Rupture of the posterior horn of the outer meniscus. Characteristic symptoms and treatment of rupture of the posterior horn of the medial meniscus

Although the bones of the knee joints are the largest in the human skeleton, the majority of injuries occur in the knee. Injury occurs due to high loads on this part of the limb. Let's talk about such an injury as damage to the posterior horn of the medial meniscus and methods to eliminate its consequences.

Appointment of the meniscus

The limb joint refers 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 are displaced in the right direction;
• act as shock absorbers, softening shocks and shocks while running, jumping, walking.

Injury to shock-absorbing elements occurs with various articular injuries, precisely because of the load that these articular parts take on. Each knee has two menisci, which are made up of cartilage:

• lateral (outer);
• medial (internal).

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

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

Why injury happens

A common injury to the cartilage plate is a tear, complete or incomplete. Professional athletes and dancers are often injured, and whose specialty is associated with high loads. Injuries occur in the elderly, and as a result of accidental, unforeseen 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.

These causes lead to injuries of the meniscus of varying severity.

Classification

Symptoms of trauma to the cartilage 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. Pain is weak, and becomes more intense during squats or jumps. There may be slight swelling above the kneecap;
• 2 degree injury is accompanied by severe pain. It is difficult to straighten the limb even with outside help. You can move with a limp, but at any moment the joint can become blocked. Puffiness gradually becomes more and more, and the skin changes shade;
• 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 the 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 cyanotic.

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

1. pain intensifies if you press on the patella from the inside and at the same time straighten the limb (Bazhov's technique);
2. the skin of the knee area becomes too sensitive (Turner's symptom);
3. when the patient lies down, the palm passes under the injured knee without problems (Land's symptom).

After the diagnosis is made, the doctor decides which treatment method to apply.

Horizontal gap

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

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

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

• with this type of tearing of the internal shock-absorbing plate, injury occurs, directed to the joint capsule;
• there is swelling in the area of ​​the joint gap. This development of the pathology has common signs with damage to the anterior meniscus horn of the external cartilage, therefore, special attention is needed when diagnosing.

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

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

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

Synovitis due to trauma to the medial meniscus

Against the background of damage to the posterior horn of the medial meniscus, synovitis may begin. This pathology develops due to structural cartilage changes that occur in the tissues during injury. When ruptured, synovial fluid begins to be produced in large volume, and fills the joint cavity.

As synovitis (fluid buildup) develops, it becomes increasingly difficult to move. 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, at the time of diagnosis, the symptoms of a torn meniscus are similar to chronic arthritis.

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

Therapeutic techniques

With any articular injury, treatment should be started in a timely manner, without delay. If you postpone the appeal to the clinic, then the trauma passes to a chronic course. 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. In the treatment of such injuries, traditional methods are often used.

Complex, traditional therapy for injuries of the internal meniscus includes the following activities:

1. an articular blockade is performed using special medications, after which the motor ability of the joint is partially restored;
2. anti-inflammatory drugs are prescribed to remove puffiness;
3. recovery period, including a set of special gymnastic exercises, physiotherapy and massage sessions;
4. then comes the reception of chondoprotectors (drugs that help restore the structure of the cartilage). Hyaluronic acid is present among the active components of chondoprotectors. The course of admission can last up to six months.

During the entire course of treatment, painkillers are present, because damage to the ligaments is accompanied by constant pain. To eliminate pain, drugs such as Ibuprofen, Diclofenac, Paracetamol are prescribed.

Surgical intervention

When the meniscus is injured, the following points serve as indications for surgical manipulations:

• severe injuries;
• when cartilage is crushed and tissues cannot be restored;
• severe injuries of the meniscus 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 cartilage plate:

1. resection broken elements, or meniscus. This kind of manipulation is performed with incomplete or complete anguish;
2. recovery destroyed tissues;
3. replacement destroyed tissue by implants;
4. stitching menisci. Such surgical intervention is carried out in case of fresh damage, and immediate medical attention is sought.

Let us consider in more detail the types of surgical treatment of knee injuries.

Arthrotomy

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

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

Partial meniscectomy

When repairing the meniscus, the damaged edges are trimmed so that there is a flat surface.

Endoprosthetics

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

Stitching of damaged tissues

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

Stitching is performed only with fresh damage.

