Rupture of the posterior horn and body of the lateral meniscus. Damage to the posterior horn of the meniscus

The structure of the meniscus includes the body of the meniscus and two horns - anterior and posterior. The cartilage itself is fibrous, the blood supply comes from the joint capsule, so the blood circulation is quite intense.

Meniscus injury is the most common injury. The knees themselves are a weak point in the human skeleton, because the daily load on them begins from the very moment the child begins to walk. Very often they occur during outdoor games, when playing contact sports, with too sudden movements or with falls. Another cause of meniscal tears is injuries sustained in an accident.

Treatment of a posterior horn rupture can be surgical or conservative.

Conservative treatment

Conservative treatment consists of adequate pain relief. If blood accumulates in the joint cavity, it is punctured and the blood is pumped out. If a joint blockade occurs after an injury, it is eliminated. If it occurs combined with other knee injuries, then a plaster splint is applied to provide complete rest to the leg. In this case, rehabilitation takes more than one month. To restore knee function, gentle physical therapy is prescribed.

With an isolated rupture of the posterior horn of the medial meniscus, the recovery period is shorter. In these cases, plaster is not applied, because it is not necessary to completely immobilize the joint - this can lead to stiffness of the joint.

Surgery

If conservative treatment does not help, if the effusion in the joint persists, then the question of surgical treatment arises. Also, indications for surgical treatment are the occurrence of mechanical symptoms: clicks in the knee, pain, the occurrence of joint blockades with limited range of motion.

Currently, the following types of operations are performed:

Arthroscopic surgery.

The operation is performed through two very small incisions through which the arthroscope is inserted. During the operation, the separated small part of the meniscus is removed. The meniscus is not completely removed because its functions in the body are very important;

Arthroscopic suture of the meniscus.

If the gap is significant, then an arthroscopic suture technique is used. This technique allows you to restore damaged cartilage. Using one stitch, the incompletely separated part of the posterior horn of the meniscus is sutured to the body of the meniscus. The disadvantage of this method is that it can only be carried out in the first few hours after the injury.

Meniscus transplantation.

Replacement of the meniscus with a donor one is carried out when the cartilage of one’s meniscus is completely destroyed. But such operations are carried out quite rarely, because the scientific community does not yet have a consensus on the feasibility of this operation.

Rehabilitation

After both conservative and surgical treatment, it is necessary to undergo a full course of rehabilitation: develop the knee, increase leg strength, train the quadriceps femoris muscle to stabilize the damaged knee.

Posterior horn

Treatment of a tear in the posterior horn of the lateral (outer) meniscus

The lateral meniscus is a structure in the knee joint that has a shape close to a ring. Compared to the medial meniscus, the lateral meniscus is slightly wider. The meniscus can be divided into three parts: the body of the meniscus (middle part), the anterior horn and the posterior horn. The anterior horn is attached to the internal intercondylar eminence. The posterior horn of the lateral meniscus is attached directly to the lateral intercondylar eminence.

Statistics

Rupture of the posterior horn of the lateral meniscus is an injury that is quite common among athletes, people leading an active lifestyle, as well as those whose professional activities involve heavy physical labor. According to statistics, this injury is more common than anterior cruciate ligament injury. However, approximately one third of all cases of ligament rupture are associated with a meniscus tear. In terms of frequency, damage of the “watering can handle” type is in first place. Isolated damage to the posterior horn of the meniscus accounts for about a third of all meniscus injuries.

Causes

Injury to the posterior horn of the lateral meniscus varies from patient to patient. The causes of injury largely depend on the age of the person. Thus, in young people under 35 years of age, the cause of injury is most often mechanical impact. In elderly patients, the cause of rupture of the posterior horn is most often a degenerative change in the meniscal tissue.

In women, rupture of the posterior horn of the external meniscus occurs less frequently than in men, and the rupture itself is usually organic in nature. In children and adolescents, rupture of the posterior horn also occurs, usually due to awkward movement.

Injury resulting from mechanical impact can have two possible causes: direct impact or rotation. The direct impact in this case is associated with a strong blow to the knee. The victim's foot is usually fixed at the moment of impact. Damage to the posterior horn is also possible with awkward, sharp bending of the leg at the knee joint. Age-related changes in the meniscus significantly increase the risk of injury.

The rotational mechanism of injury implies that a meniscus rupture occurs in the event of a sharp twisting (rotation) of the ankle with the foot fixed. The condyles of the tibia and femur with such rotation shift in opposite directions. The meniscus also becomes displaced while attached to the tibia. If there is excessive displacement, there is a high risk of rupture.

