Longitudinal rupture of the posterior horn of the medial meniscus. What methods are used to treat damage to the posterior horn of the medial meniscus? Synovitis due to trauma to the medial meniscus

Knee pain is a common reason for seeking medical attention. They can occur due to various pathologies, including damage to the menisci - special cartilage plates located between the articular surfaces. Their main task is to cushion and stabilize the joint. And in conditions of significant loads that the knee has to experience, this is extremely important.

The pathology of the menisci is more often traumatic in nature, manifesting itself either as an isolated injury or in combination with ruptures of the ligamentous apparatus. This is more typical for young people who are actively involved in sports. After 40 years, cases of degenerative changes predominate, which lead to a rupture of the menisci. It is possible to eliminate such problems of the knee joint after finding out their origin, clinical manifestations and severity.

The reasons

Degenerative-dystrophic processes do not develop in a healthy organism. This must be preceded by violations at various levels: local and general. They have a clear relationship, which distinguishes the development of pathology from traumatic injuries, when only a mechanical effect on the knee joint is sufficient. Undoubtedly, injuries and prolonged excessive stress on the joints are the key points in the formation of degenerative changes, but there are other conditions that contribute to such processes:

Dysplasia of the knee.
Obesity.
Gout.
Rheumatoid arthritis.
Rheumatism.
Osteoarthritis.
Infectious diseases (tuberculosis, brucellosis, yersiniosis).
Connective tissue diseases (lupus erythematosus, scleroderma).
Endocrine pathology (hypothyroidism).
Systemic vasculitis.

Dystrophic processes in the knee joint are largely due to metabolic, immune, endocrine and vascular disorders, which can occur in conjunction with age-related changes that inevitably appear after 50 years.

Degenerative changes in the menisci develop due to many reasons. In most cases, there is a combined effect of adverse factors.

Symptoms

Damage of a degenerative-dystrophic nature - meniscopathy - does not occur suddenly. It takes time for the initiation and progression of pathological processes in the knee joint. The following symptoms may appear first:

Feeling of fatigue in the joint.
Crunching, rubbing and clicking in the knee.
Periodic pain after intense exercise.

Over time, pathological changes appear not only in the menisci, but also in the adjacent articular surfaces, ligaments. Tissues become less durable, which contributes to their damage. As a result, ruptures of cartilage shock-absorbing pads can occur even without previous trauma - just an awkward movement, squatting or simply bending the leg is enough. In this case, the symptoms worsen, the following signs become characteristic:

Swelling and redness in the joint space.
Restriction of movements.
Knee instability.
Blocking (jamming) of the joint.

But most often, chronic damage, which is dystrophic in nature, occurs with the only symptom - pain, only occasionally manifesting itself as blocking the joint. The severity of symptoms varies from minimal to very strong, when it is impossible to even stand on one leg or make any movements. Unpleasant sensations can disturb only when going down the stairs or during squats. It depends on the degree of damage and what structures are involved. The concomitant pathology of the knee joint also plays a role: fractures of the condyles, torn ligaments, osteoarthritis.

According to their localization, the breaks can be located in the following zones:

The body of the meniscus: internal (medial) or external (lateral).
Anterior horn of the lateral meniscus.
Posterior horn of the inner meniscus.
Combined damage.

More often you can meet ruptures of the outer meniscus, because it has more mobility than the inner one. The latter is more often torn when combined with damage to the anterior cruciate ligament. Degenerative changes in the posterior horn of the medial meniscus are accompanied by less intense symptoms, signs of wedging are often absent. The anterior horn comes off much less frequently.

If the lesion affects the vascular zone, then the development of hemarthrosis (accumulation of blood) is likely. The joint swells significantly, which can be seen from the change in the shape of the patella zone. Palpation is characterized by pain in the joint space that occurs during tests with passive flexion and extension of the knee.

A lesion of the internal or external meniscus can be suspected clinically, but additional methods help confirm the diagnosis.

Diagnostics

To make a final conclusion about meniscopathy, it is necessary to conduct an imaging examination. This includes x-rays or magnetic resonance imaging. The latter method has significant advantages, since it allows you to accurately assess the state of intra- and periarticular soft tissues, and does not have radiation exposure. According to the results of tomography, the degree of damage to the meniscus is determined (according to Stoller):

1 - focal changes that do not reach the surface layer.
2 - linear changes that do not reach the surface layer.
3 - changes reach the surface of the meniscus.

One can speak of a true break only in the latter case. In addition, the picture clearly shows the dislocation of cartilaginous structures, a change in shape, and the detachment of one of the horns.

Treatment

It is necessary to treat meniscopathy of the knee joint in a complex manner. Apply conservative and operative methods. Depending on the severity of the disease, the effect of the drugs used may be different. To achieve maximum results, you should follow all the recommendations of the doctor. And first of all, it is necessary to reduce the load on the sore leg. You can wear an elastic bandage or a knee brace, but completely immobilizing the joint with a cast is fundamentally wrong - this will not improve its function, but will lead to contractures.

Degenerative-dystrophic changes in the menisci require persistent and intensive therapy, which can take quite a long time.

Medical therapy

The pathology of the knee joint, including meniscal damage, requires the use of medications. Drugs are especially needed for acute ruptures, but chronic processes cannot be effectively corrected without drugs. With dystrophic changes, it is important to normalize the biochemical processes in the body. To improve the condition of the meniscus and reduce symptoms, use the following medicines:

Non-steroidal anti-inflammatory.
Chondroprotectors.
metabolic.
Vascular.
Vitamins.

All drugs should be taken according to the recommendations of a specialist. Self-medication is not allowed.

They also use the possibilities of physiotherapy to restore the integrity of the meniscus. For this purpose, some procedures are used: electro- and phonophoresis, laser and wave treatment, magnetic, paraffin and balneotherapy. Which of them are indicated in each case, the doctor will determine. But a pronounced effect from the isolated use of physiotherapy should not be expected - it is used only in combination with other methods.

