What is a meniscus? This is a kind of shock absorber, which is a cartilage gasket. Each meniscus, resembling a horseshoe in shape, consists directly of a body and horns (back and front) closing the “crescent”.
Where are these cartilage pads located? In those places that are experiencing increased stress, namely in such joints as:
- the knee, that is, between the femur and tibia (small and large) bones;
- sternoclavicular (meaning the joint of the arm with the chest);
- temporomandibular (connection of the base of the skull with the lower jaw);
- acromioclavicular (i.e. articulation of the articular surface of the clavicle with the scapular bone).
In the knee joint there are two cartilage pads connected by a transverse ligament:
- Medial (i.e., internal cartilage). It is associated with the lateral ligament of the knee joint located on the inside. The medial meniscus is slightly mobile.
- Lateral (i.e., external cartilage). It is wider and more mobile than the inner meniscus. As a result, his injury occurs much less frequently.
Menisci are crucial knee elements. They perform the function of load distribution and allow the body to be in a stable state. In the case of their degeneration, the patient experiences debilitating pain and instability during movement. Over time, a progressive illness can lead to the fact that the mobility of the lower limb will be completely lost.
What are degenerative changes in the medial meniscus? How to deal with them? Are there preventative measures for the disease? Let's get it right.
What are degenerative changes in the medial and lateral menisci
These are anatomical lesions that could occur due to:
- atypical joint structure;
- diseases
- injuries.
Moreover, it is the medial meniscus that is most often injured due to its rigid fixation and the impossibility of displacement in one direction or another without serious consequences for the knee joint. The horns of the inner cartilage are located quite close to the condyles (that is, the bulges, of which there are two on the tibia: medial and lateral), which creates a difficult situation in case of any displacement of the bone process. And as a result, either a meniscus rupture or its damage.
Pain syndrome aching in the knee, discomfort and stiffness in movement when the meniscus ruptures can be felt for many months or even years.
Degenerative changes in the medial meniscus are disorders observed in the structure of the organ that inevitably lead to the loss of its functionality (partial, and sometimes complete).
Types of meniscus lesions
There are several of them:
- The gap is either the body itself, or the back or front horns. With degenerative changes in the posterior horn of the medial meniscus, it is quite difficult for the patient to bend the knee, and if the anterior horn is impaired, to extend the knee joint.
- Separation of the meniscus (or part thereof) at the attachment site. This damage can completely block the operation of the knee joint.
- A rupture of the cruciate or lateral ligaments of the menisci, which is characterized by excessive mobility of the cartilage pads.
- The formation of a pathological cavity (i.e. cyst) in the body of the meniscus. It can develop for a long time completely asymptomatic.
- Changes of a degenerative-dystrophic nature that can develop after an injury (i.e., meniscopathy).
Degenerative changes in the posterior horn of the medial meniscus, anterior horn, or even the body itself can be diagnosed in people belonging to different age categories (even in children). The risk group includes primarily those whose professional activity involves active movements. These are dancers, ballet dancers and athletes. But other people should also take care of themselves.
Stages of the disease
Degenerative changes in the medial meniscus of the knee joint undergo several stages of their development:
- Sharp. Its duration depends on the causes that triggered the ailment.
- Chronic It is in this stage that the acute form can smoothly flow after 1.5-2 weeks. At this stage, the patient complains of pain, clicks and a crunch in the knee joint, which only intensify. In the area of the knee, the articular cushion can be palpated.
In this case, the patient is recommended bed rest, so as not to once again load the leg, injured.
Classification of damage to cartilage pads
There are 4 degrees of meniscus degeneration according to the classification introduced by American orthopedist Stephen Stoller into medical practice. Moreover, it is unlikely that it will be possible to accurately identify damage to the cartilage pads on the eye: this can only be done using MRI. So, the degrees of meniscus degeneration are as follows:
- 0 degree. No changes of a pathological nature are observed, that is, it is simply the norm.