Symptoms

Damage to the posterior horn of the lateral meniscus manifests itself with symptoms such as pain, impaired joint mobility, and even complete blocking of the joint. The complexity of the injury in diagnostic terms is due to the fact that often a rupture of the posterior horn of the meniscus can manifest itself only with nonspecific symptoms, which are also characteristic of other injuries: damage to the ligaments or the patella.

A complete tear of the horn of the meniscus, in contrast to minor tears, often manifests itself as a blockade of the joint. The blockade is due to the fact that the torn fragment of the meniscus is displaced and restrained by the structures of the joint. A typical rupture of the posterior horn is a limitation in the ability to bend the leg at the knee.

In case of an acute, severe rupture accompanied by damage to the anterior cruciate ligament (ACL), the symptoms are pronounced: swelling appears, usually on the anterior surface of the joint, severe pain, the patient cannot step on the leg.

Conservative treatment

For small tears, non-surgical treatment is preferred. Puncture gives good results when blocking a joint - removing blood helps to “free” the joint and eliminate the blockage. Further treatment consists of undergoing a series of physiotherapeutic procedures: therapeutic exercises, electromyostimulation and massage.

Often, during conservative treatment, medications from the group of chondroprotectors are also prescribed. However, if there is serious damage to the posterior horn, then this measure will not be able to completely restore the meniscal tissue. In addition, the course of chondroprotectors often lasts more than one year, which extends the treatment over time.

Surgical treatment

For significant ruptures, surgical treatment may be prescribed. The most commonly used method is arthroscopic removal of part of the meniscus. Complete removal is not practiced, since in the absence of the meniscus the entire load falls on the knee cartilage, which leads to their rapid wear.

Rehabilitation

The rehabilitation period after meniscus surgery lasts up to 3-4 months. A set of measures during this period is aimed at reducing swelling of the knee joint, reducing pain and restoring the full range of motion in the joint. It is worth noting that full recovery is possible even if the meniscus is removed.

Changes in the meniscus are anatomical damage that occurs as a result of injury, a previous illness, or an unnatural structure of the joints. As a rule, 11 occur as a result of severe injuries, which cause injury to the cartilage discs and, accordingly, pain begins. These changes in the internal menisci are more often diagnosed in males.
As it moves, the meniscus changes significantly in shape. Any meniscus, according to its anatomical structure, is divided into several parts: anterior horn, posterior horn, body. The medial meniscus along the outer surface is quite firmly connected to the joint capsule. If we compare the medial and lateral meniscus, the first one is not so mobile.

Damage to the lateral and medial meniscus have many similarities. It should be noted that damage to the medial meniscus is much more common than the medial one. Also, one should not exclude the fact that damage to two menisci may occur at once. More damage occurs to the posterior horn of the meniscus. In case of longitudinal injuries of the posterior medial meniscus, an external examination will not help to determine the changes that have occurred; for this it is necessary to use only medical equipment.
To determine the extent of damage, doctors resort to using an artiscope hook. If there is a gap, the tip of the probe will fit completely into it. Due to a flap tear, the flap may bend slightly into the posteromedial section or into the medial flag, respectively, in this case the meniscus looks thickened or compacted.

Damage to the posterior horn of the medial meniscus

The posterior horn of the meniscus is the internal part, and has the distinctive feature that it has no blood circulation. The meniscus is nourished by the circulation of synovial fluid. This is why 11.1 is inevitable, since tissues do not count on regeneration. In order to confirm or refute the above damage, first of all, a clinical examination of the patient is carried out, then he is prescribed an x-ray. It should be noted that the menisci themselves are transparent and will not be visible on an x-ray, but an x-ray will help exclude bone damage, which has similar symptoms. To accurately determine the intra-articular structure, the patient is prescribed magnetic resonance imaging as well as computed tomography. If necessary, a person should undergo an ultrasound examination.
When the above damage occurs, the patient experiences certain symptoms.
- As soon as the injury is sustained, the person feels sharp pain for the first 5 minutes. Before injury, a person may hear a certain clicking sound.

After the pain has passed, the person can move around, but this will provoke the occurrence of new pain. After 10 to 12 hours, the patient will begin to feel a sudden burning sensation in the knee. During the period of flexion and extension of the knee, the pain only intensifies.
- If you press your finger on the joint space while the leg is bent at 90° at the knee joint, the patient experiences severe pain. If you continue to press and straighten the shin, the pain intensifies as a result of the fact that during the period of extension, the meniscus simply rests against the tissue, which is immobile due to the finger.
- Unbearable pain begins to bother you when walking up the stairs.
The patient is also asked to undergo a certain test. The patient, while standing, should bend his legs slightly at the knee joints. Next, the person is asked to carefully turn the torso, first to the right side, then to the left. If pain occurs in the knee joint during the period of turning inward (in relation to the injured leg), this indicates that damage to the posterior horn of the medial meniscus has occurred; if the pain occurs when turning outward, it means that the lateral meniscus is damaged.