Physiotherapy

Even with meniscus ruptures, exercise therapy is indicated. It should include exercises aimed at strengthening the thigh muscles - the anterior and posterior groups. This allows you to stabilize the knee and eliminate its instability. But still, you should be careful during classes, exclude sudden movements, especially rotational ones.

Conservative measures are good for small tears, as well as for the elderly, who often have signs of osteoarthritis.

Operation

If the damage to the internal or external meniscus reaches 3 degrees according to Stoller, they are of considerable size and are accompanied by severe symptoms, as well as with the ineffectiveness of previous therapy, that is, all indications for surgical intervention. Only a doctor can determine when the operation should begin, but you should not hesitate with this.

The most common surgical treatment is arthroscopic surgery. This is a minimally invasive technology that can be used to perform a meniscectomy (partial removal), suture, transplant or meniscus arthroplasty.

Pain in the knee may appear due to the development of degenerative processes and rupture of the meniscus. It is important to carry out treatment in a timely manner in order to restore damaged tissues. What is better to use - conservative therapy or surgery - is determined by the clinical situation.

The pathology of the musculoskeletal system includes a rupture of the posterior horn of the medial meniscus. This injury is the result of an indirect injury to the lower extremity. The human knee joint is very complex. Each of them has 2 menisci. They are made up of cartilage. They consist of a body, back and front horns. Menisci are essential for cushioning, limiting range of motion, and matching bone surfaces.

Types of breaks

A rupture of the posterior horn of the medial meniscus is a type of closed joint injury. This pathology is most often found in adults. In children, this injury is rare. Women suffer from this disease 2 times more often than men. The rupture is often combined with damage to the cruciate ligament of the knee.

This is the most common joint injury. Complex rupture is diagnosed mainly in people from 18 to 40 years old. This is due to an active lifestyle. Sometimes there is a combined damage to both menisci.

The relevance of this problem is due to the fact that such an injury often requires surgical intervention and a long recovery period.

After surgical treatment, patients move on crutches. Distinguish between complete and incomplete tissue rupture. The following options for rupture of the medial meniscus are known:

longitudinal;
vertical;
patchwork oblique;
radial transverse;
horizontal;
degenerative with crushing of tissues;
isolated;
combined.

An isolated rupture of the posterior kind is diagnosed in 30% of all cases of this injury.

Causes of damage

The development of this pathology is based on a strong extension of the lower leg or its sharp turn outward. The longitudinal gap is due to several reasons. The main etiological factors are:

falling on a hard surface;
bruises;
traffic accidents;
blows;
degenerative processes against the background of gout and rheumatism;
stretching;
microtrauma.

Rupture of the posterior horn of the meniscus is most often caused by indirect and combined trauma. This usually happens in winter in ice. Failure to take precautions, haste, drunkenness and fighting all contribute to injury. Often, rupture occurs with fixed extension of the joint. Athletes face the same problem. The risk group includes football players, figure skaters, gymnasts and hockey players.

Permanent damage causes meniscopathy. Subsequently, with sharp turns, a gap occurs. Separately, degenerative damage is highlighted. It occurs mainly in elderly people with repeated microtraumas. The reason may be intense exercise during training or careless work. Degenerative horizontal rupture of the posterior horn of the medial meniscus often occurs against the background of rheumatism.

It is facilitated by previously transferred angina and scarlet fever. At the heart of damage to the menisci on the background of rheumatism is a violation of the blood supply to tissues with edema and other pathological changes. The fibers become less elastic and strong. They are not able to withstand a large load.

Less commonly, the cause of the rupture is gout. Traumatization of tissues by uric acid crystals occurs. Collagen fibers become thinner and less durable.

How does the gap manifest?

If there is damage to the posterior horn of the medial meniscus, then the following symptoms are possible:

pain in the knee area;
restriction of movements;
crackling while walking.

In the acute period, reactive inflammation develops. The intensity of the pain syndrome is determined by the degree of rupture. If it is incomplete, then the symptoms are mild. Clinical signs persist for 2-4 weeks. Flap rupture of moderate severity is characterized by acute pain and limited extension of the limb in the knee.

The sick person can walk. If proper treatment is not carried out, then this pathology becomes chronic. Severe pain in combination with tissue edema is characteristic of a severe rupture. In such people, small blood vessels in the knee area can be damaged. Hemarthrosis develops. Blood accumulates in the cavity of the knee joint.

Supporting the leg is difficult. In severe cases, the local temperature rises. The skin takes on a bluish tint. The knee joint becomes spherical. After 2-3 weeks from the moment of injury, a subacute period develops. It is characterized by localized pain, effusion, and blockages. Specific symptoms of Roche, Baykov and Steiman-Bragard are typical. With the degenerative form of this pathology of the meniscus, complaints can appear only during work.

Patient examination plan

It is necessary to treat a linear rupture after clarifying the diagnosis. The following research will be required:

general clinical tests;
CT or MRI;
radiography;
arthroscopy.

Differential diagnosis is carried out in the following cases:

Koenig's disease;
arthritis of various etiologies;
gonarthrosis;
Hoff's disease;
softening of cartilage tissue;
osteoporosis.

If the posterior horn of the meniscus is damaged, treatment begins after assessing the condition of the joint tissues. Magnetic resonance imaging is very informative. Its advantage is the absence of radiation exposure. According to the indications, arthroscopy is performed. This is an endoscopic method of research. Examination of the knee can be carried out for both therapeutic and diagnostic purposes. Arthroscopy can be used to visually assess the condition of the knee joint. Before the procedure it is necessary to pass a number of tests. The study can be carried out on an outpatient basis.

Medical tactics

Partial damage to the meniscus requires conservative therapy. The main aspects of treatment are:

plaster overlay;
the use of painkillers;
puncture of the knee joint;
keeping calm;
setting cold compresses;
physiotherapy;
massage;
physiotherapy.

