much less frequently.

Menisci perform very important functions. First of all, they act as shock absorbers during joint movement. In addition, the menisci stabilize the position of the entire knee in space. Finally, they contain receptors that send operational information to the cerebral cortex about the behavior of the entire leg.

When the internal meniscus is removed, the contact area of ​​the knee bones decreases by 50-70%, and the load on the ligaments increases by more than 100%. In the absence of an external meniscus, the contact area will decrease by 40-50%, but the load will increase by more than 200%.

The meniscus is a cartilage pad that sits between joints and acts as a shock absorber.

During motor activity, the menisci can change their shape, making the gait smooth and not dangerous.

The knee joint contains the outer (lateral) and inner (medial) menisci.

The medial meniscus is less mobile, so it is susceptible to various injuries, among which ruptures should be noted.

Each meniscus can be divided into three parts: anterior horn, posterior horn, and body.

The posterior horn of the meniscus, which is the internal part, is characterized by the absence of a circulatory system. The circulation of synovial fluid is responsible for nutrition.

In this regard, damage to the posterior horn of the medial meniscus is irreversible, because the tissue is not designed for regeneration. The injury is difficult to diagnose, and therefore magnetic resonance imaging is a mandatory procedure.

Meniscus injuries can be caused by various diseases and other reasons. Knowing all the reasons that increase risks, you can guarantee the maintenance of ideal health.

• Mechanical injuries can be caused by external mechanical influence. The danger is caused by the combined nature of the damage. In most cases, several elements of the knee joint are affected at once. The injury can be global and include damage to the ligaments of the knee joint, rupture of the posterior horn of the medial meniscus, rupture of the body of the lateral meniscus, and fracture of the joint capsule. In this situation, treatment must be started in a timely manner and must be thoughtful, since only in this case can unwanted complications be avoided and all functions restored.
• Genetic causes suggest a predisposition to various joint diseases. Diseases may be hereditary or a congenital disorder. In many cases, chronic diseases of the knee joint develop due to the fact that the menisci quickly wear out, lack nutrition, and blood circulation in the knee joint is impaired. Degenerative damage may appear early. Damage to cartilaginous ligaments and menisci can occur at a young age.
• Joint pathologies caused by previous or chronic diseases are usually classified as a biological type of damage. As a result, the risk of injury increases due to exposure to pathogens. Ruptures of the horn or body of the meniscus, abrasion, and separation of fragments may be accompanied by inflammatory processes.

It should be noted that the above list represents only the main reasons.

A common injury to the cartilage plate is a tear, complete or incomplete. Professional athletes and dancers, whose specialty involves high loads, are often injured. Injuries occur in older people and as a result of accidental, unexpected stress on the knee area.

Damage to the body of the posterior horn of the medial meniscus occurs for the following main reasons:

• increased sports loads (jogging over rough terrain, jumping);
• active walking, prolonged squatting position;
• chronic articular pathologies in which inflammation of the knee region develops;
• congenital articular pathology.

The listed reasons lead to meniscus injuries of varying severity.

Classification

Symptoms of injury to cartilaginous elements depend on the severity of the damage to the cartilage tissue. There are the following stages of internal meniscal injury:

• Stage 1 (mild). Movement of the injured limb is normal. The pain is mild and becomes more intense during squats or jumps. There may be slight swelling above the kneecap;
• Grade 2 injury is accompanied by severe pain. The limb is difficult to straighten even with outside help. You can move while limping, but the joint can become blocked at any moment. The swelling gradually becomes greater, and the skin changes color;
• Damage to the posterior horn of the medial meniscus of the 3rd degree is accompanied by pain syndromes of such intensity that it is impossible to tolerate. It hurts most at the location of the kneecap. Any physical activity is impossible. The knee becomes larger in size, and the skin changes its healthy color to purple or bluish.

If the medial meniscus is damaged, the following symptoms exist:

1. the pain intensifies if you press on the kneecap from the inside and simultaneously straighten the limb (Bazhov’s maneuver);
2. the skin of the knee area becomes overly sensitive (Turner's symptom);
3. when the patient lies down, the palm passes under the injured knee without any problems (Land's symptom).