Treatment of the posterior horn of the medial meniscus begins with specialists confirming the diagnosis. If the damage is minor, treatment will be carried out conservatively. The patient is prescribed special medications that eliminate pain and inflammation. It is also necessary to undergo a full course of manual therapy and physiotherapy. If the damage to the posterior horn of the medial meniscus is serious enough, then surgery cannot be avoided. Any specialist in any case tries to preserve the meniscus, regardless of the fact that the posterior horn is damaged. The main goal is to maximize the preservation of the organ's capabilities. If the patient undergoes arthroscopy. Then the healing period of the peripheral meniscus is significantly reduced.

Treatment of damage to the posterior horn of the meniscus is based on restoring the functions of the knee joint. It should be noted that any rehabilitation period must be supervised by medical personnel. Doctors prescribe a certain set of measures, taking into account all the individual characteristics of the patient. The recovery period can be completed at home, but you must visit the clinic several times a week. It is necessary to emphasize that the rehabilitation period after injury is based on completing a course of massage and physical therapy. In order to stimulate muscles and develop joints, the load must have different dosages.
As soon as the patient has the first signs that there is damage to the medial meniscus, there is no need to waste time by being at home with the thought that everything will pass; it is urgent to go for a consultation with specialists. In most cases, the patient needs from 4 to 7 months for the final recovery of the damaged posterior horn of the medial meniscus. Everyday life is allowed to continue after 1 month after the operation. Timely seeking help, a confirmed diagnosis, as well as a fully completed course of treatment and rehabilitation increases the chances of a full recovery.

The structure of the knee joint determines not only the stabilization of the knee or its shock absorption under loads, but also its mobility. Disturbance of the normal functions of the knee due to mechanical damage or degenerative changes leads to stiffness in the joint and loss of normal amplitude of flexion-extension movements.

The anatomy of the knee joint distinguishes the following functional elements:

The patella or kneecap, located in the tendons of the quadriceps femoris muscle, is mobile and serves as an external protection of the joint from lateral displacements of the tibia and femur;

Internal and external collateral ligaments provide fixation of the femur and tibia;

The anterior and posterior cruciate ligaments, as well as the collateral ligaments, are designed for fixation;

In addition to the tibia and femur connected into a joint, the knee is distinguished by the fibula, which serves to carry out rotation (rotation movements) of the foot;

The meniscus is a crescent-shaped cartilage plate designed to cushion and stabilize the joint; the presence of nerve endings allows it to function as a signal to the brain about the position of the knee joint. There are external (lateral) and internal (medial) meniscus.

The structure of the meniscus

Menisci have a cartilaginous structure, equipped with blood vessels that allow nutrition, as well as a network of nerve endings.

In their shape, the menisci look like plates, crescent-shaped, and sometimes disc-shaped, in which the posterior and anterior horn of meniscus, as well as his body.

Lateral meniscus, also called external (external), is more mobile due to the lack of rigid fixation; this circumstance is the reason that during mechanical injuries it moves, which prevents injury.

Unlike the lateral medial meniscus has a more rigid fixation by means of attachment to the ligaments, therefore, in case of injury, it is damaged much more often, also in most cases damage to the internal meniscus is of a combined nature, that is, combined with trauma to other elements of the knee joint, in most cases directly to the lateral and cruciate ligaments associated with injuries posterior horn of the meniscus.

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Purpose of the meniscus

The limb joint belongs to a complex structure, where each element solves a specific problem. Each knee is equipped with menisci that bisect the articular cavity and perform the following tasks:

stabilizing. During any physical activity, the articular surfaces shift in the desired direction;
act as shock absorbers, softening shocks and shocks during running, jumping, and walking.

Injury to shock-absorbing elements occurs with various joint injuries, precisely because of the load that these joint parts take on. In each knee there are two menisci, consisting of cartilage tissue:

lateral (outer);
medial (internal).

Each type of shock-absorbing plate is formed by a body and horns (back and front). Shock-absorbing elements move freely during physical activity.

The main damage occurs to the posterior horn of the internal meniscus.

Why does injury occur?

A common injury to the cartilage plate is a tear, complete or incomplete. Professional athletes and dancers, whose specialty involves high loads, are often injured. Injuries occur in older people and as a result of accidental, unexpected stress on the knee area.