- 1 degree. In this case, some focal pathologies are observed, but not reaching the edges of the cartilage pad. Degenerative changes in the medial meniscus of the 1st degree are characterized by minor damage to the cartilage tissue of the horn and can very often develop as a result of injuries received during movement along an inclined plane, squats with a load or jumping. The patient has a swelling of the knee joint, and he feels pain in it.
- 2 degree. There is a linear focus of damage to the cartilage pad. Degenerative changes in the medial meniscus of the 2nd degree are characterized by swelling of the tissues and pain, which only increase. In the knee bag, there is an accumulation of blood and a separation of the meniscus horn, parts of which fall into the joint cavity, thereby blocking the organ's motor function. 2nd degree involves operational activities.
- Grade 3 Damage reaches one of the edges of the meniscus, leading to its rupture.
Degenerative changes in the medial meniscus 2 tbsp. and 1 tbsp. - This is a borderline lesion, but grade 3 is a real meniscus tear. Do not bring your health situation to critical! Take care of yourself.
Possible causes of the development of the disease
The reasons for the development of degenerative changes in the medial meniscus can be:
- Diseases such as bone tuberculosis, gout, osteoarthrosis, syphilis, rheumatism and other pathologies in the presence of which joint damage occurs.
- Sprain.
- Physical activity in large volumes - whether it is work in the country on the arrangement of beds or just playing sports.
- Frequent knee injury.
- The presence of excess weight.
- Dysplasia (i.e. abnormal development) of the knee joint.
- Cartilage pad displacement.
- Flat feet (omission of the transverse or longitudinal arches of the foot). In this case, the load on the knee joint increases.
- Circulatory disorders in the limbs.
- The result of the natural aging of the body as a whole.
Symptoms of pathology
The main signs of degenerative changes in the medial meniscus:
- A pronounced inflammatory process (i.e., redness and swelling).
- Pain sensations of an acute and aching nature.
- Some limitation in movement.
- The presence of discomfort and instability in the knee joint.
- A feeling of having a foreign body in the knee.
- The appearance of a crunch and clicks during any attempt to straighten a leg, for example, when squatting or descending stairs.
- Decreased muscle tone in the thigh.
- Blockage of the knee joint at a certain position of the leg, for example, when bending.
Important! At the first signs of degenerative changes in the posterior horn of the medial meniscus, its body, the anterior horn of the outer cartilage, or all at once together, it is necessary to contact a medical institution for help.
Your actions for damage to the knee
First of all, you must immediately call "emergency care". The following should be done:
- We put the patient in bed, providing him with complete rest.
- We apply either a cold compress or something from the freezer wrapped in cotton cloth to the inner thigh surface.
- We give the patient painkillers.
Diagnostics
If the patient has an injury to the knee joint, which manifests itself quite clearly, then it is not difficult for a specialist to determine the pathology. If the damage is moderate and does not occur in an explicit form, then the diagnosis is complicated. In this case, the following types of instrumental studies are prescribed (based on signs of degenerative changes in the medial meniscus):
- MRI and CT, with which you can assess the severity of pathological changes in the knee joint. Three-dimensional image allows you to do this with a high degree of accuracy.
- Roentgenography. In the process of the study, a snapshot of the knee joint in two projections is obtained, which allows you to determine the stage of the pathology. The downside of radiography is that degeneration can be determined solely by indirect signs, that is, the method does not give an accurate picture of the pathological process.
- Ultrasound It features high information content and non-invasiveness. Using this method, you can observe almost all the elements of the knee joint. With ultrasound, the radiation load on the body is completely absent.
- Arthroscopy Using a special device (endoscope) inserted into the cavity of the knee joint through small incisions, the specialist determines the condition of the synovial (articular) fluid and tissues of the knee. Using a video camera, a specialist observes a picture of what is happening on the monitor.
On a note! The diagnostic procedure smoothly goes into a medical one, since in the process it eliminates the dangerous consequences of an injury, including tears or tears.