Arthroscopy

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

To perform the operation, several small incisions are made in the joint cavity, through which the instrumentation is inserted along with the camera. Through the incisions, during the intervention, a saline solution is supplied.

The technique of arthroscopy is remarkable not only for its low traumatism during the procedure, but also for the fact that you can simultaneously see the true state of the damaged limb. Arthroscopy is also used as one of the diagnostic methods in making a diagnosis after damage to the meniscus of the knee joint.

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Anatomy

The menisci of the knee joint are crescent-shaped cartilage formations that increase the congruence of the articular surfaces, act as shock absorbers in the joint, participate in the nutrition of the hyaline cartilage, and also stabilize the knee joint. When moving in the knee joint, the menisci move in different directions, slide along the tibial plateau, their shape and tension may change. There are two menisci of the knee joint:
- medial meniscus
- outer (lateral) meniscus

The menisci are made up of fibrous cartilage. As a rule, the menisci are crescent-shaped, although there are variants of disc-shaped menisci (more often external). On a transverse section, the shape of the meniscus is close to a triangle, the base facing the joint capsule.

Allocate meniscus body, anterior and posterior horn of the meniscus. The medial meniscus forms a larger semicircle than the lateral one. Its narrow anterior horn inserts on the medial part of the intercondylar eminence, anterior to the ACL (anterior cruciate ligament), and its broad posterior horn inserts on the lateral part of the intercondylar eminence, anterior to the PCL (posterior cruciate ligament) and posterior to the insertion of the lateral meniscus. The medial meniscus is firmly fixed to the joint capsule throughout and therefore less mobile, which leads to a greater frequency of its damage. The lateral meniscus is wider than the medial one and has an almost annular shape. Also, the lateral meniscus is more mobile, which reduces the frequency of its rupture.

It is carried out from the arteries of the joint capsule. According to the degree of blood supply 3 zones. The most well-perfused area of ​​the meniscus is located closer to the joint capsule (red zone). The inner parts of the menisci do not have their own blood supply (white zone), the nutrition of this part is carried out due to the circulation of the intraarticular fluid. Therefore, meniscal injuries near the joint capsule (paracapsular tears) are more likely to heal, and tears on the inside of the meniscus tend not to heal. These features largely determine the tactics of meniscus injury treatment, and the possibility of performing a meniscus suture.

According to the localization of damage, there are several types of meniscal injury: damage to the body of the meniscus (rupture like a "watering can handle", longitudinal tear, transverse tear, horizontal tear, patchwork tear, etc.), damage to the anterior or posterior horn of the meniscus, paracapsular damage.

There are both isolated damage to the internal or external meniscus, and their combined damage. Sometimes a meniscal injury is part of a more complex injury to the structures of the knee joint.

Symptoms

Meniscus injury are among the most common pathologies of the knee joint.

The typical mechanism of meniscus injury is injury caused by rotation of a bent or half-bent leg at the time of its functional load, with a fixed foot (playing football, hockey, other game sports, collisions, falling while skiing).

Less often, meniscal tears occur when squatting, jumping, uncoordinated movement. Against the background of degenerative changes, an injury that leads to damage to the meniscus may be minor.

In the clinical picture of meniscus injury, it is customary to distinguish between acute and chronic periods. Acute period occurs immediately after the initial injury. The patient develops strong pain in the knee joint, limitation of movement due to pain, sometimes the lower leg is fixed in the flexion position ( blockade of the joint). In an acute case, a meniscus tear is often accompanied by bleeding into the cavity of the knee joint ( hemarthrosis). There is swelling of the joint area.

Often, meniscus damage in recent cases is not diagnosed, often a diagnosis of a bruised joint or sprain is made. As a result of conservative treatment, primarily due to the fixation of the leg and the creation of rest, the condition gradually improves. However, with serious damage to the meniscus, the problem remains.

After some time, when the load is resumed, or with a repeated minor injury, and often with an awkward movement, pain again occurs, joint function is impaired, synovial fluid in the joint accumulates again ( post-traumatic synovitis), or blockades of the joint are repeated. This is the so-called chronic period diseases. In this case, one can say about stale or chronic damage to the meniscus.