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

increased sports loads (jogging over rough terrain, jumping);
active walking, prolonged squatting position;
chronic articular pathologies in which inflammation of the knee region develops;
congenital articular pathology.

The listed reasons lead to meniscus injuries of varying severity.

Classification

Symptoms of injury to cartilaginous elements depend on the severity of the damage to the cartilage tissue. There are the following stages of internal meniscal damage:

Stage 1 (mild). Movement of the injured limb is normal. The pain is mild and becomes more intense during squats or jumps. There may be slight swelling above the kneecap;
2nd degree injury is accompanied by severe pain. The limb is difficult to straighten even with outside help. You can move while limping, but the joint can become blocked at any moment. The swelling gradually becomes greater, and the skin changes color;
damage to the posterior horn of the medial meniscus 3 degrees accompanied by pain syndromes of such intensity that it is impossible to endure. It hurts most at the location of the kneecap. Any physical activity is impossible. The knee becomes larger in size, and the skin changes its healthy color to purple or bluish.

If the medial meniscus is damaged, the following symptoms exist:

the pain intensifies if you press on the kneecap from the inside and simultaneously straighten the limb (Bazhov’s maneuver);
the skin of the knee area becomes overly sensitive (Turner's symptom);
when the patient lies down, the palm passes under the injured knee without any problems (Land's symptom).

After making a diagnosis, the doctor decides which treatment method to use.

Horizontal gap

Depending on the location of the injured area and the general characteristics of the injury, types of injury to the medial meniscus are distinguished:

walking along;
oblique;
passing across;
horizontal;
chronic form of pathology.

Features of horizontal damage to the posterior horn of the medial meniscus are the following:

with this type of tear of the internal shock-absorbing plate, injury occurs directed to the joint capsule;
Swelling occurs in the area of the joint gap. This development of pathology has common symptoms with damage to the anterior meniscal horn of the outer cartilage, so special attention is required when diagnosing.

With horizontal, partial damage, the cavity begins to accumulate excess synovial fluid. Pathology can be diagnosed by ultrasound.

After the first symptoms are relieved, a set of special gymnastic exercises is developed for each patient. Physiotherapy and massage sessions are prescribed.

If traditional treatment methods do not give a positive result, then surgical intervention is indicated.

Synovitis due to injury to the medial meniscus

Due to damage to the posterior horn of the medial meniscus, synovitis may begin. This pathology develops due to structural cartilaginous changes that occur in tissues when injured. When a rupture occurs, synovial fluid begins to be produced in large volumes and fills the joint cavity.

As synovitis (fluid accumulation) develops, it becomes increasingly difficult to perform movements. If there is a transition to the degenerative course of the pathology, then the knee is constantly in a bent position. As a result, muscle spasm develops.

Advanced forms of synovitis lead to the development of arthritis. Therefore, during diagnosis, the symptoms of a torn meniscus are similar to chronic arthritis.

If synovitis is not treated in time, the cartilaginous surface will be completely destroyed. The joint will no longer receive nutrition, which will lead to further disability.

Treatment methods

For any joint injury, treatment must be started promptly, without delay. If you delay going to the clinic, the trauma becomes chronic. The chronic course of the pathology leads to changes in the tissue structure of the joints and further deformation of the damaged limb.

Treatment for damage to the posterior horn of the medial meniscus can be conservative or surgical. When treating such injuries, traditional methods are often used.

Complex, traditional therapy for injury to the internal meniscus includes the following measures:

A joint block is performed using special medications, after which the motor ability of the joint is partially restored;
anti-inflammatory medications are prescribed to remove swelling;
recovery period, including a set of special gymnastic exercises, physiotherapy and massage sessions;
Next comes the use of chondoprotectors (drugs that help restore the structure of cartilage). Among the active components of chondoprotectors is Hyaluronic acid. The course of treatment can last up to six months.

Throughout the entire course of treatment, painkillers are used, because ligament damage is accompanied by constant pain. To eliminate pain, medications such as Ibuprofen, Diclofenac, and Paracetamol are prescribed.

Surgical intervention

In case of injury to the meniscus, the following points are indications for surgical manipulation:

severe injuries;
when the cartilage is crushed and the tissue cannot be restored;
severe injuries to the meniscal horns;
tear of the posterior horn;
articular cyst.

The following types of surgical procedures are performed in case of damage to the posterior horn of the shock-absorbing cartilaginous plate:

resection torn elements or meniscus. This type of manipulation is performed with incomplete or complete tear;
recovery destroyed tissues;
replacement destroyed tissue by implants;
stitching menisci. Such surgical intervention is carried out in case of fresh injury and immediate medical attention is sought.