Treatment for degenerative changes
Treatment of degenerative changes in the medial meniscus depends on the causes of the joint damage and the existing disorders. It can be either conservative or surgical. But first of all, experts perform the following:
- In the case of blockage of the knee joint using manual therapy, the articulation is reduced.
- In the first 3-4 days after the injury, exudate - fluid is actively released into the joint bag. Specialists take this fluid (make a puncture) several times in order to reduce swelling and restore motor function. After the procedure, the joint cavity is washed with antiseptic agents.
- Often at the beginning of treatment (in order to reduce the load on the damaged cartilage pad), the knee joint is fixed using either a special orthopedic apparatus or a plaster cast.
Drug treatment should be comprehensive:
- Hormone therapy. The drugs of this group have an anti-inflammatory effect and are especially good for pathologies of a rheumatic nature (for example, "Hydrocortisone" or "Diprospan"). The best effect is achieved with the direct introduction of the drug into the joint cavity.
Important! We recommend taking medications of this group for a short period, since hormones have a devastating effect on cartilage.
- Painkillers. For example, for stopping inflammation or pain, drugs such as Ibuprofen, Don, Caver or Synarta give a good effect (they all belong to the group of non-steroidal drugs).
- Muscle relaxants. They are prescribed to reduce joint load and relieve muscle spasm (for example, "Midokalm").
- Chondroprotectors. Preparations such as Chondroitin, Glucosamine or hyaluronic acid contribute to the quickest recovery of meniscus function.
- A variety of ointments help fight swelling (for example, Voltaren, Dolgit, or Diclofenac).
Important! All drugs can only be prescribed by a doctor. Remember: self-medication is dangerous.
A good effect in the fight against the disease is given by physiotherapeutic methods:
- Electrophoresis Using this procedure, it is possible to cover the damaged surface with small particles of the drug, thereby ensuring their deep penetration into the tissue cells.
- Iontophoresis. This procedure, based on the process of ion migration under the influence of a small direct current, eliminates puffiness.
- Ultrasound Therapy
- UHF
- Shock wave therapy.
- Applications with mountain wax (ozokerite) or paraffin.
- Exercise therapy.
Do not forget about such a simple method as massage the damaged area of the knee.
Surgical measures are prescribed in case of cyst formation, multiple meniscus tears and necrosis. The following operations can be performed:
- Arthroscopy In this case, through two small (up to 1 cm) incisions, a special device called an arthroscope is introduced and the damage is removed. This surgery is referred to as minimally invasive surgery.
- Replacing a damaged meniscus with a prosthesis.
Important! All operations are carried out only after acute inflammation of the knee joint has been removed. The operated person should avoid any physical exertion.
In order for the treatment results to be positive, it is necessary to contact a medical institution for help in a timely manner. Moreover, it is necessary to tune in to long-term therapy, since it will take about 0.5-1 years to cope with degenerative-dystrophic changes in menisci.
Is rehabilitation needed
Of course, it is needed, especially after operational measures. What is rehabilitation aimed at:
- restoration of muscle tone of a damaged limb;
- normalization of blood circulation;
- reduction of pain;
- restoration of the functioning of the knee joint in full.
A set of exercises and the frequency of their implementation are developed for each patient individually, guided by the severity of the injury or the complexity of the pathology. Moreover, after surgery, exercise therapy begins 2 months after the operation, and with conservative treatment - 15-20 days after the injury.
Prevention
To avoid degenerative changes in the medial meniscus, you should follow simple precautions:
- Eat a balanced diet, exercise and constantly monitor body weight. Being overweight adversely affects the joints.
- To avoid trouble with the knee, it is better to fix it with an elastic bandage or special pads.
- Do not abruptly engage in physical work or sports: you must first warm up the muscles, kneading them and gradually increasing the load.
- More often undergo a general examination to identify pathologies that contribute to the development of degenerative changes in the cartilage pad, and begin their timely treatment.
- We recommend playing sports in comfortable shoes to reduce the risk of falling to zero.