Typical symptoms: The patient complains of pain in the projection of the meniscus during movements, and usually can clearly show the pain point quite clearly. Limitation of range of motion (impossibility of full extension of the leg, or full squat). violation of movements in the knee joint. A symptom of joint blockade, when the torn part of the meniscus moves in the joint cavity and is periodically infringed between the articular surfaces of the femur and tibia. In some cases, the patient himself knows how to eliminate the resulting block of the joint or resorts to the help of outsiders. After the blockade of the joint is eliminated, movements in it again become possible in full. Periodically, reactive inflammation of the inner lining of the joint occurs, synovial fluid accumulates in the joint - post-traumatic synovitis. Gradually, weakening and impaired coordination of muscles develops - muscle hypotrophy, impaired gait.

An additional danger of chronic meniscus damage is the gradual damage to the articular cartilage, and the development of post-traumatic arthrosis.

Diagnosis of meniscal injury includes taking an anamnesis, a clinical examination by a specialist, and instrumental research methods. To exclude damage to bone structures and clarify the relationship between the components of the joint, as a rule, an x-ray examination is performed (damage to the menisci is not visible on the pictures, since the menisci are transparent to x-rays). To visualize menisci and other intra-articular structures, the most informative non-invasive method at present is magnetic resonance imaging (MRI), computed tomography (CT), ultrasound diagnostics (ultrasound) is also used.

1 intact menisci.
2 Damage to the posterior horn of the meniscus.

Traumatic injuries of the menisci are often combined with damage to other structures of the knee joint: cruciate ligaments, lateral ligaments, cartilage, knee joint capsule.

The most accurate and complete diagnosis is carried out during the initial stage of arthroscopic surgery, during examination and revision of all parts of the joint.

Treatment of meniscal injuries

Conservative treatment: First aid is usually anesthesia, puncture of the joint, removal of blood accumulated in the joint, if necessary, the blockade of the joint is eliminated. To create rest, a plaster splint bandage or splint is applied. The term of immobilization is 3-4 weeks (sometimes up to 6 weeks). A protective regimen is prescribed, local cold, observation in dynamics, non-steroidal anti-inflammatory drugs. After some time, physiotherapy exercises, walking with a cane or crutches, physiotherapy are added. With a favorable course, restoration of function and return to sports loads is achieved in 6-8 weeks.

If it is not possible to eliminate the blockade of the joint, or after conservative treatment, the blockade of the joint occurs again, the patient is constantly worried about pain in the joint, difficulty walking - surgical treatment is indicated.

To date, the most effective treatment is arthroscopic surgery.

The operation is closed. Through 2 punctures (0.5 cm each), an arthroscope and the necessary instruments are inserted into the joint cavity. An examination of all parts of the joint is carried out, the nature and degree of damage to the meniscus is specified. Depending on the nature and location of the damage, the issue of the need to remove the damaged part of the meniscus, or the possibility of a meniscus suture, is decided.

A bit of history: In 1962, Professor Watanabe M. described the technique and performed the first endoscopic operation - a partial resection of the meniscus. In 1971 O'Connor R.L. gets acquainted with the new technique of meniscus resection and begins to apply it in his clinic. In 1975 O'Connor R.L. published the first results of arthroscopic operations, and describes the technique of endoscopic resection of a damaged meniscus fragment with subsequent alignment of the remaining part. The first works on performing an arthroscopic meniscus suture with a description of the technique and instruments were published by Wirth C.R., 1981; Stone R.G., Miller G., 1982. These works marked a new stage in meniscus surgery, since previously these operations were performed only in an open way. In modern times, most operations for meniscal injury are performed arthroscopically.

The arthroscopic technique of the operation allows the most careful treatment of the tissues of the joint. As a rule, only the damaged part of the meniscus is removed, and the edges of the defect are aligned. The greater part of the intact meniscus can be preserved, the less likely the progression of post-traumatic changes in the joint. Complete removal of the meniscus leads to the development of severe arthrosis.
With a fresh injury, and the localization of damage is closer to the paracapsular zone, an operation can be performed - an arthroscopic meniscus suture.

The decision on the tactics of the treatment is made by the operating surgeon during the operation, based on the study of the damaged meniscus and technical capabilities.

Due to the low invasiveness of the operation, the inpatient stage of treatment usually takes 1-3 days. In the postoperative period, physical activity is limited to 2-4 weeks. In some cases, walking on crutches and wearing a knee brace is recommended. Rehabilitation treatment can begin from the first week. Full recovery and return to sports activities usually occur within 4-6 weeks.