If the cause was degenerative-dystrophic processes, then chondroprotectors are prescribed. These are drugs that strengthen the cartilage of the joints. They contain chondroitin sulfate and glucosamine. Chondroprotectors include Artra, Teraflex, Dona and Chondrogard. To eliminate the pain syndrome, NSAIDs are prescribed (Ibuprofen, Movalis, Diclofenac Retard). These medicines are taken orally and applied to the skin around the joint.

External means are used after removal of the plaster. Patients need to observe motor rest. To accelerate the healing of the medial meniscus, physiotherapy is performed (electrophoresis, UHF therapy, exposure to magnetic fields). Often a puncture is required. A needle is inserted into the joint. With a small amount of blood, the puncture is not performed.

During the procedure, analgesics and anti-inflammatory drugs may be administered. In severe cases, radical treatment is required. The indications for the operation are:

detachment of the horns and body of the medial meniscus;
lack of effect from conservative therapy;
displaced rupture;
crushing of tissues.

The most common are reconstructive surgeries. Complete meniscectomy is less common. This is due to the fact that the removal of the medial meniscus in the future can lead to the development of deforming gonarthrosis. Special structures are used to restore tissues. In the case of peripheral and vertical tears, the meniscus can be sutured.

Such an intervention is justified only if there are no degenerative changes in the cartilage tissue. A complete meniscectomy can be performed only with a large detachment and severe damage to the meniscus. Arthroscopic surgery is now widely used. Their advantage is less trauma. After the operation, painkillers, physiotherapy and gymnastics are prescribed. Up to a year, patients need to remain calm.

Forecast and preventive measures

The prognosis for a rupture of the posterior horn of the internal meniscus of the knee is most often favorable. It worsens with severe hemarthrosis, concomitant lesions and untimely treatment. After therapy, the pain syndrome disappears and the range of motion is restored. In some cases, gait instability and discomfort during walking are observed.

The accumulation of a large amount of blood in the knee joint, in the absence of proper assistance, can cause arthrosis.

In the elderly, treatment is difficult due to the impossibility of the operation. Rupture of the horns of the medial meniscus can be prevented. To do this, you must adhere to the following recommendations:

avoid sudden foot movements;
observe safety precautions while working at work and at home;
stop drinking alcohol;
do not get into fights;
wear knee pads when playing sports;
to refuse traumatic activities;
be careful during ice;
in winter weather, wear shoes with thread;
refuse to engage in extreme sports;
timely treat arthritis and arthrosis;
diversify the diet;
move more;
take vitamin and mineral supplements;
treat rheumatism and gout in a timely manner.

A torn meniscus is a very common pathology in adults and adolescents. In case of a fall or bruise and pain syndrome, you need to contact the emergency room.

Rupture of the posterior horn of the medial meniscus of the knee joint - treatment, symptoms, complete analysis of the injury

One of the most complex structures of the human body parts are joints, both large and small. The structural features of the knee joint allow us to consider it the most susceptible to various injuries, such as fractures, bruises, hematomas, arthrosis, rupture of the posterior horn of the medial meniscus.

This is justified by the fact that the bones of the joint (femur, tibia), ligaments, menisci and patella, working together, provide normal flexion when walking, sitting and running. However, heavy loads on the knee, placed on it during various manipulations, can lead to a rupture of the posterior horn of the meniscus.

Rupture of the posterior horn of the internal meniscus is an injury to the knee joint caused by damage to the cartilage layer located between the femur and tibia.

Anatomical features of the cartilage tissue of the knee

The meniscus is the cartilaginous tissue of the knee, located between two adjacent bones and ensuring the sliding of one bone over the other, ensuring unimpeded flexion/extension of the knee.

The structure of the knee joint includes two types of menisci:

External (lateral).
Internal (medial).

The most mobile is considered external. Therefore, its damage is much less common than damage to the internal.

The inner (medial) meniscus is a cartilaginous lining connected to the bones of the knee joint by a ligament located on the side of the inner side, it is less mobile, therefore, people with a lesion of the medial meniscus more often turn to traumatology. Damage to the posterior horn of the medial meniscus is accompanied by damage to the ligament that connects the meniscus to the knee joint.

In appearance, it looks like a crescent moon lined with a porous fabric. The body of the cartilage pad consists of three parts:

Anterior horn;
middle part;
Back horn.

The cartilages of the knee perform several important functions, without which a full-fledged movement would be impossible:

Cushioning while walking, running, jumping.
Stabilization of the knee at rest.
Permeated with nerve endings that send signals to the brain about the movement of the knee joint.

Knee injury is not uncommon. At the same time, not only people who lead an active lifestyle can get injured, but also those who, for example, sit on squats for a long time, try to rotate on one leg, and make long jumps. Tissue destruction occurs and over time, people over 40 are at risk. Injured knees at a young age eventually become chronic diseases in old age.

The nature of its damage may be different depending on exactly where the rupture occurred and what shape it has.

Break shapes

Cartilage ruptures can be different in nature and form of the lesion. Modern traumatology distinguishes the following groups of ruptures of the internal meniscus:

Longitudinal;
degenerative;
oblique;
transverse;
Rupture of the posterior horn;
horizontal;
Rupture of the anterior horn.

Rupture of the posterior horn

Rupture of the posterior horn of the medial meniscus is one of the most common groups of knee injuries. This is the most dangerous damage.

Tears in the posterior horn can be:

Horizontal, that is, a longitudinal gap, in which the separation of tissue layers from one another occurs, followed by blocking the mobility of the knee joint.
Radial, that is, such damage to the knee joint, in which oblique transverse tears of the cartilage tissue appear. The edges of the lesion look like rags, which, falling between the bones of the joint, create a crack of the knee joint.
Combined, that is, bearing damage to the (medial) internal meniscus of two types - horizontal and radial.

Symptoms of an injury to the posterior horn of the medial meniscus

The symptoms of the resulting injury depend on what form it wears. If this is an acute form, then the signs of injury are as follows:

Sharp pain even at rest.
Hemorrhage within the tissue.
Blockage of the knee.
Arthroscopy tissue has smooth edges.
Swelling and redness.

