The knee joint has a complex structure, its most important component is the meniscus. It performs the function of load distribution, therefore, it is most prone to traumatic injuries. What knee injuries can be distinguished? What are the features of the diagnosis and treatment of such injuries?
Anatomy
Before you consider the main damage, especially their diagnosis and treatment, you should familiarize yourself with the anatomy of the knee. The meniscus is a cartilage of a lunar shape, less often disk-shaped. This is an important part of the knee joint, since these formations have the function of shock absorption and load stabilization. Menisci glide over the surface of the tibia, which ensures optimal pressure distribution during movement. In total, there are two menisci in the knee joint, which are called medial and lateral. The meniscus itself consists of a body and horns - front and back. Injuries of the medial cartilage are more common, since it is characterized by low mobility due to attachment with the help of the inner lateral ligament of the meniscus. Lateral, in contrast to the medial, is very mobile and less likely to be traumatic.
Types of Knee Injuries
Meniscus damage is a very common injury, and many causes can lead to this. Knee injuries (meniscus is damaged especially often), according to traumatology, are more common in old age. What types of damage can be distinguished?
- Violation of the attachment of the meniscus - its separation. This phenomenon more often occurs in the anterior and posterior horn, less often in the body, in the paracapsular zone.
- Damage to the internal ligament, which is responsible for the static medial meniscus. Its rupture makes the knee cartilage too mobile. This is a predisposing factor to the attachment of additional injuries, as a result of which more severe combined damage may occur.
- The rupture of the horns and body of the meniscus, which often occurs in the transchordal region.
- Cysts, which can be single-chamber or multi-chamber, as well as one-sided and two-sided. These formations have an oval or round shape.
- A degenerative change in the meniscus, which can occur as a result of chronic trauma, as well as due to an abnormal structure or any systemic diseases. Most often, a fixed medial meniscus is prone to this, since the slightest traumatic movement can cause microtrauma (a person may not even notice it), followed by degenerative processes.
Etiology
The main cause of meniscus damage is trauma, which can occur as a result of a sharp extension of the joint, atypical rotational movements, as well as direct exposure (shock, fall). The most dangerous is chronic trauma, which in the initial stages may not cause any discomfort, and in the future become the cause of degenerative changes. Some systemic diseases can also lead to them, such as gout, chronic intoxication or rheumatism.
Symptoms
An acute period occurs immediately after damage to the knee joint. At this time, the patient is worried about intense pain, limiting the movement of the limb. In addition, blockade phenomena are possible - fixation of a limb in a certain position. Damage is accompanied by bleeding in the joint cavity, resulting in a characteristic edema in this area. Often, based on these symptoms, a diagnosis of “bruise” or “ligament rupture” is made. Conservative treatment temporarily alleviates the patient’s condition, but later on the trauma may again make itself felt.
The chronic period, which is the outcome of an acute lesion, is characterized by the resumption of pain. The cause of this phenomenon may be excessive load or sudden movement. The pain syndrome is not intense, it occurs only with pressure on the joint. Movements are limited, and in some cases periodic blockades are possible. In this period, accumulation of fluid in the cavity is possible, as well as muscle weakening.
A thorough diagnosis and proper treatment can prevent the transition of an acute period to a chronic one. At the first sign, you should consult a doctor.
The extent of meniscus damage
Gaps can be either complete or incomplete. The former are the most traumatic and dangerous, they require long-term treatment and recovery. Most often, the anterior horn or combined lesion of the antlers is susceptible to changes. Also, all injuries can be divided into two groups - with and without displacement. Again, the first require a longer rehabilitation.
Diagnostics
The diagnosis is made on the basis of complaints and data from special studies. Most often, patients are treated with knee flexion causing pain. In some cases, the pain syndrome worries even at rest. Soreness alone is not enough to draw up a treatment plan, more thorough diagnosis is needed. A medical history is necessarily accompanied by obtaining data to identify the cause of the injury. The patient is asked if there were fractures, dislocations and other injuries of the lower limb, and also identify the presence of systemic diseases that can cause degenerative changes in the cartilage.
One of the methods is the Epley diagnostic test, which is carried out in the position of the patient on the stomach. He is asked to bend the leg at the knee joint, the doctor at this time presses on the heel, and with the other hand makes accurate rotational movements of the lower leg and foot. A positive symptom is the occurrence of pain.
The most accurate examination is an x-ray, it should be carried out if there is pain and discomfort, as well as if the knee clicks. A more advanced method is x-ray using a contrast medium that is injected into the cavity of the knee joint (contrast arthro-roentgenography). This method allows you to track the slightest pathological changes in the meniscus and ligaments.
The first place in information content is occupied by MRI (magnetic resonance imaging), which allows layer-by-layer to study the condition of the joint.
Treatment
Diagnosis is followed by immediate treatment. What therapy is required for knee injuries? The meniscus is the most important element of the knee joint, which acts as a shock absorber. If it is damaged, specialists, if possible, carry out conservative treatment, which takes place only with minor injuries.
It is necessary to reduce the load on the knee joint, to provide it with relative peace, however, complete immobilization is not recommended. The application of gypsum in the joint area is fraught with the formation of contracture, as a result there is a risk that the function of the knee will not be fully restored. Complete immobilization is required only if there is a fracture of the bones of the lower limb or a rupture of the ligaments (combined damage). In addition to these activities is drug therapy. At the very beginning of treatment, analgesics are often required that will ease the pain syndrome. Chondroprotectors (glucosamine, chondroitin sulfate) are required. These drugs accelerate the synthesis of cartilage, and also affect the intraarticular fluid.
More severe injuries require surgical treatment. Among the indications for it can be distinguished:
- restriction of movement in the joint and clicks;
- severe pain syndrome;
- effusion in the joint cavity;
- significant ruptures of the meniscus;
- lack of effect from conservative treatment.
Adaptation
Complete recovery of the meniscus does not occur immediately. After conducting therapeutic measures, it is recommended to perform physical exercises and light massage. This will reduce the length of the adaptation period and eliminate the risk of contracture formation. Exercises should be performed regularly. The gymnastics complex should not contain sudden movements, charging should be carried out slowly and smoothly. Also during this period, heavy drinking and taking multivitamins is required, which has a beneficial effect on the processes of restoration of cartilage tissue.
Prevention
It is advisable to pay attention to preventive measures for people involved in sports. First of all, it is necessary to avoid sudden movements during running, squats and other exercises involving the knee joint. You should also pay attention to comfortable shoes, and when performing exercises, use fixing bandages on the knee joints. Such prevention will reduce the risk of injuries by several times.
Knee injuries (meniscus and other formations) require timely treatment. Diagnosis in the early stages will allow you to avoid complications and limit yourself to conservative therapy. Therefore, at the first signs of damage, you should consult a doctor, even if only a little discomfort worries. Modern methods will help to draw up a true picture of the disease and timely proceed with treatment.