After making a diagnosis, the doctor decides which treatment method to apply.

The meniscus is cartilage tissue that consists of fibers and serves as a shock absorber for the knee joint. It looks like two crescents, their ends are called horns.

The lesser crescent is the outer (lateral) part of the meniscus, and the greater crescent is the inner (medial).

There are different types of breaks:

• vertical and horizontal;
• oblique and transverse;
• degenerative;
• ruptures of the posterior and anterior horns of the meniscus.

But most often, a rupture of the posterior horn of the internal meniscus occurs, since it is less mobile.

Causes

Degenerative-dystrophic processes do not develop in a healthy body. This must be preceded by violations at various levels: local and general.

They have a clear relationship, which distinguishes the development of pathology from traumatic injuries, when only mechanical impact on the knee joint is sufficient. Undoubtedly, injuries and prolonged excessive stress on joints are key factors in the formation of degenerative changes, but there are other conditions that contribute to such processes:

• Dysplasia of the knee joint.
• Obesity.
• Gout.
• Rheumatoid arthritis.
• Rheumatism.
• Osteoarthritis.
• Infectious diseases (tuberculosis, brucellosis, yersiniosis).
• Connective tissue diseases (lupus erythematosus, scleroderma).
• Endocrine pathology (hypothyroidism).
• Systemic vasculitis.

Dystrophic processes in the knee joint are largely due to metabolic, immune, endocrine and vascular disorders, which can occur in conjunction with age-related changes that inevitably appear after 50 years.

Degenerative changes in the menisci develop due to many reasons. In most cases, there is a combined effect of unfavorable factors.

Now experts point to only one reason for the rupture – acute injury. This is explained by the fact that no other impact on the joint can cause damage to the cartilage responsible for shock absorption.

It is also worth noting that there are the following risk factors that predispose to rupture:

• congenital joint weakness;
• regular jumping, running on uneven surfaces;
• injuries resulting from degenerative diseases;
• rotational movements performed on one leg without lifting it off the ground;
• long-term squatting;
• intense walking.

Damage to the posterior horn of the medial meniscus is a polyetiological pathological condition that develops under the influence of various factors:

• The impact of kinetic force on the knee area in the form of a blow or fall on it.
• Excessive flexion of the knee, leading to tension in the ligaments that secure the menisci.
• Rotation of the femur with the tibia fixed.
• Frequent and long walking.
• Congenital changes that cause a decrease in the strength of the knee ligaments, as well as its cartilage.
• Degenerative-dystrophic processes in the cartilaginous structures of the knee, leading to their thinning and damage. This cause most often occurs in older people.

Finding out the causes allows the doctor not only to select the optimal treatment, but also to give recommendations regarding the prevention of recurrence.

Injury to the posterior horn of the lateral meniscus varies from patient to patient. The causes of injury largely depend on the age of the person. Thus, in young people under 35 years of age, the cause of injury is most often mechanical impact. In elderly patients, the cause of rupture of the posterior horn is most often a degenerative change in the meniscal tissue.

In women, rupture of the posterior horn of the external meniscus occurs less frequently than in men, and the rupture itself is usually organic in nature. In children and adolescents, rupture of the posterior horn also occurs, usually due to awkward movement.

Injury resulting from mechanical impact can have two possible causes: direct impact or rotation. The direct impact in this case is associated with a strong blow to the knee.

The victim's foot is usually fixed at the moment of impact. Damage to the posterior horn is also possible with awkward, sharp bending of the leg at the knee joint.

Age-related changes in the meniscus significantly increase the risk of injury.

The rotational mechanism of injury implies that a meniscus rupture occurs in the event of a sharp twisting (rotation) of the ankle with the foot fixed. The condyles of the tibia and femur with such rotation shift in opposite directions. The meniscus also becomes displaced while attached to the tibia. If there is excessive displacement, there is a high risk of rupture.

Types of breaks

Most injuries to the extremities occur on the internal part (more than 70%). The outer part suffers less often (about 20%). And only 5% are cases of damage to both types of meniscus.

