Treatment of the meniscus is performed when it is damaged or torn. Most often this phenomenon occurs in people who overload their lower limbs for a long period of time. It is an occupational disease of athletes. It can also occur in other people as a result of its infringement, rupture or microtraumatic impact.
Concept
It is impossible to fully work the knee joint without a meniscus. Its treatment is mainly required for athletes who experience heavy loads on the lower limbs.
These formations are located between the femoral region and the lower leg in the knee joint tissue. They are crescent-shaped spacers between the joints. The menisci are designed to provide cushioning, preventing injury, making the knee joint less mobile. They can shrink and stretch.
The following types are distinguished:
- lateral;
- medial.
Or, easierspeaking, inner and outer. Most often, the first one with a cartilaginous structure is affected.
Most often the disease affects men aged 18-19 and 29-30 years. After 40 years, the treatment of the meniscus of the knee joint should be aimed at the regeneration of tendon tissues.
Reasons
The main ones requiring meniscus treatment are as follows:
- lower limb overload - most common among athletes, ballroom dancers and movers;
- the processes of dystrophy and degeneration during aging of the body - after 50 years, synovial cerebrospinal fluid is formed in smaller quantities, articular tissues become less elastic;
- presence of arthrosis and arthritis;
- other pathologies: diabetes mellitus, rheumatism, cancer, gout associated with impaired metabolism, blood supply and innervation;
- postoperative complications;
- re-injury;
- comorbidities of the musculoskeletal system;
- improper rotation of the joint;
- high jump, fall;
- heavy weight lifting;
- permanent vertical loads;
- blunt force.
Repeated knee and meniscus injuries lead to chronic meniscitis.
Chronic ailments such as cancer, hormonal imbalance, diabetes, rheumatism lead to a rupture of the knee meniscus. It can lead to repeated trauma to the rehabilitated limb, aggravated by a blow and a sharp turn.knee out or in.
Traumatization of the meniscus can be provoked by the following reasons:
- getting hit with a sharp object in their projection area;
- weak ligamentous apparatus;
- walking on your fingertips;
- unnatural knee rotation;
- increased load on him;
- sharp movements;
- overweight;
- forcing movements during extension.
Closer to the age of 30, internal drying of cartilage begins to occur, which progresses as a person ages. A breakdown can occur with a small load, which is unusual for the body.
The posterior horns of the meniscus are usually affected, subsequently spreading to the anterior parts and the 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 joint pinching and pain syndromes.
Types of injury
In traumatology, the following types of meniscus tears are distinguished:
- cystic degeneration, more common in outer lining;
- meniscopathy - appears as a result of chronic injury or degeneration;
- damage to the pericapsular and inner zones of the meniscus;
- tears in the back, front horns and the inside of the body;
- separation from attachment zone.
Meniscus tears can be:
- full;
- incomplete;
- longitudinal;
- transverse;
- patchwork;
- fragmented.
Damages can be without displacement and with such in relation to the torn off part.
Treatment of the meniscus of the knee joint in traumatology is required immediately. This type of injury accounts for about 40% of their total number. If the meniscus is damaged, the treatment consists in its rapid reduction. If this is not possible, an operation is assigned.
Signs
The symptoms and treatment of the meniscus are interrelated. The main signs of a traumatic rupture of this pad are as follows:
- hemarthrosis, resulting in intra-articular accumulation of blood;
- swelling due to the accumulation of intra-articular fluid, noted after a few days;
- blockade of the joint - observed when the cartilage changes its position, which prevents the normal course of movement of the joint;
- pain syndromes when moving - if the internal 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 with a load on the joint;
- on the 2-3rd day, there may be an increase in body temperature.
Injury associated with age-related changes, there are also accumulations of intra-articular fluid, inflammatory processes accompanied by swelling, pain, impaired motor ability, as well as degenerative dynamics of the structure.
The periods of damage to the considered lining are divided intoacute and chronic. The first begins immediately after the rupture of the meniscus. Treatment should be carried out immediately according to the results of the diagnosis. Pain is noted in the area of the knee joint, movements are limited.
The meniscus can be damaged without blocking the knee joint. In this case, the pain is not localized in a certain area at first, and only then is its concentration observed along the line of the joint space, after edema, hemarthrosis or joint fluid appears. Sometimes the diagnosis gives an incorrect result. But there are symptoms of the knee meniscus, and treatment is carried out. This contributes to the disappearance of pain, swelling, joint fluid, which may reappear after an awkward movement or minor injury.