The chronic form (an old rupture) is characterized by the following symptoms:

Cracking of the knee joint during movement;
Accumulation of synovial fluid;
The tissue during arthroscopy is stratified, similar to a porous sponge.

Treatment of cartilage damage

In order for the acute form not to become chronic, it is necessary to immediately begin treatment. If treatment is started late, then the tissue begins to acquire significant destruction, turning into tatters. Destruction of the tissue leads to degeneration of the cartilage, which in turn leads to knee arthrosis and its immobility.

Stages of conservative treatment

The conservative method is used in the acute non-started stage in the early stages of the course of the disease. Therapy by conservative methods consists of several stages.

Relieve inflammation, pain and swelling with non-steroidal anti-inflammatory drugs (NSAIDs).
In cases of “jamming” of the knee joint, reposition is applied, that is, reduction with the help of manual therapy or traction.
Physiotherapy.
Massotherapy.
Physiotherapy.

Treatment with chondroprotectors.
Joint treatment with hyaluronic acid.
Treatment with folk remedies.
Pain relief with analgesics.
Plaster cast (on doctor's recommendation).

Stages of surgical treatment

The surgical method is used only in the most extreme cases, when, for example, the tissue is so damaged that it cannot be restored, or if conservative methods have not helped.

Surgical methods for repairing torn cartilage consist of the following manipulations:

Arthrotomy - partial removal of damaged cartilage with extensive tissue damage;
Meniscotomy - complete removal of cartilage tissue; Transplantation - moving the donor meniscus to the patient;
Endoprosthetics - the introduction of artificial cartilage into the knee;
Stitching of damaged cartilage (performed with minor damage);
Arthroscopy - knee puncture in two places in order to carry out the following cartilage manipulations (for example, stitching or arthroplasty).

After the treatment is carried out, regardless of what methods it was carried out (conservative or surgical), the patient will have a long course of rehabilitation. The patient is obliged to provide himself with complete rest throughout the entire time while the treatment is being carried out and after it. Any physical activity after the end of therapy is contraindicated. The patient must take care that the cold does not penetrate to the limbs, and the knee is not subjected to sudden movements.

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Conclusion

Thus, knee injury is an injury that occurs much more often than any other injury. In traumatology, several types of meniscal injuries are known: ruptures of the anterior horn, ruptures of the posterior horn, and ruptures of the middle part. Such injuries can be different in size and shape, so there are several types: horizontal, transverse, oblique, longitudinal, degenerative. Rupture of the posterior horn of the medial meniscus is much more common than that of the anterior or medial meniscus. This is due to the fact that the medial meniscus is less mobile than the lateral one, therefore, the pressure on it when moving is greater.

Treatment of injured cartilage is carried out both conservatively and surgically. Which method will be chosen is determined by the attending physician based on how severe the damage is, what form (acute or chronic) the damage has, what condition the cartilage tissue of the knee is in, what kind of rupture is present (horizontal, radial or combined).

Almost always, the attending physician tries to resort to the conservative method, and only then, if he turned out to be powerless, to the surgical one.

Treatment of cartilage injuries should be started immediately, otherwise the chronic form of the injury can lead to complete destruction of the articular tissue and immobility of the knee.

In order to avoid injury to the lower extremities, turns, sudden movements, falls, jumps from a height should be avoided. After treatment of the meniscus, physical activity is usually contraindicated. Dear readers, that’s all for today, share in the comments about your experience in treating meniscus injuries, in what ways did you solve your problems?

In the article, we will consider in what cases there is a rupture of the posterior horn of the medial meniscus.

One of the most complex structures of the bone parts of the human body are joints, both small and large. Features of the structure of the knee joint allow it to be considered prone to various injuries such as bruises, fractures, hematomas, arthrosis. It is also possible such a complex injury as a rupture of the posterior horn in the medial meniscus.

This is due to the fact that the bones of this joint (tibia, femur), ligaments, patella and menisci, working in a complex, ensure proper flexion when sitting, walking and running. However, excessive loads on the knee, which are placed on it during various manipulations, can lead to a violation of the integrity of the posterior horn of the medial meniscus. This is such a traumatization of the knee joint, which is caused by damage to the cartilage layers located between the tibia and femur.

Anatomical features of the cartilage of the knee joint

Let's take a closer look at how this structure works.

The meniscus is a cartilaginous structure of the knee, which is located between the closing bones and ensures that the bones slide one over the other, which contributes to the unhindered extension of this joint.

The menisci are of two types. Namely:

medial (internal);
lateral (external).

Obviously, the most mobile is the outer one. Therefore, its damage is much less common than damage to the internal.

The medial (internal) meniscus is a cartilaginous lining associated with the bones of the knee joint, located on the side from the inside. It is not very mobile, therefore it is prone to damage. Rupture of the posterior horn of the medial meniscus is also accompanied by damage to the ligamentous apparatus that connects it to the knee joint.

Visually, this structure looks like a crescent, the horn is lined with porous tissue. The cartilage lining consists of three main parts:

anterior horn;
middle part;
back horn.

The cartilages of the knee joint perform several important functions, without which full-fledged movement would be impossible:

depreciation in the process of walking, jumping, running;
resting knee stabilization.

These structures are permeated with many nerve endings that send information about the movements of the knee joint to the brain.

Functions of the meniscus

Let's take a closer look at what functions the meniscus performs.

The joint of the lower limb refers to a combined structure, where each element is called upon to solve certain problems. The knee is equipped with menisci, which divide the articular cavity in half, and perform the following tasks:

stabilizing - the time of any physical activity, the articular surface is shifted in the right direction;
acts as shock absorbers to soften shocks and shocks while running, walking, jumping.