The following types of breaks are distinguished:

• vertical gap (longitudinal);
• oblique;
• degenerative;
• transverse (radial);
• horizontally;
• injury to the horns (anterior or posterior).

Let us tell you more about the types of meniscal tears and types of treatment.

Tear of the posterior horn of the medial meniscus

As noted, many people experience combined meniscal injuries that include a tear or avulsion of the posterior or anterior horn.

• Tears or the appearance of a part of the meniscus in the capsule of the knee joint, torn off due to abrasion or damage, are one of the most common cases in traumatology. These types of damage usually include the formation of a fragment by tearing off part of the meniscus.
• Tears are injuries in which part of the meniscus is torn. In most cases, ruptures occur in the thinnest parts, which should take an active part in motor activity. The thinnest and most functional parts are the horns and the edges of the menisci.

Depending on the main causative factor that led to the development of the pathological condition of the cartilaginous structures of the knee, traumatic and pathological degenerative damage to the posterior horn of the medial meniscus is distinguished.

According to the criterion of the duration of the injury or pathological violation of the integrity of this cartilaginous structure, fresh and old damage to the posterior horn of the medial meniscus is distinguished. Combined damage to the body and posterior horn of the medial meniscus was also identified separately.

Signs of ruptures

Damage to the medial meniscus most often occurs during physical exercise: running on terrain, spinning on one leg, sudden lunges and other situations.

Depending on the clinical manifestations, acute and chronic tears of the medial meniscus are distinguished. A distinctive feature of the first form is intense pain of a sudden nature, localized along the line of the joint fissure, where damage to the cartilaginous layer presumably occurred.

Other typical symptoms of a medial meniscus tear in the knee include:

• severe limitation of motor ability (if the torn area blocks the movement of the joint);
• hemarthrosis (bleeding into the joint cavity);
• edema.

Note: When the knee is bent, a person does not always feel intense pain. It appears more often when trying to straighten the leg. This is a hallmark sign of injury to the inner part of the intercartilaginous spacer.

Typically, a rupture of the meniscus of the knee joint occurs due to an unnatural position of the knee or pinching of the cartilage cavity after injury to the knee area.

The main symptoms include:

1. Intense pain syndrome, the strongest peak of which occurs at the very moment of injury and lasts for some time, after which it may fade away - the person will be able to step on the leg with some restrictions. It happens that the pain is preceded by a soft click. After a while, the pain transforms into another form - as if a nail was stuck into the knee, it intensifies during the flexion-extension process.
2. Swelling that appears after a certain time after injury.
3. Joint blocking, jamming. This symptom is considered the main one during a rupture of the medial meniscus; it manifests itself after mechanical clamping of the cartilaginous part by the bones of the knee.
4. Hemarthrosis, manifested in the accumulation of blood inside the joint when the red area of ​​the meniscus is injured.

The main sign of a meniscus tear is severe pain in the knee joint. When the posterior horn ruptures, the pain is localized mainly in the popliteal region. If you touch the knee with noticeable pressure, the pain increases sharply. It is practically impossible to move due to pain.

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Symptoms

When the meniscus of the knee joint is damaged, there are two characteristic periods - acute and chronic. The acute period lasts 4-5 weeks and is characterized by a number of painful symptoms.

The moment of meniscus damage is usually determined by a cracking sound and sharp pain in the knee area. In the first period after the injury, a cracking sound and pain accompanies a person during exertion (for example, moving up the stairs).

Swelling develops in the knee area. Often a meniscus tear is accompanied by hemorrhage into the joint.

A tear of the medial meniscus of the knee joint has a number of characteristic symptoms. Injury to the internal posterior horn of the meniscus causes intense pain on the inside of the knee. When you press with your finger in the area where the horn of the meniscus attaches to the knee ligament, a sharp pain appears. A rupture of the posterior horn causes blockage of movement in the knee joint.

The gap can be determined by performing flexion movements. It manifests itself in the form of sharp pain when straightening the leg and turning the lower leg outward.