Diagnosis
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 increases with knee extension and pressure on the joint space;
- Apli - carried out when the patient is in a prone position - there is pressure on the leg bent at the knee, namely on the foot with a turn;
- Landau - taking the “Turkish seat” pose leads to pain syndrome;
- Polyakova - discomfort occurs when lifting a he althy leg from a prone position, the body rises based on the heel of the injured limb or on the shoulder blades;
- McMurray - the pain increases with pressure on the inner zone of the joint space of the knee, which is in a half-bent state withsimultaneous extension and turning of the leg outward.
Also perform other tests.
First, the doctor asks about the symptoms, examines the knee joint. He should examine him for the presence of fluid and check the muscles for the presence of atrophy.
In addition, additional studies are scheduled:
- MRI;
- ultrasound;
- radiography.
Treatment
In the acute phase of the disease, when the joint is blocked, the treatment of the meniscus is performed under local anesthesia, eliminating the blockade. If there is any liquid, then the joint is punctured. A plaster cast is applied to the knee joint, which is in a bent state, for up to 3 weeks. Subsequently, physiotherapy and exercise therapy are prescribed.
If it is impossible to remove the blockade, their repeated occurrence, limiting movements in the joint in the chronic phase, an operation is prescribed in which they try to save the meniscus, since its removal contributes to faster wear of the joints and the development of osteoarthritis.
Ignoring the symptoms and treatment of meniscal injuries leads to degeneration of adjacent 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 syndromes by taking NSAIDs:
- "Indomethacin";
- "Diclofenac";
- Ketorolac;
- Ibuprofen and others.
In the presence of edema, intra-articular injections of corticosteroids are prescribed:
- "Dexamethasone";
- Prednisolone and others.
At the time of setting the plaster, painkillers and chondroprotectors are prescribed: "Chondroitin sulfate", "Chondroxide", which help restore damaged cartilage and meniscus. Antibiotics (Lincomycin) and vitamins C and B may also be taken.
Physiotherapy
With the help of ongoing procedures, they tone muscles, eliminate swelling, muscle atrophy, and reduce pain syndromes.
The main ones are as follows:
- UHF;
- aerotherapy;
- electromyostimulation;
- hydrotherapy;
- therapeutic massage;
- exposure to ultrasound;
- magnetotherapy.
Folk treatment
Compresses can be applied to a 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 cloth. It is applied for 2 hours daily for a month.
You can also apply fresh burdock leaves as a compress at night.
You can rub infusion of onion 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.
Against swelling and pain syndromes can be takenpine baths. To do this, boil 500 g of needles in 2 liters of water for half an hour, then filter and pour into warm water in the bathroom. This procedure is carried out every other day. Its duration is half an hour.
If the pain intensifies, do not bend or straighten your legs, for which the knee can be fixed with an elastic bandage.
Therapeutic exercise
In order to restore the meniscus without surgery, some exercise therapy exercises are performed:
- During rehabilitation, a rubber ball should be placed under the knee, which is squeezed for several minutes.
- They move on the mat 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. At the same time, its extension is carried out only to the required level.
The advantages of the method include the following:
- epidermis under the tape breathes;
- knee not completely immobilized;
- load mainly falls on teip;
- use period 3-7 days;
- helps accelerate joint recovery.
Rules for taping:
- the skin is cleansed, degreased, hairline is removed in the area of this procedure;
- the tape during treatment is fixed from the distally located area to the proximal localized area, while prevention - vice versa;
- strength of application is determined by the doctor;
- better fixation is achieved by wiping the tapehand;
- with proper application after 40-45 minutes, you can start physical education or be in the shower;
- in case of severe stiffness of the knee or its compression, the tape is removed and the procedure is repeated, taking into account errors;
- nerves and vessels during fixation should not be pinched, and folds should not appear;
- in case of cyanosis, pallor, discomfort, the tension of the tape is reduced or removed by consulting a doctor.
Surgery
Surgery for the treatment of ruptures of the knee meniscus, as well as its crushing, displacement, tearing of ligaments, body and horns, profuse hemorrhage.
The most effective arthroscopy. In this case, restoration is carried out with partial or complete removal and, if necessary, transplantation of the meniscus.
Also, the operation is performed using an endoscope.
Rejections of donor or artificial organs in this case are rare.
After the operation, drug treatment is prescribed according to the principles indicated above.
Rehabilitation time depends on the presence of concomitant pathologies, immunity and age of the patient. It can be 4-6 months.
In closing
Meniscus treatment aims to reduce pain, restore cartilage and remove fluids. For mild injuries, drug therapy with NSAIDs, chondroprotectors, and gypsum can be used. In addition, physiotherapeuticprocedures, treatment with folk remedies, taping. The recovery process takes a long time. If tears are observed, then the meniscus is treated with surgery. If you do not see a doctor in time, contracture, ankylosis of the joints may form, which can only be eliminated by prosthetics.