Traumatization of shock-absorbing elements is observed with various articular injuries, in particular, due to the loads that these articular structures take on. Each knee joint has two menisci, which are made up of cartilage. Each type of shock-absorbing plates is formed by horns (front and rear) and a body. Shock-absorbing components move freely in the process of physical activity. The bulk of the damage is associated with the posterior horn of the medial meniscus.

The causes of this pathology

The most common damage to the cartilage plates is considered to be a tear, absolute or partial. Professional dancers and athletes, whose specialty is sometimes associated with increased loads, can be injured. Injuries are also observed in the elderly, occur as a result of unforeseen, accidental loads on the knee area.

Damage to the body of the posterior horn occurs for the following reasons:

excessive sports loads (jumping, jogging over rough terrain);
active walking, long squat position;
articular pathologies of a chronic nature, in which the development of an inflammatory process in the knee region occurs;
congenital articular pathologies.

These factors lead to traumatization of the posterior horn of the medial meniscus of varying degrees of complexity.

Stages of this pathology

Symptoms of traumatization of cartilaginous elements depend on the severity of cartilage damage. The following stages of violation of the integrity of the posterior horn are known:

Stage 1 (mild form) of damage to the posterior horn of the medial meniscus, in which the movements of the damaged limb are normal, the pain syndrome is weak, it becomes more intense during jumps or squats. In some cases, there is a slight swelling in the patella.
2 degree. The posterior horn of the medial meniscus is significantly damaged, which is accompanied by an intense pain syndrome, and the limb is difficult to straighten even with outside help. It is possible to move at the same time, but the patient is lame, at any moment the knee joint may be immobilized. Puffiness gradually becomes more and more pronounced.
Damage to the posterior horn of the medial meniscus of the 3rd degree is accompanied by pain syndromes of such strength that it cannot be tolerated. Most painful in the area of the kneecap. Any physical activity with the development of such an injury is impossible. The knee significantly increases in size, and the skin changes its healthy color to cyanotic or purple.

If the posterior horn of the medial meniscus is damaged, the following symptoms are present:

The pain intensifies if you press the cup from the back side and simultaneously straighten the leg (Bazhov's technique).
The skin in the knee area becomes too sensitive (Turner's symptom).
When the patient is in a prone position, the palm passes under the damaged knee joint (Land's syndrome).

After establishing the diagnosis of damage to the posterior horn of the medial meniscus of the knee joint, the specialist decides which therapeutic technique to apply.

Features of the horizontal tear of the posterior horn

Features are in the following points:

with this type of tear, injury occurs, which is directed to the joint capsule;
swelling develops in the area of the joint gap - a similar development of the pathological process has common symptoms with damage to the anterior horn of the external cartilage;
with partial horizontal damage, excess fluid accumulates in the cavity.

meniscus tear

In what cases does this happen?

Injury to the knee joints is a fairly common occurrence. At the same time, not only active people can receive such injuries, but also those who, for example, squat for a long time, try to spin on one leg, and make various long and high jumps. Tissue destruction can occur gradually over time, with people over 40 at risk. Damaged knee menisci at a young age gradually begin to acquire an old character in older people.

Damage can be very diverse, depending on where the gap is observed and what shape it has.

Forms of meniscus tears

Ruptures of cartilaginous tissue can be different in the form of the lesion and in nature. In modern traumatology, the following categories of ruptures are distinguished:

longitudinal;
degenerative;
oblique;
transverse;
rupture of the posterior horn;
horizontal type;
tear of the anterior horn.

Rupture of the posterior horn of the medial meniscus of the knee joint

Such a rupture is one of the most common categories of knee injury and the most dangerous injury. Similar damage also has some varieties:

horizontal, which is also called a longitudinal gap, with it there is a separation of tissue layers from each other, followed by blocking of the movements of the knee;
radial, which is such damage to the knee joints, with it oblique transverse ruptures of cartilage tissue develop, while the lesions are in the form of tatters (the latter, sinking between the bones of the joint, provoke a crack in the knee joint);
combined, bearing damage to the (medial) inner section of the meniscus of two varieties - radial and horizontal.

Injury symptoms

How this pathology manifests itself is described in detail below.

The symptoms of the resulting injury depend on the form of the pathology. If this damage is acute, then the symptoms of injury may be as follows:

acute pain syndrome, which manifests itself even in a calm state;
hemorrhage into tissues;
blocking knee activity;
swelling and redness.

Chronic forms (an old rupture), which are characterized by the following symptoms:

cracking in the knee joint during movement;

accumulation of synovial fluid in the joint;

tissue at arthroscopy is stratified, similar to a porous sponge.

Learn how to treat a torn posterior horn of the medial meniscus.

Therapy for cartilage damage

In order for the acute stage of the pathology not to become chronic, it is necessary to begin treatment immediately. If you are late during therapeutic procedures, the tissues begin to acquire significant destruction and turn into tatters. The destruction of tissues leads to the development of degeneration of cartilage structures, which, in turn, provokes the occurrence of knee arthrosis and complete immobility of this joint.

Therapy for damage to the posterior horn of the medial meniscus depends on the degree of injury.

Stages of conservative treatment of this pathology

Traditional methods are used in acute, not advanced stages in the early stages of the course of the pathological process. Therapy with conservative methods consists of several stages, which include:

elimination of inflammation, pain syndrome and swelling with the help of anti-inflammatory non-steroidal drugs;
in cases of “jamming” of the knee, reposition is used, namely reduction by means of traction or manual therapy;
therapeutic exercises, gymnastics;
therapeutic massage;
physiotherapy activities;
the use of chondroprotectors;
hyaluronic acid treatment;
therapy with the help of folk recipes;
pain relief with analgesics;
plaster casts.

What else is the treatment for a torn posterior horn of the medial meniscus?

Stages of surgical treatment of the disease

Surgical techniques are used only in the most difficult cases, when, for example, tissues are so damaged that they cannot be restored if traditional methods of therapy have not helped the patient.