Pain also occurs when the leg is strongly bent at the knee. According to the severity of damage to the meniscus of the knee joint, they are divided into minor, moderate and severe.

Small tears (partial), including the horns of the meniscus, are characterized by pain and slight swelling in the knee area. Such signs of injury cease to appear after 3-4 weeks.

With moderate severity of injury, all the considered symptoms of the acute period appear, but they are limited in nature and appear during physical activity, such as jumping, moving up inclined planes, and squatting. Without treatment, this form of injury becomes chronic. This degree is typical for some tears of the anterior and posterior horn of the medial meniscus.

With severe injury, pain and swelling of the knee become obvious; hemorrhage occurs into the joint cavity. The horn is completely torn off from the meniscus, and its parts end up inside the joints, which causes a blockage of movement. Independent movement of a person becomes difficult. Severe injury requires surgery.

Traumatic ruptures.

After this injury, a person may feel pain and notice swelling of the knee.

If you experience pain when going down stairs, you may suspect a tear in the back of the meniscus.

When a meniscus ruptures, one part can come off, after which it will hang loose and interfere with the full functioning of the knee joint. Small tears can cause difficulty moving and painful clicking sounds in the knee joint.

A large tear leads to a blockade of the knee joint, due to the fact that the torn and dangling part of the meniscus moves to the very center and begins to interfere with various movements.

Damage to the posterior horn of the meniscus of the medial meniscus in most cases is limited to impaired motor activity of the knee joint and knee flexion.

In case of injury, sometimes the pain is particularly intense, as a result of which a person cannot step on his leg. In other cases, the tear may cause pain only when performing certain movements, such as going up or down stairs.

Acute rupture.

In this case, a person may suffer from swelling of the knee, which develops in a minimum time and is particularly pronounced.

Degenerative ruptures.

Many people after forty years suffer from degenerative meniscal tears that are chronic.

Increased pain and swelling of the knee cannot always be detected, since their development occurs gradually.

The signs of a meniscus tear have already been discussed in more detail in one of the previous articles, so we will focus only on the main points. Typically, an injury occurs when parts of a joint are in an unnatural position at a specific moment (namely at the moment of rupture). Less commonly, this occurs as a result of pinched cartilage.

Note! As a rule, a rupture is accompanied by other damage to the joint, which means that in some cases it - a rupture - is not so easy to identify during differential diagnosis.

1. Sharp pain. It is especially acute at the time of injury and lasts for several minutes. Sometimes you can hear a characteristic click in the knee before pain appears. After a while, the pain subsides and the person can walk again, but this is not easy for him.

   The next morning, a different pain is felt - as if a nail had been stuck into the knee - which only intensifies when flexed/extended.

2. Swelling. Usually it does not appear immediately, but several hours after the injury.
3. “Jaming” of the joint (blockade). This is the main symptom of a medial meniscus tear, occurring after the separated part of the cartilage is pinched by the bones, and the motor functions of the limb are impaired. It is worth knowing that this symptom is also observed with sprained ligaments, so the true cause of the pain can be found out only after diagnosis.
4. Intra-articular accumulation of blood (hemarthrosis). This happens if the “red zone” of the shock-absorbing cartilage layer is damaged.

Today, medicine differentiates between acute and chronic (advanced) ruptures, which is possible thanks to the use of hardware diagnostics. Thus, a “fresh” rupture has smooth edges and is accompanied by hemarthrosis. In cases of chronic injury, the cartilage is multi-fibered and there is swelling caused by the accumulation of fluids.

Diagnostics

To make a definitive conclusion about meniscopathy, it is necessary to conduct an imaging examination. This includes radiography or magnetic resonance imaging.

The latter method has significant advantages, since it allows you to accurately assess the condition of intra- and periarticular soft tissues and does not have radiation exposure. Based on the tomography results, the degree of damage to the meniscus is determined (according to Stoller):

• 1 – focal changes that do not reach the surface layer.
• 2 – linear changes that do not reach the surface layer.
• 3 – changes reach the surface of the meniscus.

We can talk about a true break only in the latter case. In addition, the image clearly shows the dislocation of cartilaginous structures, changes in shape, and separation of one of the horns.