Let's take a closer look at the types of surgical treatment for knee injuries.

Arthrotomy

The essence of arthrotomy comes down to complete resection of the damaged meniscus. This operation is performed in rare cases when the articular tissues, including blood vessels, are completely damaged and cannot be restored.

Modern surgeons and orthopedists have recognized this technique as ineffective and is practically not used anywhere.

Partial meniscectomy

When restoring the meniscus, the damaged edges are trimmed so that there is a smooth surface.

Endoprosthetics

A donor organ is transplanted to the site of the damaged meniscus. This type of surgical intervention is not performed often, because rejection of the donor material is possible.

Stitching damaged tissues

Surgical treatment of this type aims to restore destroyed cartilage tissue. This type of surgical intervention gives positive results if the injury has affected the thickest part of the meniscus, and there is a possibility of healing of the damaged surface.

Stitching is performed only for fresh damage.

Arthroscopy

Surgical intervention using arthroscopic techniques is considered the most modern and effective method of treatment. With all the advantages, trauma during the operation is practically eliminated.

To perform the operation, several small incisions are made in the articular cavity, through which the instruments are inserted along with the camera. During the intervention, saline solution is supplied through the incisions.

The arthroscopy technique is remarkable not only for its low traumatism during its implementation, but also because it is possible to simultaneously see the true condition of the injured limb. Arthroscopy is also used as one of the diagnostic methods when making a diagnosis after damage to the meniscus of the knee joint.

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Meniscus injuries

A meniscus injury is the most common injury to the knee joint. The knees themselves are a weak point in the human skeleton, because the daily load on them begins from the very moment the child begins to walk. Very often, damage to the meniscus occurs during outdoor games, when playing contact sports, during too sudden movements or during falls. Another cause of meniscal tears is knee injuries sustained in road accidents.

Treatment of a tear of the posterior horn of the medial meniscus can be surgical or conservative.

Conservative treatment

Conservative treatment consists of adequate pain relief. If blood accumulates in the joint cavity, it is punctured and the blood is pumped out. If a joint blockade occurs after an injury, it is eliminated. If a meniscus tear occurs, combined with other knee injuries, a plaster splint is applied to provide complete rest to the leg. In this case, rehabilitation takes more than one month. To restore knee function, gentle physical therapy is prescribed.

Surgery

Currently, the following types of operations are performed:

Arthroscopic surgery.

Arthroscopic suture of the meniscus.

Meniscus transplantation.

Rehabilitation

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As a rule, a torn meniscus affects football players, dancers and other people whose lives are connected with sports. But you should be prepared for the fact that a disease of this kind can overtake you, so it is important to know the symptoms and treatment methods.

A rupture of the posterior horn of the medial meniscus is the result of an injury that can be sustained not only by athletes or overly active individuals, but also by older people who simultaneously suffer from other diseases, such as arthrosis.

So what is a torn meniscus? To understand this, you need to know, in general, what a meniscus is. This term refers to a special fibrous cartilage tissue that is responsible for shock absorption in the joint. In addition to the knee joint, such cartilage is also found in the joints of the human body. However, it is the injury to the posterior horn of the meniscus that is considered the most common and dangerous injury, which threatens complications and serious consequences.

A little about menisci

A healthy knee joint has two cartilaginous inserts, external and internal, respectively, lateral and medial. Both of these tabs are crescent shaped. The lateral meniscus is dense and quite mobile, which ensures its safety, that is, the external meniscus is less likely to be injured. As for the internal meniscus, it is rigid. Thus, medial meniscus injury is the most common injury.

The meniscus itself is not simple and consists of three elements: the body, the posterior and anterior horn. Part of this cartilage is penetrated by a capillary network, which forms the red zone. This area is the densest and is located on the edge. In the middle is the thinnest part of the meniscus, the so-called white zone, which is completely devoid of blood vessels. After an injury, it is important to correctly determine which part of the meniscus was torn. The living zone of cartilage is subject to better restoration.

There was a time when experts believed that as a result of complete removal of the damaged meniscus, the patient would be relieved of all problems associated with the injury. However, today it has been proven that both the external and internal menisci have very important functions for joint cartilage and bones. The meniscus cushions and protects the joint and its complete removal will lead to arthrosis.

Today, experts talk about only one obvious cause of such an injury: a rupture of the posterior horn of the medial meniscus. This cause is considered to be an acute injury, since not any aggressive impact on the knee joint can lead to damage to the cartilage responsible for shock absorption of the joints.