Operative methods for restoring torn cartilage of the posterior horn consist of the following manipulations:

Arthrotomy - partial removal of damaged cartilage with extensive tissue damage.
Meniscotomy is the complete removal of cartilage.
Transplantation - moving the donor meniscus to the patient.
Endoprosthetics - the introduction of artificial cartilage into the knee joint.
Stitching of damaged cartilage (performed with minor injuries).
Arthroscopy - a puncture of the knee joint in two places in order to carry out the following manipulations with cartilage tissue (for example, endoprosthesis replacement or stitching).

After the therapy (regardless of what methods it was carried out - surgical or conservative), the patient will have a long course of rehabilitation. It necessarily includes absolute rest throughout the course. Any physical activity after the end of treatment is contraindicated. The patient should take care that his limbs are not supercooled, it is impossible not to make sudden movements.

Tears of the posterior horn of the medial meniscus of the knee joint are a fairly common injury that occurs more often than other injuries. These injuries can vary in size and shape. Rupture of the posterior horn of the meniscus occurs much more often than its middle part or anterior horn. This is due to the fact that the meniscus in this area is the least mobile, and, consequently, the pressure on it during movements is greater.

Treatment of this cartilage tissue injury should begin immediately, otherwise its chronic nature can lead to complete destruction of the joint tissue and its absolute immobility.

In order to avoid injury to the posterior horn, one should not make sudden movements in the form of turns, avoid falls, jumps from a height. This is especially true for people over the age of 40. After treatment of the posterior horn of the medial meniscus, exercise is generally contraindicated.

The knee joint has a rather complex structure. It consists of the femur and tibia, the patella (patella), as well as the ligament system that ensures the stability of the bones of the joint. Another part of the knee joint is the menisci - cartilage between the femur and tibia. When moving, a large load is placed on the knee, which leads to frequent injury to its elements. A tear in the posterior horn of the medial meniscus is one such injury.

Injuries to the knee joint are dangerous, painful and fraught with consequences. Rupture of the posterior horn of the meniscus, which can occur in almost any active person, is the most common and dangerous injury. It is dangerous primarily due to complications, therefore, it requires timely detection and treatment.

What is a meniscus

Menisci are very important structural units of the knee joint. They are curved strips of fibrous cartilage that sit between the bones of a joint. The shape resembles a crescent with elongated edges. It is customary to divide them into zones: the body of the meniscus (middle part); elongated end parts - the posterior and anterior horns of the meniscus.

There are two menisci in the knee joint: medial (inner) and lateral (outer). They are attached to the tibia with their ends. The medial is located on the inside of the knee and is connected to the internal lateral ligament. In addition, it is connected along the outer edge with the capsule of the knee joint, through which partial blood circulation is provided.

The cartilaginous section of the meniscus, adjacent to the capsule, contains a significant number of capillaries and is supplied with blood. This part of the medial meniscus is called the red zone. The middle region (intermediate zone) contains a small number of vessels and is very poorly supplied with blood. Finally, the inner region (white zone) has no circulatory system at all. The lateral meniscus is located in the outer region of the knee. It is more mobile than the medial, and its damage occurs much less frequently.

Menisci perform very important functions. First of all, they play the role of shock absorbers during the movement of the joint. In addition, the menisci stabilize the position of the entire knee in space. Finally, they contain receptors that send operational information to the cerebral cortex about the behavior of the entire leg.

When the inner meniscus is removed, the area of contact of the knee bones decreases by 50-70%, and the load on the ligaments increases by more than 100%. In the absence of an external meniscus, the contact area will decrease by 40-50%, but the load will increase by more than 200%.
meniscal injury

One of the characteristic injuries of the menisci is their rupture. Studies show that such injuries can occur not only in people involved in sports, dancing or hard work, but also in casual activities, as well as in the elderly. It has been established that a meniscal tear is diagnosed in an average of 70 out of every 100,000 people. At a young age (up to 30 years), the damage is acute; with increasing age (over 40 years), the chronic form begins to predominate.

The cause of a torn meniscus can be an excessive lateral load along with twisting of the lower leg. Such loads are typical when performing certain movements (cross-country running, jumping on uneven surfaces, rotation on one leg, prolonged squatting). In addition, ruptures can be caused by joint diseases, tissue aging, or pathological abnormalities. The cause of damage can be a sharp strong blow to the knee or a quick extension of the leg. According to the nature and location of the damage, several types of ruptures can be distinguished:
longitudinal (vertical);

oblique (patchwork);

transverse (radial);

horizontal;

rupture of the anterior horn of the lateral or medial meniscus;

rupture of the posterior horn of the menisci;

degenerative rupture.

Degenerative rupture is associated with changes in tissues due to diseases or due to aging.

Symptoms of a meniscus injury

In case of damage to the meniscus of the knee joint, two characteristic periods are distinguished - acute and chronic. The acute period lasts 4-5 weeks and is characterized by a number of painful symptoms. The moment of damage to the meniscus, as a rule, is determined by the sound, resembling a crack, and a sharp pain in the knee area. In the first period after an injury, cracking and pain accompanies a person during exertion (for example, walking up stairs). Swelling develops in the knee area. Often, a meniscus tear is accompanied by hemorrhage into the joint.

In the acute period, the movement of the leg in the knee joint in a person is limited or completely impossible. Due to the accumulation of fluid in the knee area, the effect of a “floating patella” may occur.

The chronic period of meniscus rupture is less painful. Attacks of pain occur only with sudden movements of the leg or increased loads. During this period, it is quite difficult to determine the fact of a meniscus rupture. To diagnose an injury, methods based on characteristic symptoms have been developed.

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Baikov's symptom is based on the detection of pain when fingers are pressed on the outer side of the knee with simultaneous extension of the lower leg. Land's symptom determines the injury by the degree of straightening of the leg in the knee joint, when the leg lies freely on the surface (in case of injury, the palm of the hand is placed between the surface and the knee). Turner's symptom takes into account the increased sensitivity of the skin on the inner surface of the knee joint and the upper part of the lower leg from the inside. The symptom of the blockade establishes a gap in the jamming of the knee joint when a person moves up the stairs. This symptom is characteristic of a torn posterior horn of the internal meniscus.