With timely diagnosis and a skilled operation, the treatment gives excellent functional results and allows you to fully restore physical activity.

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Development mechanism

The knee has a complex structure. The joint includes the surfaces of the condyles of the femur, the cavity of the lower leg, and the patella. For better stabilization, cushioning and load reduction, paired cartilaginous formations are localized in the joint space, which are called medial (internal) and lateral (external) menisci. They have the shape of a crescent, the narrowed edges of which are directed forward and backward - the anterior and posterior horns.

The outer meniscus is a more mobile formation, therefore, with excessive mechanical action, it shifts slightly, which prevents its traumatic damage. The medial meniscus is fixed by ligaments more rigidly; when exposed to mechanical force, it does not move, as a result of which damage occurs more often in various departments, in particular in the region of the posterior horn.

The reasons

Damage to the posterior horn of the medial meniscus is a polyetiological pathological condition that develops under the influence of various factors:

• The impact of kinetic force in the knee area in the form of a blow or fall on it.
• Excessive bending of the knee, leading to tension in the ligaments that fix the menisci.
• Rotation (rotation) of the femur with a fixed lower leg.
• Frequent and long walking.
• Congenital changes that cause a decrease in the strength of the knee ligaments, as well as its cartilage.
• Degenerative-dystrophic processes in the cartilaginous structures of the knee, leading to their thinning and damage. This cause is most common in the elderly.

Finding out the reasons allows the doctor not only to choose the optimal treatment, but also to give recommendations regarding the prevention of re-development.

Kinds

Violation of the structure and shape of the medial meniscus in the region of the posterior horn is classified according to several criteria. Depending on the severity of the injury, there are:

Depending on the main causative factor that led to the development of the pathological condition of the cartilaginous structures of the knee, traumatic and pathological degenerative damage to the posterior horn of the medial meniscus is distinguished.

According to the criterion of prescription of an injury or a pathological violation of the integrity of this cartilaginous structure, fresh and chronic damage to the posterior horn of the medial meniscus is distinguished. Combined damage to the body and the posterior horn of the medial meniscus is also highlighted separately.

Manifestations

Clinical signs of damage to the posterior horn of the medial meniscus are relatively characteristic and include:

• Pain that is localized on the inner surface of the knee joint. The severity of pain depends on the cause of the violation of the integrity of this structure. They are more intense with traumatic injury and increase dramatically while walking or going down stairs.
• Violation of the state and functions of the knee, accompanied by a limitation of the fullness of range of motion (active and passive movements). With a complete detachment of the posterior horn of the medial meniscus, a complete block in the knee may occur against the background of sharp pain.
• Signs of the development of inflammation, including hyperemia (redness) of the skin of the knee area, swelling of the soft tissues, as well as a local increase in temperature, which is felt after touching the knee.

With the development of a degenerative process, the gradual destruction of cartilage structures is accompanied by the appearance of characteristic clicks and a crunch in the knee during movements.

Clinical manifestations are the basis for the doctor to prescribe an objective additional diagnosis. It includes research, primarily aimed at visualizing the internal structures of the joint:

Arthroscopy also allows for therapeutic manipulations under visual control after additional introduction of special microinstrumentation into the joint cavity.

Damage to the posterior horn of the medial meniscus - treatment

After an objective diagnosis with the determination of localization, the severity of the violation of the integrity of the cartilaginous structures of the joint, the doctor prescribes a comprehensive treatment. It includes several areas of activities, which include conservative therapy, surgical intervention, as well as subsequent rehabilitation. Mostly all events complement each other and are assigned sequentially.

Treatment without surgery

If partial damage to the posterior horn of the medial meniscus was diagnosed (grade 1 or 2), then conservative treatment is possible. It includes the use of drugs of various pharmacological groups (non-steroidal anti-inflammatory drugs, vitamin preparations, chondroprotectors), the performance of physiotherapeutic procedures (electrophoresis, mud baths, ozocerite). During therapeutic measures, functional rest for the knee joint is necessarily ensured.

The main goal of the operation is to restore the anatomical integrity of the medial meniscus, which allows to ensure the normal functional state of the knee joint in the future.

Surgical intervention can be performed with open access or with the help of arthroscopy. Modern arthroscopic intervention is considered the method of choice, since it is less traumatic and can significantly reduce the duration of the postoperative rehabilitation period.

