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 susceptible to traumatic lesions. What knee injuries can be distinguished? What are the features of the diagnosis and treatment of such injuries?
Anatomy
Before considering the main injuries, the features of their diagnosis and treatment, you should familiarize yourself with the anatomy of the knee. The meniscus is a semi-lunar cartilage, rarely disc-shaped. This is an important part of the knee joint, since these formations have the function of shock absorption and load stabilization. The menisci slide over the surface of the tibia, which ensures optimal distribution of pressure 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 - anterior and posterior. Injuries to the medial cartilage are more common, as it is characterized by low mobility due to fastening with the help of the internal lateral ligament of the meniscus. The lateral, in contrast to the medial, is very mobile and is less likely to be subjected to traumaticexposed.
Types of knee injuries
Injury to the meniscus is a very common injury, and there can be many reasons for this. Knee injuries (the meniscus is damaged especially often), according to traumatology, are more common in old age. What types of damage can be identified?
- Violation of the attachment of the meniscus - its separation. This phenomenon occurs more often in the region of the anterior and posterior horns, less often in the region of the body, in the paracapsular zone.
- Injury 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 for the attachment of additional injuries, resulting in a more severe combined injury.
- Rupture of the horns and body of the meniscus, which occurs more often in the transchordal region.
- Cysts, which can be single-chamber or multi-chamber, as well as unilateral and bilateral. These formations are oval or round in shape.
- Degenerative change in the meniscus, which can occur due to chronic trauma, as well as due to an abnormal structure or any systemic diseases. Most often, a fixed medial meniscus is subject to this, since the slightest traumatic movement can cause microtrauma (a person may not even notice it), after which degenerative processes begin.
Etiology
Main cause of meniscus injury- an injury that can occur due to a sharp extension of the joint, atypical rotational movements, as well as direct impact (hit, fall). The most dangerous is chronic trauma, which at the initial stages may not cause any discomfort, and in the future become the cause of degenerative changes. Some systemic diseases, such as gout, chronic intoxication or rheumatism, can also lead to them.
Symptoms
Acute period occurs immediately after damage to the knee joint. At this time, the patient is worried about an intense pain syndrome that limits the movement of the limb. In addition, blockade phenomena are possible - fixing the limb in a certain position. Damage is accompanied by bleeding into the joint cavity, resulting in a characteristic edema in this area. Often, on the basis of these symptoms, a diagnosis of "bruise" or "rupture of ligaments" is made. Conservative treatment temporarily relieves the patient's condition, but in the future, the injury 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. During this period, accumulation of fluid in the cavity is possible, as well as weakening of the muscles.
Prevent transitionacute period in the chronic can be a thorough diagnosis and proper treatment. Seek medical attention at the first sign.
Degrees of meniscus damage
Breaks can be either complete or incomplete. The former are the most traumatic and dangerous, they require long-term treatment and recovery. The anterior horn or combined lesions of the horns are most often affected. Also, all injuries can be divided into two groups - with and without displacement. Again, the former require longer rehabilitation.
Diagnosis
The diagnosis is made on the basis of complaints and data from special studies. Most often, patients complain that bending the knee causes pain. In some cases, the pain syndrome bothers even at rest. Soreness alone is not enough to draw up a treatment plan, a more thorough diagnosis is needed. The collection of anamnesis is necessarily accompanied by the receipt of 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 the presence of systemic diseases that can cause degenerative changes in the cartilage.
One of the methods is the Epley diagnostic test, which is performed with the patient in the prone position. He is asked to bend his 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. Pain is a positive symptom.
The most accurate examination is an X-ray, it shouldit is necessary to carry out if there is pain and discomfort, as well as if the knee clicks. A more advanced method is an x-ray using a contrast agent, which is injected into the cavity of the knee joint (contrast arthroroentgenography). This method allows you to track the slightest pathological changes in the meniscus and ligaments.
The first place in terms of information content is occupied by MRI (magnetic resonance imaging), which allows you to study the state of the joint in layers.
Treatment
Diagnosis followed by prompt 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, but complete immobilization is not recommended. The imposition of plaster 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 rupture of the ligaments (combined injury). In addition to these activities is drug therapy. At the very beginning of treatment, analgesics are often required to relieve pain. It is mandatory to take chondroprotectors (glucosamine, chondroitin sulfate). These drugs accelerate the synthesis of cartilage tissue, and also affect intraarticularliquid.
More severe injuries require surgical treatment. Among the indications for it are:
- limitation of movement in the joint and clicks;
- expressed pain syndrome;
- effusion in the joint cavity;
- significant meniscus tears;
- lack of effect from conservative treatment.
Adaptation
Full recovery of the meniscus does not occur immediately. After carrying out therapeutic measures, it is recommended to perform physical exercises and light massage. This will reduce the duration of the adaptation period and eliminate the risk of contracture formation. Exercise should be done regularly. The gymnastics complex should not contain sudden movements, exercises should be carried out slowly and smoothly. Also during this period, drinking plenty of water and taking multivitamins is required, which has a beneficial effect on the processes of cartilage tissue restoration.
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 when running, squatting and other exercises involving the knee joint. You should also pay attention to comfortable shoes, and when doing exercises, use fixing bandages on the knee joints. Such prevention will reduce the risk of injury several times.
Injuries of the knee (meniscus and other formations) require timely treatment. Early diagnosis can help avoidcomplications and limited to conservative therapy. Therefore, at the first sign of damage, you should consult a doctor, even if you are only concerned about slight discomfort. Modern methods will help to make a correct picture of the disease and start treatment in a timely manner.
