Meniscus is treated if it is damaged or ruptured. Most often this phenomenon occurs in people overloading their lower limbs for a long period of time. It is a professional ailment of athletes. It can also occur in other people as a result of its infringement, rupture or microtraumatic impact.
The concept
The full work of the knee joint without a meniscus is impossible. Its treatment is mainly required for athletes who experience large loads on the lower extremities.
These formations are located between the femoral region and the lower leg in the knee joint tissue. They are gaskets between the joints of a half-month shape. The menisci are designed to cushion, avoiding injury, making the knee joint less mobile. They can contract and stretch.
The following types are distinguished:
Or, more simply, internal and external. Most often, the first with a cartilaginous structure is affected.
Most often the disease affects men aged 18-19 and 29-30 years. After 40 years, treatment of the meniscus of the knee joint should be directed to the regeneration of tendon tissues.
Causes
The main ones requiring meniscus treatment are the following:
- overload of the lower extremities - most typical for athletes, ballroom dancers and movers;
- processes of dystrophy and degeneration during the aging of the body - after 50 years, synovial cerebrospinal fluid forms in smaller quantities, articular tissues become less elastic;
- the presence of arthrosis and arthritis;
- other pathologies: diabetes mellitus, rheumatism, cancer, gout associated with impaired metabolism, blood supply and innervation;
- postoperative complications;
- repeated injuries;
- concomitant diseases of the musculoskeletal system;
- improper rotation of the joint;
- high jumps and from it, fall;
- sharp lifting weights;
- constant loads in the vertical plane;
- hit with a blunt object.
Repeated injuries of the knee joint and meniscus lead to the development of chronic meniscitis.
Chronic ailments such as cancer, hormonal imbalance, diabetes mellitus, rheumatism lead to rupture of the knee meniscus. Repeated injury of a rehabilitated limb, aggravated by a blow and a sharp turn of the knee out or in, can lead to it.
The following causes can cause trauma to the meniscus:
- its receipt with a sharp object in their projection zone;
- weak ligamentous apparatus;
- walking at your fingertips;
- unnatural rotation of the knee;
- increased load on it;
- sudden movements;
- overweight;
- forcing movements during extension.
Closer to the age of 30, internal drying of the cartilage begins, which progresses as a person ages. Disruption can occur with a small load, which is unusual for the body.
The horn of the meniscus is usually affected, subsequently it spreads to the front parts and body. With a horizontal crack affecting the lower and upper segments, joint blocking does not occur. Radial and vertical lesions displace the meniscus, which can cause pinching of the joint and the appearance of pain syndromes.
Types of injuries
In traumatology, the following types of meniscus tears are distinguished:
- cystic degeneration, more characteristic of the external lining;
- meniscopathy - appears as a result of chronic trauma or degeneration;
- damage to the pericapsular and internal areas of the meniscus;
- ruptures of the back, front horns and the internal part of the body;
- separation from the zone of attachment.
Meniscus tears can be:
- full;
- incomplete;
- longitudinal;
- transverse;
- flap-like;
- fragmented.
Damage can be without displacement and with that in relation to the torn part.
Treatment of the meniscus of the knee in traumatology requires immediate treatment. This type of injury accounts for about 40% of their total number. If the meniscus is damaged, the treatment consists in its quick reduction. If it is impossible to carry out this operation is assigned.
Signs
Symptoms and treatment of meniscus are interconnected. The main signs of a traumatic rupture of this gasket are as follows:
- hemarthrosis, as a result of which there is an intraarticular accumulation of blood;
- swelling due to accumulation of intraarticular fluid, is noted after a few days;
- joint blockage - observed when the cartilage changes its position, which prevents the normal course of movement of the joint;
- pain during movement - if the inner meniscus is torn, it becomes difficult to move up the stairs;
- severe pain after an injury with a specific click, over time they subside and manifest themselves when the load on the joint;
- on the 2-3rd day, an increase in body temperature may be noted.
In case of injuries associated with age-related changes, accumulations of intraarticular fluid, inflammatory processes accompanied by swelling, pain, impaired motor ability, as well as degenerative dynamics of the structure are also noted.
Damage periods of the lining in question are divided into acute and chronic. The first begins immediately after a meniscus rupture. Treatment should be carried out immediately according to the results of diagnosis. In the area of the knee joint, pain is noted, movements are limited.
The meniscus can be damaged without blocking the knee joint. In this case, the pain is not initially localized in a certain area, and only then is its concentration observed along the joint gap, after edema, hemarthrosis or joint fluid appears. Sometimes the diagnosis gives the wrong result. But there are symptoms of a knee meniscus, and treatment is ongoing. This contributes to the disappearance of pain, swelling, joint fluid, which can again appear after an awkward movement or minor injury.
Diagnostics
Before treating a damaged meniscus, it is necessary to identify the characteristic signs of this damage or rupture. To do this, the doctor conducts provocative tests:
- Baykova - the pain intensifies with extension of the knee and pressure on the joint space;
- Apley - is carried out while the patient is lying down - there is pressure on the leg bent at the knee, namely on the foot with a turn;
- Landau - the adoption of the pose "seat in Turkish" leads to the appearance of pain;
- Polyakova - discomfort occurs when lifting a healthy leg from a prone position, the body rises with support on the heel of the damaged limb or on the shoulder blades;
- McMurray - the pain intensifies with pressure on the inner zone of the joint space of the knee, which is in a bent state with simultaneous extension and unfolding of the leg outward.