Rehabilitation

Regardless of the type of treatment performed, rehabilitation measures are necessarily prescribed, which include the performance of special gymnastic exercises with a gradual increase in the load on the joint.

Timely diagnosis, treatment and rehabilitation of violations of the integrity of the medial meniscus of the knee allows you to achieve a favorable prognosis for the restoration of the functional state of the knee joint.

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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:

1. External (lateral).
2. 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:

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

meniscus tears

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 can 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:

1. 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.
2. 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.
3. 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:

1. Sharp pain even at rest.
2. Hemorrhage within the tissue.
3. Blockage of the knee.
4. Arthroscopy tissue has smooth edges.
5. 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 used, 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.

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?

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Types of breaks

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

The horns of the meniscus are processes of connective tissue that fix 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 extreme parts of the meniscus, there are denser areas - this is the body of the cartilage.

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

Sometimes degenerative processes of the cartilaginous 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 gap does not always occur instantly due to too much load, bumps and falls. Sometimes it develops over time. Symptoms may or may not be present in this situation. However, if the cartilaginous joint is left untreated, sooner or later its edges will rupture.

Damage to the posterior horn

Types of injuries:

Anterior horn injury

Damage to the anterior horn develops in general according to the same pattern as the posterior horn:

1. The patient often loses the ability to move.
2. The pains are piercing, not allowing to bend and unbend the leg.
3. Muscles weaken, become flabby.

The anterior horn is torn more often than the posterior horn, as it is somewhat less thick. In most cases, damage is of the longitudinal type. In addition, the ruptures are stronger and more often form flaps of cartilage tissue.

signs

The main symptom of a torn meniscus is severe pain in the knee joint. When the posterior horn is torn, the pain is localized mainly in the popliteal region. If you touch the knee with palpable pressure, the pain increases dramatically. It is almost impossible to move because of the pain.

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

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

The knee joint will swell and lose stability. Because of this, doctors may advise not to stand up, even if the injured person is physically capable of it.

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

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

• a sharp pain pierces if you press on the front of the knee while straightening the lower leg;
• the injured lower limb can straighten more than usual;
• the skin in the knee and upper leg becomes more sensitive;
• when trying to climb the 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. Before the doctors arrive, the victim must not be allowed to move. Ice should be applied to relieve pain and avoid severe swelling.

When the paramedics arrive, they will give you an injection of painkillers. After that, it will be possible, without torturing the victim, to impose a temporary splint.

This is necessary to immobilize the knee joint and prevent damage from worsening. You may need 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 gap and localization. The primary task of the doctor is to choose between conservative therapy and surgical.

Options

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

The surgeon can carry out the following actions:

• sew up cartilage flaps;
• remove the entire joint or posterior horn;
• fix 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, an incision is made in the skin. A drainage tube, a light source and an endoscopic lens are inserted through it. These devices help make the operation less traumatic.

All manipulations with the meniscus, including removal, are carried out with thin instruments inserted through the incision. This provides not only less "bloody" operation, but in principle makes it possible. The region of the posterior horn is difficult to reach, and only in this way can it be influenced.

Conservative therapy and rehabilitation after surgery may include:

An intact knee joint has 2 cartilaginous inlays: lateral and medial. These tabs look like a crescent. The outer meniscus has a fairly dense base, it is more mobile, so it is much less likely to be injured. The medial meniscus is not flexible enough, so damage to the medial meniscus occurs most frequently.

Rupture of the posterior horn of the medial meniscus.

At the present time, qualified specialists name one main reason for the origin of the rupture of the posterior horn of the medial meniscus. This cause is an acute injury. There are also a couple of additional factors that contribute to the occurrence of the above injury.
- A strong jump, which is done on a very flat surface.
- Rotation on one leg, without taking off the foot.
- Too active walking or prolonged sitting on squats.
- Injury, which is obtained as a result of a disease of the joints.
- Pathology in the form of weak joints or ligaments.
When the posterior horn of the medial meniscus is torn, the patient immediately feels severe pain, which lasts for a long time. Before feeling pain, the person hears a clicking sound. The patient may experience a blockade of the internal meniscus, this symptomatology occurs as a result of clamping between the bones of a torn meniscus particle. The patient develops hemarthrosis. After a short amount of time, the patient develops swelling of this joint.