Acute pain is not something to joke about, just like all the symptoms described above. Seeing a doctor with a rupture of the posterior horn of the medial meniscus or other types of ruptures of the cartilage tissue of the knee is mandatory. It must be carried out in a short period of time.

At the medical institution, the victim will be examined and referred to:

1. X-ray, which is used when there are visible signs of rupture. It is considered not particularly effective and is used to exclude concomitant bone fractures.
2. Ultrasound diagnostics, the effect of which directly depends on the qualifications of the traumatologist.
3. MRI and CT, considered the most reliable way to determine a rupture.

Based on the results of the above examination methods, treatment tactics are selected.

Arthroscopy also makes it possible to carry out therapeutic manipulations under visual control after additional introduction of special microinstruments into the joint cavity.

Treatment

Treatment for a tear of the posterior horn of the medial meniscus (similarly to the anterior horn of the medial meniscus) depends on the site of the injury and its severity. Based on this, the method is determined - conservative or surgical treatment.

The conservative (therapeutic) method is applicable for small and moderate ruptures. This treatment is based on a number of therapeutic measures and is often effective.

The first step is to provide assistance in case of injury. To do this, it is necessary to provide the victim with peace; apply a cold compress to the inside of the knee; administer an anesthetic injection; apply a plaster bandage. If necessary, fluid should be punctured.

Typically, the conservative method involves long-term treatment for 6-12 months. First, the knee joint is reduced (repositioned) if there is a blockade. Manual methods can be used to remove the blockade. For the first 3 weeks, rest should be ensured, and the knee joint should be immobilized using a plaster splint.

When cartilage is damaged, it is necessary to restore and fuse it. For this purpose, a course of taking chondroprotectors and hyaluronic acid is prescribed.

The use of drugs containing chondroitin and glucosamine is recommended as protectors. Painful symptoms and inflammatory processes must be eliminated by taking non-steroidal anti-inflammatory drugs (diclofenac, ibuprofen, indomethacin) and others.

To eliminate swelling and accelerate healing, external agents in the form of ointments (amzan, voltaren, dollit and others) are used. The treatment process includes a course of physiotherapy and special therapeutic exercises. Therapeutic massage gives a good effect.

Treatment of meniscopathy of the knee joint is necessary in a comprehensive manner. Conservative and surgical methods are used.

Depending on the severity of the disease, the effect of the drugs used may be different. To achieve maximum results, you should follow all doctor's recommendations.

And first of all, it is necessary to reduce the load on the sore leg. You can wear an elastic bandage or a knee orthosis, but completely immobilizing the joint with a cast is fundamentally wrong - this will not improve its function, but will lead to contractures.

Degenerative-dystrophic changes in the menisci require persistent and intensive therapy, which can take quite a long time.

Drug therapy

Pathology of the knee joint, including damage to the menisci, requires the use of medications. Drugs are especially necessary for acute ruptures, but chronic processes cannot be effectively corrected without drugs.

With dystrophic changes, it is important to normalize biochemical processes in the body. To improve the condition of the meniscus and reduce symptoms, the following medications are used:

• Nonsteroidal anti-inflammatory drugs.
• Chondroprotectors.
• Metabolic.
• Vascular.
• Vitamins.

All medications must be taken according to the recommendations of a specialist. Self-medication is not allowed.

Physiotherapy

Physiotherapy is also used to restore the integrity of the meniscus. For this purpose, several procedures are used: electro- and phonophoresis, laser and wave treatment, magneto-, paraffin- and balneotherapy.

Which of them are indicated in each case will be determined by the doctor. But one should not expect a pronounced effect from the isolated use of physiotherapy - it is used only in combination with other methods.

Physiotherapy

Even with meniscus tears, physical therapy is indicated. It should include exercises aimed at strengthening the thigh muscles - the anterior and posterior groups. This allows you to stabilize the knee and eliminate its instability. But you should still be careful during exercise and avoid sudden movements, especially rotational ones.

Conservative measures are good for small tears, as well as for older people, who often show signs of osteoarthritis.