In medicine, there are several factors that predispose to cartilage damage:

vigorous jumping or running performed on an uneven surface;

twisting on one leg without lifting the limb from the surface;

fairly active walking or long squatting;

injury sustained in the presence of degenerative joint diseases;

congenital pathology in the form of weakness of joints and ligaments.

Symptoms

Typically, damage to the medial meniscus of the knee joint occurs as a result of the unnatural position of parts of the joint at a certain moment when the injury occurs. Or the rupture occurs due to pinching of the meniscus between the tibia and femur. The tear is often accompanied by other knee injuries, so the differential diagnosis can be difficult at times.

Doctors advise people who are at risk to know and pay attention to symptoms indicating a meniscus tear. Signs of injury to the internal meniscus include:

pain that is very sharp at the time of injury and lasts for several minutes. You may hear a clicking sound before the pain sets in. After some time, the acute pain may subside and you will be able to walk, although it will be difficult to do so through the pain. The next morning you will feel pain in your knee, as if a nail has been stuck there, and when you try to bend or straighten your knee, the pain will intensify. After rest, the pain will gradually subside;

jamming of the knee joint or in other words blockage. This symptom is very characteristic of a rupture of the internal meniscus. A meniscal block occurs when the torn part of the meniscus becomes pinched between the bones, as a result of which the motor function of the joint is impaired. This symptom is also characteristic of ligament damage, so you can find out the true cause of the pain only after diagnosing the knee;

hemarthrosis. This term refers to the presence of blood in the joint. This happens when the rupture occurs in the red zone, that is, in the zone penetrated by capillaries;

swelling of the knee joint. As a rule, swelling does not appear immediately after a knee injury.

Nowadays, medicine has learned to distinguish between an acute tear of the medial meniscus and a chronic one. This may have been due to hardware diagnostics. Arthroscopy examines the condition of cartilage and fluid. A recent tear of the internal meniscus has smooth edges and an accumulation of blood in the joint. While in case of chronic injury, the cartilage tissue is multi-fiber, there is swelling from the accumulation of synovial fluid, and often the nearby cartilage is also damaged.

A tear of the posterior horn of the medial meniscus must be treated immediately after the injury, since over time, untreated damage will become chronic.

If treatment is not timely, meniscopathy develops, which often, in almost half of the cases, leads to changes in the structure of the joint and, consequently, to degradation of the cartilaginous surface of the bone. This, in turn, will inevitably lead to arthrosis of the knee joint (gonarthrosis).

Conservative treatment

Primary tear of the posterior horn of the meniscus must be treated with therapeutic methods. Naturally, injuries occur when the patient needs emergency surgery, but in most cases conservative treatment is sufficient. Therapeutic measures for this damage, as a rule, include several very effective stages (of course, if the disease is not advanced!):

reposition, that is, realignment of the knee joint during blockade. Manual therapy helps a lot, as well as hardware traction;

elimination of joint swelling. To do this, specialists prescribe anti-inflammatory drugs to the patient;

rehabilitation activities such as exercise therapy, massage, physiotherapy;

The longest, but at the same time the most important process is the restoration of the menisci. Typically, the patient is prescribed courses of chondroprotectors and hyaluronic acid, which are carried out for 3-6 months annually;

Do not forget about painkillers, since damage to the posterior horn of the meniscus is usually accompanied by severe pain. There are many analgesics used for these purposes. Among them, for example, ibuprofen, paracetamol, diclofenac, indomethacin and many other drugs, dosage

Be healthy!

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Types of breaks

The meniscus is a part of the knee joint that protects the bone tissue from friction and strengthens the joint from the inside. The menisci are located between the bony epiphyses of the knee and stabilize its position.

The horns of the meniscus are the extensions of connective tissue that secure the shape of the knee joint. They do not allow the position of the bones to change relative to each other. Between the horns, the outermost parts of the meniscus, there are denser areas - this is the body of cartilage.

The medial meniscus is fixed by horns on the bone, it is located on the inside of the lower limb. The lateral one is located in the outer part. The lateral meniscus is largely responsible for mobility. Therefore, its damage occurs less frequently. But the medial one stabilizes the joint and does not always withstand tension.
Meniscal tears account for 4 out of 5 cases of all knee injuries. In most cases, they occur due to too much stress or sudden movements.

Sometimes degenerative processes in the cartilage tissue of the joint become a concomitant risk factor. Osteoarthritis of the knee increases the likelihood of traumatic injury. This also includes excess weight, lack of habit of ligaments to loads.

The rupture does not always occur instantly due to too much stress, shocks and falls. Sometimes it develops over a long period of time. Symptoms may or may not be present in this situation. However, if the cartilage junction is not treated, sooner or later its edges will rupture.