Damage to the posterior horn of the medial meniscus.

Damage to the posterior horn of the medial meniscus occurs due to the incorrect position of the parts of the joints during the formation of damage. Qualified specialists strongly recommend that you know the first symptoms of damage to the above part of the knee, especially for people who are at risk. There are two types of damage to the above part.
- Traumatic tear occurs as a result, if the joint is slightly bent, a rotating movement occurs in this joint.
- Degenerative rupture typically occurs in the 45 to 50 age group. Often damage to this form occurs due to repeated microtrauma.

Posterior horn of the medial meniscus, methods of treatment.

If the rupture of the above type of meniscus is mild or moderately severe, then the treatment is prescribed in a conservative way. The patient is strongly advised not to do strong physical exertion on the affected knee. To do this, the patient is assigned crutches, it is necessary to minimize long walks in the fresh air. Compliance with bed rest is not necessary, a person can quite easily do all the housework. In order to relieve pain and swelling, the patient is advised to apply ice packs to the injured area for 15-20 minutes at least 3 times a day. It is forbidden to keep ice for a long time, due to the fact that damage to the skin can occur.
A person with this injury must wear an elastic bandage. The bandage will not only help the swelling go down faster, but also significantly limit the mobility of the knee. Specialists should show the patient how to adjust the bandage. While watching TV or reading, the leg should be slightly higher than the heart. If you are worried about severe pain, it is allowed to use paracetamol or non-steroidal medicines.
If conservative treatment does not show the desired result, the patient is prescribed surgery. There are several types of surgical intervention.
1. Restoration of the meniscus. This type of intervention is quite gentle and is performed on patients under the age of forty, due to the fact that their cartilage tissue is healthy.
2. Removal of the meniscus, is prescribed if there is severe damage to the cartilage tissue. This operation is prescribed extremely rarely, since the complete removal of the meniscus can provoke complications.
3. Meniscus transplantation, is prescribed if it is not possible to restore a damaged meniscus. The transplant is made of artificial material or there is a donor.
A couple of days before the operation, the medical staff conducts a conversation with the patient, telling in detail about the course of the operation. A few weeks before the scheduled date of surgery, the patient is strongly advised to completely eliminate the use of tobacco and alcohol, as this will significantly reduce the risk of blood clots. The success rate increases if the operation is performed within 2 months of the injury.
After the operation, the patient is prescribed a course of physiotherapy. The time it takes a person to return to normal life is directly related to how well the operation went and how long the postoperative period lasts.

The peculiarity of the knee joint is that it easily adapts to atypical conditions for it. Trauma, damage, meniscus tears, cartilage cracking - all this causes acute pain only at first. Then the symptoms subside, which makes the patient think that everything has passed. He is in no hurry to see a doctor, continuing to live a normal life. That is why a chronic meniscus tear is a fairly common diagnosis. Another reason for this condition is misdiagnosis. If there are no pronounced symptoms, and a competent examination was not carried out, then the injury is taken for a normal sprain or bruise, which is why ineffective treatment is prescribed. It only temporarily relieves the symptoms, without eliminating the disease itself.

signs

As a person gets used to the aching pain in the knee, he may not notice the characteristic symptoms. An old meniscus injury is indicated by:

• frequent pain in the joint, aggravated after long standing and physical exertion;
• relief after rest;
• restriction in movement - there are difficulties when trying to fully bend or straighten the leg;
• from time to time there is a reactive inflammation of the joint, which is accompanied by redness, swelling. Possible synovitis.

If treatment is still not provided, then the articular cartilage is gradually destroyed, which invariably leads to post-traumatic arthrosis. Restoring the joint in such cases is almost impossible. The person loses the ability to walk normally, uses a cane or a wheelchair.

Kinds

Since there are two menisci in the knee joint, there are ruptures of the inner (medial) and outer (lateral) ones. Each has its own symptoms. Chronic damage to the medial meniscus of the knee joint is more often diagnosed. This is due to the fact that he is less mobile and more prone to injury. Tears are possible in different places of the cartilage:

• meniscus body;
• anterior horn;
• back horn.

It is also necessary to establish the cause of the injury. The treatment of pathology will depend on this. There are traumatic ruptures and degenerative ones. The latter develop against the background of existing joint diseases and are caused by a weakening of the cartilage structure. As a rule, they occur in older people against the background of a general weakening of the musculoskeletal system.