Typical symptoms of a medial meniscus tear

Rupture of the medial meniscus of the knee joint has a number of characteristic symptoms. Injury to the internal posterior horn of the meniscus causes intense pain in the knee area from the inside. When you press your finger in the area where the meniscus horn attaches to the knee ligament, a sharp pain appears. A tear in the posterior horn causes blockage of movement in the knee joint.

You can determine the gap by making flexion movements. It manifests itself in the form of a sharp pain when the leg is extended and the lower leg is turned outward. The pain also pierces with strong bending of the leg at the knee. According to the severity of damage to the meniscus of the knee joint are divided into small, moderate and severe. Small tears (partial), including the horns of the meniscus, are characterized by pain and slight swelling in the knee area. Such signs of injury cease to appear after 3-4 weeks.

With a moderate degree of injury, all the considered symptoms of the acute period appear, but they are limited and manifest themselves during physical exertion, such as jumping, moving up inclined planes, and squatting. Without treatment, this form of injury becomes chronic. This degree is characteristic of some ruptures of the anterior and posterior horns of the medial meniscus.

With a severe degree of injury, pain and swelling of the knee become obvious; hemorrhage occurs in the joint cavity. The horn is completely detached from the meniscus, and its parts are inside the joints, which causes a blockade of movements. Independent movement of a person is difficult. Severe injury requires surgical intervention.

Read also: Proper rehabilitation for a fracture of the patella
Mechanism of rupture of the posterior horn

A very dangerous longitudinal tear (complete or partial), as a rule, begins to develop from the posterior horn of the medial meniscus. With a complete rupture, the separated part of the meniscus horn can migrate into the cavity between the joints and block their movement.

On the border of the middle of the body of the meniscus and the beginning of the posterior horn of the inner meniscus, oblique tears often develop. This is usually a partial tear, but the edge may be embedded between joints. This produces a crackling sound and painful sensations (rolling pain).

Often, the rupture of the posterior horn of the internal meniscus is combined in nature, combining different types of damage. Such gaps develop simultaneously in several directions and planes. They are characteristic of the degenerative mechanism of damage.

A horizontal rupture of the posterior horn of the medial meniscus originates from its inner surface and develops in the direction of the capsule. Such damage causes swelling in the joint space (pathology is also characteristic of the anterior horn of the lateral meniscus).

Conservative treatments

Treatment of a tear in the posterior horn of the medial meniscus (similar to that of the anterior horn of the medial meniscus) depends on the site of the injury and its severity. Based on this, the method is determined - conservative or surgical treatment.

The conservative (therapeutic) method is applicable for small ruptures and a rupture of moderate severity. Such treatment is based on a number of therapeutic interventions and is often effective.

The first step is to provide assistance in case of injury. To do this, it is necessary to provide the victim with peace; apply a cold compress on the inside of the knee; inject an anesthetic; apply a plaster bandage. If necessary, fluid should be punctured.

Usually the conservative method involves long-term treatment for 6-12 months. Initially, reduction (reposition) of the knee joint is performed in the presence of a blockade. Manual methods can be used to remove the blockade. For the first 3 weeks, rest should be ensured, and the knee joint should be immobilized with a plaster splint.

When cartilage is damaged, it is necessary to repair and repair them. For this purpose, a course of taking chondroprotectors and hyaluronic acid is prescribed. As protectors, the use of drugs containing chondroitin and glucosamine is recommended. Painful symptoms and inflammatory processes must be eliminated by taking non-steroidal anti-inflammatory drugs (diclofenac, ibuprofen, indomethacin) and others.

To eliminate puffiness and accelerate healing, external agents are used in the form of ointments (Amzan, Voltaren, Dolgit and others). The treatment process includes a course of physiotherapy and special therapeutic exercises. A therapeutic massage gives a good effect.

Surgical treatment

With severe damage, there is a need for surgical intervention. With crushing of the cartilage, severe rupture and displacement of the meniscus, complete breakage of the anterior or posterior horns of the meniscus, a surgical operation is necessary. Surgical treatment is divided into several types: removal of a meniscus or detached horn; recovery; suturing the place of the rupture; fastening detached horns with clamps; meniscus transplant.

One of the most complex structures of the human body parts are joints, both large and small. The structural features of the knee joint allow us to consider it the most susceptible to various injuries, such as fractures, hematomas, rupture of the posterior horn of the medial meniscus.

Rupture of the posterior horn of the internal meniscus is an injury to the knee joint caused by damage to the cartilage layer located between the femur and tibia.

Anatomical features of the cartilage tissue of the knee

- cartilaginous tissue of the knee, located between two interlocking bones and ensuring the sliding of one bone over the other, ensuring unimpeded flexion / extension of the knee.

The structure of the knee joint includes two types of menisci:

External (lateral).
Internal (medial).

The most mobile is considered external. Therefore, its damage is much less common than damage to the internal.

In appearance, it looks like a crescent moon lined with a porous fabric. The body of the cartilage pad consists of three parts:

Anterior horn;
middle part;
Back horn.

The cartilages of the knee perform several important functions, without which a full-fledged movement would be impossible:

Cushioning while walking, running, jumping.
Stabilization of the knee at rest.
Permeated with nerve endings that send signals to the brain about the movement of the knee joint.

meniscus tears

The illustration shows a rupture of the anterior horn of the external meniscus of the knee joint.

The nature of its damage may be different depending on exactly where the rupture occurred and what shape it has.

Break shapes

Cartilage ruptures can be different in nature and form of the lesion. Modern traumatology distinguishes the following groups of ruptures of the internal meniscus:

Longitudinal;
degenerative;
oblique;
transverse;
Rupture of the posterior horn;
horizontal;
Rupture of the anterior horn.