Other tests are also performed.
First, the doctor asks about the available symptoms, examines the knee joint. He should examine him for the presence of fluid and check his muscles for the presence of atrophy.
In addition, additional studies are prescribed:
- MRI
- Ultrasound
- radiography.
Treatment
In the acute phase of an ailment when the joint is blocked, meniscus treatment is performed under local anesthesia, eliminating the blockade. If there is any fluid, then the joint is punctured. In a bent knee, a gypsum lagoon is applied for up to 3 weeks. Subsequently, physiotherapy and exercise therapy are prescribed.
If it is impossible to remove the blockade, the occurrence of their repeated, limiting movements in the joint in the chronic phase, an operation is prescribed in which the meniscus is tried to be saved, since its removal contributes to faster wear of the joints and the development of osteoarthritis.
Ignoring the symptoms and treating meniscus lesions leads to degeneration of neighboring cartilage, destruction of tissue, both cartilage and bone. If they are not cured, arthrosis occurs, leading to disability.
Drug therapy
It is mainly aimed at reducing pain by taking NSAIDs:
- "Indomethacin";
- Diclofenac
- "Ketorolac";
- Ibuprofen and others.
In the presence of edema, intraarticular injections of corticosteroids are prescribed:
- "Dexamethasone";
- "Prednisolone" and others.
At the time of setting the gypsum, painkillers and chondroprotectors are prescribed: “Chondroitin sulfate”, “Chondroxide”, which contribute to the restoration of damaged cartilage and meniscus. Antibiotics (Linkomycin) and vitamins C and group B may also be taken.
Physiotherapy
With the help of ongoing procedures, they tone the muscles, eliminate puffiness, muscle atrophy, and reduce pain syndromes.
The main ones are the following:
- UHF;
- aerotherapy;
- electromyostimulation;
- hydrotherapy;
- massotherapy;
- exposure to ultrasound;
- magnetotherapy.
Alternative treatment
Compresses can be applied to the sore knee. They are made from honey and alcohol in a ratio of 1: 1. The mass is melted, distributed over the knee, covered with cellophane and fabric. It is applied for 2 hours daily for a month.
Also in the form of a compress for the night you can apply fresh leaves of burdock.
You can rub the infusion of onions and garlic. It is prepared by grinding 2 heads of these vegetables, then pour them with 500 ml of 6% apple cider vinegar and insist for a week. After that, they are rubbed into the knee with massage movements for 10 minutes 2 times a day.
Coniferous baths can be taken against edema and pain syndromes . To do this, 500 g of needles are boiled in 2 liters of water for half an hour, after which they are filtered and poured into warm water in the bathroom. This procedure is carried out every other day. Its duration is half an hour.
If the pain intensifies, you need not to bend or straighten your legs, for which the knee can be fixed with an elastic bandage.
Physiotherapy
In order to restore the meniscus without surgery, perform some exercise therapy:
- During rehabilitation, a rubber ball must be placed under the knee, which is squeezed for several minutes.
- On the mat they move on their knees, resting on their hands. This exercise should be performed even in the presence of pain syndromes.
Taping
It allows you to reduce pressure on the knee joint. Moreover, its extension is carried out only to the required level.
The advantages of the method include the following:
- epidermis breathes under teip;
- the knee does not become completely immobilized;
- the load is mainly due to teip;
- period of use - 3-7 days;
- Helps accelerate joint recovery.
Rules for taping:
- the skin is cleaned, degreased, the hairline in the area of this procedure is removed;
- teip during treatment is fixed from a distally located area to a proximal localized area, with prevention, on the contrary;
- the strength of the overlay is determined by the doctor;
- better fixation is achieved by wiping the teip with a hand;
- with proper application after 40-45 minutes, you can start physical education classes or be in the shower;
- with severe stiffness of the knee or its tightness, the teip is removed and a repeated procedure is carried out taking into account errors;
- nerves and blood vessels during fixation should not be squeezed, nor folds should appear;
- with cyanosis, pallor, the appearance of discomfort, the tension of the teip is reduced or removed, in consultation with the doctor.
Surgical intervention
The operation is in the treatment of ruptures of the knee meniscus, as well as with its crushing, displacements, tearing of ligaments, body and horns, and profuse hemorrhage.
The most effective arthroscopy. In this case, restoration is carried out with partial or complete removal and, if necessary, meniscus transplantation.
Also, the operation is carried out using an endoscope.
Rejection of donor or artificial organs in this case is rare.
After the operation, medication is prescribed according to the principles indicated above.
The rehabilitation time depends on the presence of concomitant pathologies, immunity and the age of the patient. It can be 4-6 months.
Finally
Meniscus treatment is aimed at reducing pain syndromes, restoring cartilage and removing fluids. For minor injuries , drug therapy with NSAIDs, chondroprotectors, and the application of gypsum can be used. In addition, physiotherapeutic procedures, treatment with folk remedies, taping are used. The recovery process takes a long time. If tears are observed, then the meniscus is treated with surgery. With untimely access to a doctor, contracture, joint ankylosis can form, which is eliminated only by prosthetics.