Operation

If the lesion of the internal or external meniscus reaches grade 3 according to Stoller, is of significant size and is accompanied by severe symptoms, as well as if previous therapy is ineffective, then there are all indications for surgical intervention. Only a doctor can determine when surgery should begin, but there is no point in delaying it.

The most common method of surgical treatment is arthroscopic surgery. This is a minimally invasive technology that can be used to perform a meniscectomy (partial removal), suture, transplant or meniscus replacement.

Knee pain can occur due to the development of degenerative processes and meniscal rupture. It is important to carry out timely treatment to restore damaged tissue. What is better to use - conservative therapy or surgery - is determined by the clinical situation.

Once an accurate diagnosis has been made, it is necessary to begin treatment in a hospital setting.

For minor ruptures, conservative treatment is necessary. The patient takes anti-inflammatory and painkillers, undergoes manual therapy and physical therapy.

Serious damage requires surgery. In this case, the torn meniscus must be sutured. If restoration is not possible, the meniscus should be removed and a menisectomy performed.

Recently, arthroscopy, which is an invasive technique, has become increasingly popular. It is important to note that arthroscopy is a low-traumatic method characterized by the absence of complications in the postoperative period.

After surgery, the patient must spend some time in the hospital under the supervision of a physician. Rehabilitation treatment must be prescribed to promote full recovery. Rehabilitation includes therapeutic exercises, taking antibiotics and drugs to prevent inflammatory processes.

If symptoms of the third degree of severity are obvious, you need to provide first aid and call an ambulance. Until the doctors arrive, the victim must not be allowed to move. To relieve pain and avoid severe swelling, apply ice.

When emergency technicians arrive, they will give you an injection of painkillers. After this, it will be possible, without torturing the victim, to apply a temporary splint.

This is necessary to immobilize the knee joint and prevent the damage from getting worse. It may be necessary to drain fluid and blood from the joint cavity. The procedure is quite painful, but necessary.

How to treat depends on the strength of the tear and location. The primary task of the doctor is to choose between conservative and surgical therapy.

Options

If the edges of the cartilage are torn and the flaps are blocking movement, surgery will be required. You also cannot do without it if the position of the bones relative to each other is disturbed, or the meniscus is crushed.

The surgeon can perform the following interventions:

• sew up cartilage flaps;
• remove the entire joint or posterior horn;
• secure parts of the cartilage with fixing parts made of bioinert materials;
• transplant this part of the joint;
• restore the shape and position of the knee joint.

To prevent the acute form from becoming chronic, it is necessary to begin treatment immediately. If treatment is started late, the tissue begins to suffer significant damage, turning into rags. Tissue destruction leads to cartilage degeneration, which in turn leads to knee arthrosis and immobility.

Stages of conservative treatment

The conservative method is used in the acute, unadvanced stage in the early stages of the disease. Therapy using conservative methods consists of several stages.

• Relieving inflammation, pain and swelling with non-steroidal anti-inflammatory drugs (NSAIDs).
• In cases of “jamming” of the knee joint, reposition is used, that is, realignment using manual therapy or traction.
• Physiotherapy.
• Massotherapy.
• Physiotherapy.

• Treatment with chondroprotectors.
• Joint treatment with hyaluronic acid.
• Treatment with folk remedies.
• Pain relief with analgesics.
• Applying plaster (as recommended by a doctor).

Stages of surgical treatment

The surgical method is used only in the most extreme cases, when, for example, the tissue is so damaged that it cannot be restored or if conservative methods have not helped.

Surgical methods for repairing torn cartilage consist of the following procedures:

• Arthrotomy – partial removal of damaged cartilage with extensive tissue damage;
• Meniscotomy – complete removal of cartilage tissue; Transplantation – moving the donor meniscus to the patient;
• Endoprosthetics – implantation of artificial cartilage into the knee;
• Stitching of damaged cartilage (carried out for minor damage);
• Arthroscopy – puncture of the knee in two places in order to carry out further manipulations with the cartilage (for example, suturing or endoprosthetics).