Rupture of the posterior horn

Rupture of the posterior horn of the medial meniscus is one of the most common groups of knee injuries. This is the most dangerous damage.

Tears in the posterior horn can be:

Horizontal, that is, a longitudinal gap, in which the separation of tissue layers from one another occurs, followed by blocking the mobility of the knee joint.
Radial, that is, such damage to the knee joint, in which oblique transverse tears of the cartilage tissue appear. The edges of the lesion look like rags, which, falling between the bones of the joint, create a crack of the knee joint.
Combined, that is, bearing damage to the (medial) internal meniscus of two types - horizontal and radial.

Symptoms of an injury to the posterior horn of the medial meniscus

The symptoms of the resulting injury depend on what form it wears. If this is an acute form, then the signs of injury are as follows:

Sharp pain even at rest.
Hemorrhage within the tissue.
Blockage of the knee.
Swelling and redness.

The chronic form (an old rupture) is characterized by the following symptoms:

Cracking of the knee joint during movement;
The tissue during arthroscopy is stratified, similar to a porous sponge.

Treatment of cartilage damage

In order for the acute form not to become chronic, it is necessary to immediately begin treatment. If treatment is started late, then the tissue begins to acquire significant destruction, turning into tatters. Destruction of the tissue leads to degeneration of the cartilage, which in turn leads to knee arthrosis and its immobility.

Stages of conservative treatment

The conservative method is used in the acute non-started stage in the early stages of the course of the disease. Therapy by conservative methods consists of several stages.

Removal of inflammation, pain and swelling with the help of.
In cases of “jamming” of the knee joint, reposition is applied, that is, reduction with the help of manual therapy or traction.
Massotherapy.
Physiotherapy.

Pain relief with analgesics.
Plaster cast (on doctor's recommendation).

Stages of surgical treatment

The surgical method is used only in the most extreme cases, when, for example, the tissue is so damaged that it cannot be restored, or if conservative methods have not helped.

Surgical methods for repairing torn cartilage consist of the following manipulations:

Arthrotomy - partial removal of damaged cartilage with extensive tissue damage;
Meniscotomy - complete removal of cartilage tissue; Transplantation - moving the donor meniscus to the patient;
– implantation of artificial cartilage into the knee;
Stitching of damaged cartilage (performed with minor damage);
– knee puncture in two places in order to carry out the following cartilage manipulations (for example, stitching or arthroplasty).

After the treatment is carried out, regardless of what methods it was carried out (conservative or surgical), the patient will have a long one. The patient is obliged to provide himself with complete rest throughout the entire time while the treatment is being carried out and after it. Any physical activity after the end of therapy is contraindicated. The patient must take care that the cold does not penetrate to the limbs, and the knee is not subjected to sudden movements.

Conclusion

Almost always, the attending physician tries to resort to the conservative method, and only then, if he turned out to be powerless, to the surgical one.

Treatment of cartilage injuries should be started immediately, otherwise the chronic form of the injury can lead to complete destruction of the articular tissue and immobility of the knee.

Rupture of the medial meniscus of the knee joint is a pathology that is common in professional athletes and ordinary people. Depending on the causes of occurrence, two varieties are distinguished: traumatic and degenerative.

In the absence of proper therapy, chronic damage to the medial meniscus of the knee joint is converted into a neglected form. This leads to irreversible degenerative changes in the joint.

The medial meniscus is C-shaped and consists of three parts. The gaps vary in location, refer to:

posterior horn of the medial meniscus;
middle part (body);
anterior horn.

There is a classification according to the trajectory of the injury that occurred:

longitudinal;
transverse (radial);
oblique;
patchwork;
horizontal ruptures of the posterior horn of the medial meniscus.

The inner cartilage layer is attached to the tibia from the back side and to the articular capsule of the knee from the outside.

Note. Having two points of connection, the medial meniscus is less mobile. This explains the high susceptibility to injury.

Characteristic signs of a torn internal meniscus

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Damage to the medial meniscus most often occurs during physical exercise: running on rough terrain, rotating on one leg, sharp attacks and other situations.

Depending on the clinical manifestations, acute and chronic rupture of the medial meniscus is distinguished. A distinctive feature of the first form is intense pain of a sudden nature, localized along the line of the joint gap, where the damage to the cartilage layer presumably occurred.

A torn meniscus of the knee is the most common injury among internal injuries of the knee joint.

Other common symptoms of a medial meniscus tear in the knee include:

severe limitation of motor ability (if the torn area blocks the movement of the joint);
hemarthrosis (bleeding into the joint cavity);
edema.

Note: With a bent knee, a person does not always feel intense pain. It appears more often when trying to straighten the leg. This is a hallmark of injury to the interior of the intercartilaginous lining.

Surgery

Surgical manipulations are carried out by arthroscopic or arthrotomy method. The main task is to partially or completely remove the medial meniscus. The indications for surgery are:

intense pain;
significant horizontal rupture of the medial meniscus;
effusion (fluid buildup in the knee joint);
clicking when extending the knee;
blockade of the joint.

When stitching, long surgical needles are used with ligatures fixed on them (absorbable or non-absorbable suture material). Meniscus fixation techniques are used:

stitching from the inside out;
seams outside-in;
inside the joint
transplantation of the medial meniscus.

Note: Before choosing a particular technique, the physician must consider factors that benefit and harm the patient.

Reconstructive technique

Restorative operations have fewer statistics of negative outcomes compared to traditional methods of surgical intervention. They are also performed arthrotomically or arthroscopically. The main task of such manipulations is to eliminate damage to the posterior horn, to ensure the fixation of the medial meniscus on the surface of the articular capsule.

For this purpose, absorbable and non-absorbable surgical devices (arrows, buttons, and others) are used. Before fixation, pre-treatment of the injured edges is required - tissue excision to the capillary network. Then the prepared edges are combined and fixed.

Rupture of the medial meniscus must be detected in time and treated in a timely manner. Disability is a consequence of untimely access to a doctor.