Damage to the posterior horn

Types of injuries:

Anterior horn injuries

Damage to the anterior horn develops generally according to the same pattern as the posterior one:

The patient often loses the ability to move.
The pain is piercing, preventing you from bending and straightening your leg.
The muscles weaken and become flabby.

The anterior horn breaks more often than the posterior one, since it is somewhat less thick. In most cases, the damage is longitudinal. In addition, the tears are stronger and more often form flaps of cartilage tissue.

Signs

The main sign of a meniscus tear is severe pain in the knee joint. When the posterior horn ruptures, the pain is localized mainly in the popliteal region. If you touch the knee with noticeable pressure, the pain increases sharply. It is practically impossible to move due to pain.

The easiest way to understand that a rupture has occurred is when trying to move. The most severe pain occurs if the victim tries to straighten the lower limb or make other movements with the lower leg.

After injury, symptoms vary depending on how much time has passed. The first month and a half the pain is quite severe. If the patient has not lost the ability to walk, the pain will intensify with the slightest exertion. In addition, even normal walking will be accompanied by unpleasant sounds, the meniscus will crack.

The knee joint will swell and become unstable. Because of this, doctors may advise not to stand up, even if the victim is physically able to do so.

If the rupture is not traumatic, but degenerative in nature, the symptoms become chronic. The pain here is less pronounced and appears mainly during tension. Sometimes the pain does not develop immediately, and the patient does not visit the doctor for a long time. This can lead to acute traumatic disruption of the integrity of the joint.

To diagnose an injury, your doctor may use the following specific symptoms:

a sharp pain pierces if you press on the front part of the knee while straightening the lower leg;
the injured lower limb may straighten more than usual;
the skin in the knee and upper leg becomes more sensitive;
when trying to climb stairs, the knee joint “jams” and stops working.

Degrees

Classification of the condition of the knee cartilage according to Stoller:

Treatment

If symptoms of the third degree of severity are obvious, you need to provide first aid and call an ambulance. Until the doctors arrive, the victim must not be allowed to move. To relieve pain and avoid severe swelling, apply ice.

When emergency technicians arrive, they will give you an injection of painkillers. After this, it will be possible, without torturing the victim, to apply a temporary splint.

This is necessary to immobilize the knee joint and prevent the damage from getting worse. It may be necessary to drain fluid and blood from the joint cavity. The procedure is quite painful, but necessary.

How to treat depends on the strength of the tear and location. The primary task of the doctor is to choose between conservative and surgical therapy.

Options

If the edges of the cartilage are torn and the flaps are blocking movement, surgery will be required. You also cannot do without it if the position of the bones relative to each other is disturbed, or the meniscus is crushed.

The surgeon can perform the following interventions:

sew up cartilage flaps;
remove the entire joint or posterior horn;
secure parts of the cartilage with fixing parts made of bioinert materials;
transplant this part of the joint;
restore the shape and position of the knee joint.

During the operation, a skin incision is made. A drainage tube, a light source and an endoscopic lens are inserted through it. These devices help make surgery less traumatic.

All manipulations of the meniscus, including removal, are carried out with thin instruments inserted through the incision. This ensures not only that the operation is less bloody, but also makes it possible in principle. The area of the posterior horn is difficult to reach, and this is the only way to influence it.

Conservative therapy and rehabilitation after surgery may include:

Damage to the external meniscus of the knee joint

Although the bones of the knee joints are the largest in the human skeleton, it is the knee that accounts for the majority of injuries. Injury occurs due to high loads on this part of the limb. We will talk about such an injury as damage to the posterior horn of the medial meniscus and methods for eliminating its consequences.

Purpose of the meniscus

The limb joint belongs to a complex structure, where each element solves a specific problem. Each knee is equipped with menisci that bisect the articular cavity and perform the following tasks:

stabilizing. During any physical activity, the articular surfaces shift in the desired direction;
act as shock absorbers, softening shocks and shocks during running, jumping, and walking.

lateral (outer);
medial (internal).

Each type of shock-absorbing plate is formed by a body and horns (back and front). Shock-absorbing elements move freely during physical activity.

The main damage occurs to the posterior horn of the internal meniscus.

Why does injury occur?

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

increased sports loads (jogging over rough terrain, jumping);
active walking, prolonged squatting position;
chronic articular pathologies in which inflammation of the knee region develops;
congenital articular pathology.

The listed reasons lead to meniscus injuries of varying severity.