This type of injury, like any other, must be treated immediately after the injury.

Important! If left untreated for a long time, the rupture can become chronic.

If treatment is not undertaken in a timely manner, it can lead to the destruction of the cartilage of the knee joint, inflammation, changes in its structure and arthrosis. To avoid these troubles, you should immediately visit a doctor as soon as an injury occurs.

Conservative treatment method

A tear of the posterior horn of the medial meniscus of the knee is generally treated without surgery. With the exception of severe trauma requiring surgical assistance. Treatment takes place in several stages:

1. If there is a blockage of the joint, it must be removed. This is done using manual methods or with hardware traction of the joint.
2. Swelling is relieved with anti-inflammatory drugs (Diclofenac, Indomethacin).
3. Relieving pain with painkillers (Ibuprofen, Paracetamol).
4. After relieving pain and inflammation, it is necessary to begin physical therapy, physical therapy and massage.
5. The longest stage is the restoration of the cartilage that makes up the menisci. For this purpose, medications containing chondroitin sulfate and hyaluronic acid are prescribed.

These medications need to be taken for a long time; one course can last up to six months. They must be repeated annually to prevent deterioration of the cartilage.

In some cases, after traction of the joint, a cast is applied. This is done in order to provide the joint with rest and immobility for a certain time. But such a measure is not taken in all cases.

Surgical treatment methods

In the case when the above treatment method does not have the desired effect on the damaged part, they resort to surgical treatment. If the body of the meniscus itself is damaged, then most often it can be stitched.

There are several types of operations to treat damage to the horn of the meniscus, but some of them are currently performed extremely rarely, as they are considered ineffective or even harmful. These include, for example, arthrotomy. This is the removal of damaged cartilage tissue, which is performed by completely opening the knee.

Surgical methods for treating a torn meniscus of the knee joint are currently aimed at preserving or restoring it. They come in several types:

1. Partial meniscectomy. In this case, the edges of the meniscus at the site of the lesion are cut off and the remaining part is restored.
2. Arthroscopy. An operation that is performed through three punctures in the knee joint. The tools necessary for manipulation are introduced into one of them. The other receives saline solution and washes out unnecessary particles of cartilage, accumulated blood, etc. A camera is inserted into the third puncture, through which the surgeon can see everything that happens inside the knee, and thereby controls the entire process.
3. Transplantation. The patient receives a donor meniscus transplant.
4. Endoprosthetics. An artificial organ is inserted into the knee joint.

Whatever method the operation is performed, after it complete rest of the knee joint and protection from the effects of cold are necessary.

After an objective diagnosis has been carried out, determining the location and severity of the violation of the integrity of the cartilaginous structures of the joint, the doctor prescribes a comprehensive treatment. It includes several areas of action, which include conservative therapy, surgical intervention, and subsequent rehabilitation.

Mostly all activities complement each other and are assigned sequentially.
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Treatment without surgery

If partial damage to the posterior horn of the medial meniscus (grade 1 or 2) has been diagnosed, conservative treatment is possible. It includes the use of drugs of various pharmacological groups (non-steroidal anti-inflammatory drugs, vitamin preparations, chondroprotectors), the performance of physiotherapeutic procedures (electrophoresis, mud baths, ozokerite).

During therapeutic measures, functional rest for the knee joint must be ensured.
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Surgical intervention

The main purpose of the operation is to restore the anatomical integrity of the medial meniscus, which allows for the normal functional state of the knee joint in the future.

Surgery can be performed using an open approach or arthroscopy. Modern arthroscopic intervention is considered the technique of choice, since it is less traumatic and can significantly reduce the duration of the postoperative and rehabilitation period.

For small tears, non-surgical treatment is preferred. Puncture gives good results when blocking a joint - removing blood helps to “free” the joint and eliminate the blockage. Further treatment consists of undergoing a series of physiotherapeutic procedures: therapeutic exercises, electromyostimulation and massage.

Often, during conservative treatment, medications from the group of chondroprotectors are also prescribed. However, if there is serious damage to the posterior horn, then this measure will not be able to completely restore the meniscal tissue. In addition, the course of chondroprotectors often lasts more than one year, which extends the treatment over time.

For significant ruptures, surgical treatment may be prescribed. The most commonly used method is arthroscopic removal of part of the meniscus. Complete removal is not practiced, since in the absence of the meniscus the entire load falls on the knee cartilage, which leads to their rapid wear.

Surgical treatment

In case of injury to the meniscus, the following points are indications for surgical manipulation:

• severe injuries;
• when the cartilage is crushed and the tissue cannot be restored;
• severe injuries to the meniscal horns;
• tear of the posterior horn;
• articular cyst.

The following types of surgical procedures are performed in case of damage to the posterior horn of the shock-absorbing cartilaginous plate:

1. resection of torn elements or meniscus. This type of manipulation is performed with incomplete or complete tear;
2. restoration of destroyed tissues;
3. replacement of destroyed tissue with implants;
4. meniscus suturing. Such surgical intervention is carried out in case of fresh injury and immediate medical attention is sought.

Let's take a closer look at the types of surgical treatment for knee injuries.

Arthrotomy

The essence of arthrotomy comes down to complete resection of the damaged meniscus. This operation is performed in rare cases when the articular tissues, including blood vessels, are completely damaged and cannot be restored.

Modern surgeons and orthopedists have recognized this technique as ineffective and is practically not used anywhere.

Partial meniscectomy

When restoring the meniscus, the damaged edges are trimmed so that there is a smooth surface.

Endoprosthetics

A donor organ is transplanted to the site of the damaged meniscus. This type of surgical intervention is not performed often, because rejection of the donor material is possible.

Stitching damaged tissues

Surgical treatment of this type aims to restore destroyed cartilage tissue. This type of surgical intervention gives positive results if the injury has affected the thickest part of the meniscus, and there is a possibility of healing of the damaged surface.

Stitching is performed only for fresh damage.

Arthroscopy

Surgical intervention using arthroscopic techniques is considered the most modern and effective method of treatment. With all the advantages, trauma during the operation is practically eliminated.

To perform the operation, several small incisions are made in the articular cavity, through which the instruments are inserted along with the camera. During the intervention, saline solution is supplied through the incisions.

The arthroscopy technique is remarkable not only for its low traumatism during its implementation, but also because it is possible to simultaneously see the true condition of the injured limb. Arthroscopy is also used as one of the diagnostic methods when making a diagnosis after damage to the meniscus of the knee joint.

When thinking about surgery, people often worry about the wrong things and overlook important things. Reviews will help you figure out whether the operation is useful or not.

megan92 2 weeks ago

Tell me, how does anyone deal with joint pain? My knees hurt terribly ((I take painkillers, but I understand that I’m fighting the effect, not the cause... They don’t help at all!

Daria 2 weeks ago

I struggled with my painful joints for several years until I read this article by some Chinese doctor. And I forgot about “incurable” joints a long time ago. That's how things are

megan92 13 days ago

Daria 12 days ago

megan92, that’s what I wrote in my first comment) Well, I’ll duplicate it, it’s not difficult for me, catch it - link to professor's article.

Sonya 10 days ago

Isn't this a scam? Why do they sell on the Internet?

Yulek26 10 days ago

Sonya, what country do you live in?.. They sell it on the Internet because stores and pharmacies charge a brutal markup. In addition, payment is only after receipt, that is, they first looked, checked and only then paid. And now everything is sold on the Internet - from clothes to TVs, furniture and cars

Editor's response 10 days ago

Sonya, hello. This drug for the treatment of joints is indeed not sold through the pharmacy chain in order to avoid inflated prices. Currently you can only order from Official website. Be healthy!

Sonya 10 days ago

I apologize, I didn’t notice the information about cash on delivery at first. Then, it's OK! Everything is fine - for sure, if payment is made upon receipt. Thanks a lot!!))

Margo 8 days ago

Has anyone tried traditional methods of treating joints? Grandma doesn’t trust pills, the poor thing has been suffering from pain for many years...

Andrey A week ago

No matter what folk remedies I tried, nothing helped, it only got worse...