Classification

Symptoms of injury to cartilaginous elements depend on the severity of the damage to the cartilage tissue. There are the following stages of internal meniscal damage:

Stage 1 (mild). Movement of the injured limb is normal. The pain is mild and becomes more intense during squats or jumps. There may be slight swelling above the kneecap;
2nd degree injury is accompanied by severe pain. The limb is difficult to straighten even with outside help. You can move while limping, but the joint can become blocked at any moment. The swelling gradually becomes greater, and the skin changes color;
damage to the posterior horn of the medial meniscus 3 degrees accompanied by pain syndromes of such intensity that it is impossible to endure. It hurts most at the location of the kneecap. Any physical activity is impossible. The knee becomes larger in size, and the skin changes its healthy color to purple or bluish.

If the medial meniscus is damaged, the following symptoms exist:

the pain intensifies if you press on the kneecap from the inside and simultaneously straighten the limb (Bazhov’s maneuver);
the skin of the knee area becomes overly sensitive (Turner's symptom);
when the patient lies down, the palm passes under the injured knee without any problems (Land's symptom).

After making a diagnosis, the doctor decides which treatment method to use.

Horizontal gap

Depending on the location of the injured area and the general characteristics of the injury, types of injury to the medial meniscus are distinguished:

walking along;
oblique;
passing across;
horizontal;
chronic form of pathology.

Features of horizontal damage to the posterior horn of the medial meniscus are the following:

with this type of tear of the internal shock-absorbing plate, injury occurs directed to the joint capsule;
Swelling occurs in the area of the joint gap. This development of pathology has common symptoms with damage to the anterior meniscal horn of the outer cartilage, so special attention is required when diagnosing.

With horizontal, partial damage, the cavity begins to accumulate excess synovial fluid. Pathology can be diagnosed by ultrasound.

Treatment of a horizontal rupture of the posterior horn of the medial meniscus, when promptly seeking medical help, is prescribed in the form of complex, traditional therapy, because with this type of injury there is no blocking of the joint. First, non-steroidal medications are prescribed to relieve pain and swelling. The injured knee is then fixed in a plaster cast. The traditional treatment method can last from six months to 12 months. During the first 3 months, the joint is immobilized with a plaster cast.

After the first symptoms are relieved, a set of special gymnastic exercises is developed for each patient. Physiotherapy and massage sessions are prescribed.

If traditional treatment methods do not give a positive result, then surgical intervention is indicated.

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Synovitis due to injury to the medial meniscus

Advanced forms of synovitis lead to the development of arthritis. Therefore, during diagnosis, the symptoms of a torn meniscus are similar to chronic arthritis.

If synovitis is not treated in time, the cartilaginous surface will be completely destroyed. The joint will no longer receive nutrition, which will lead to further disability.

Treatment methods

Treatment for damage to the posterior horn of the medial meniscus can be conservative or surgical. When treating such injuries, traditional methods are often used.

Complex, traditional therapy for injury to the internal meniscus includes the following measures:

A joint block is performed using special medications, after which the motor ability of the joint is partially restored;
anti-inflammatory medications are prescribed to remove swelling;
recovery period, including a set of special gymnastic exercises, physiotherapy and massage sessions;
Next comes the use of chondoprotectors (drugs that help restore the structure of cartilage). Among the active components of chondoprotectors is Hyaluronic acid. The course of treatment can last up to six months.

Surgical intervention

In case of injury to the meniscus, the following points are indications for surgical manipulation:

severe injuries;
when the cartilage is crushed and the tissue cannot be restored;
severe injuries to the meniscal horns;
tear of the posterior horn;
articular cyst.

The following types of surgical procedures are performed in case of damage to the posterior horn of the shock-absorbing cartilaginous plate:

resection torn elements or meniscus. This type of manipulation is performed with incomplete or complete tear;
recovery destroyed tissues;
replacement destroyed tissue by implants;
stitching menisci. Such surgical intervention is carried out in case of fresh injury and immediate medical attention is sought.

Let's take a closer look at the types of surgical treatment for knee injuries.

Arthrotomy

Modern surgeons and orthopedists have recognized this technique as ineffective and is practically not used anywhere.

Partial meniscectomy

During surgery, the torn, dangling parts of the damaged meniscus are resected, and the surviving elements are restored.

When restoring the meniscus, the damaged edges are trimmed so that there is a smooth surface.

Endoprosthetics

A donor organ is transplanted to the site of the damaged meniscus. This type of surgical intervention is not performed often, because rejection of the donor material is possible.

Stitching damaged tissues

Stitching is performed only for fresh damage.

Arthroscopy

Surgical intervention using arthroscopic techniques is considered the most modern and effective method of treatment. With all the advantages, trauma during the operation is practically eliminated.

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