Treatment

An old meniscal injury is treated conservatively and surgically. In the first case, a set of traditional measures is assumed to restore the motor functions of the joint and ensure its mobility. That means:

• taking chondroprotectors, anti-inflammatory and pain medications;
• massage and physiotherapy;
• exercise and exercise.

Far from always, these methods are effective, because for a long time the cartilage "gets used" to its condition. It is especially difficult to cure an old rupture of the posterior horn of the medial meniscus in a conservative way. Much depends on the size of the injury and the severity of the injury. You will most likely need to wear a bandage and take the necessary medications regularly. Joint restoration is a long process and can take 1-1.5 years.

Operation

An operation is prescribed if it is impossible to eliminate the damage in a conservative way. Today, surgical intervention in most cases is carried out using arthroscopy, which is characterized by a quick rehabilitation period and a small number of complications. Endoscopic surgery (you can walk and move your knee almost immediately) and open surgeries are also popular. The latter is associated with high trauma and is carried out only in the absence of alternatives.

During a surgical operation, the doctor performs various procedures:

• stitches the torn edges of the meniscus;
• removes parts that cannot be restored;
• removes excess fluid from the joint;
• collects biomaterial for its further study.

If an old meniscus injury is treated surgically, the effect is noticeable immediately after the rehabilitation period. However, the patient is advised to refrain from heavy physical exertion for some time. The recovery period involves taking medication and doing simple exercises.

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Symptoms of a meniscus injury

The menisci of the knee are called cartilaginous formations located in the joint cavity, serving as shock absorbers of movement, stabilizers that protect the articular cartilage. There are two menisci, an inner (medial) and an outer (lateral) meniscus. Damage to the internal meniscus of the knee joint occurs much more often, due to its lesser mobility. Damage to the meniscus manifests itself in the form of limited mobility, pain in the knee, and in chronic cases, it can also be the development of arthrosis of the knee joint.

Sharp cutting pain, swelling of the joint, difficulty in moving the limbs and painful clicks indicate that the meniscus is damaged. These symptoms occur immediately after an injury and may be indicative of other joint damage. More reliable symptoms of meniscus damage appear 2-3 weeks after the injury. With such injuries, the patient feels local pain in the joint space, fluid accumulates in the joint cavity, “blockade” of the knee, weakness of the muscles of the anterior surface of the thigh.

More reliable signs of damage to the meniscus are determined using special tests. There are tests for extension of the joints (Landy, Baikov, Roche, etc.), with a certain extension of the joint, pain symptoms are felt. The technique of rotation tests is based on the manifestation of damage during the scrolling movements of the joints (Bragard, Shteiman). Meniscal injury can also be diagnosed by compression symptoms, mediolateral tests, and MRI.

Damage treatment

A meniscal injury involves different treatments, depending on the severity and type of injury. With the classical type of getting rid of ailments, it is possible to distinguish the main types of exposure used for any damage.

First of all, it is worth relieving pain, therefore, to begin with, the patient is given an anesthetic injection, after which they take a puncture of the joint, remove the accumulated blood and fluid from the joint cavity, and, if necessary, eliminate the blockade of the joints. After these procedures, the joint needs rest, to create which a gibs bandage or a splint is applied. In most cases, 3-4 weeks of immobilization is enough, but in severe cases, the period can be up to 6 weeks. It is recommended to apply local cold, non-steroidal drugs that relieve inflammation. Later, you can add physiotherapy exercises, walking with supports, various types of physiotherapy.

Surgery is recommended in severe cases, such as an old meniscus injury. One of the most popular surgical methods today is arthroscopic surgery. This type of surgery has become popular due to its careful attitude to tissues. The operation is a resection of only the damaged part of the meniscus and polishing of defects.

With such injuries as a meniscus tear, the operation is performed closed. Through two holes, an arthroscope with instruments is inserted into the joint to study the damage, after which a decision is made on partial resection of the meniscus or the possibility of sewing it up. Inpatient treatment lasts about 1-3 days, due to the low trauma of this type of operation. At the recovery stage, limited physical activity is recommended for up to 2-4 weeks. In special cases, walking with supports and wearing a knee brace is recommended. From the very first week, you can already begin rehabilitation physical education.

Rupture of the meniscus of the knee joint

The most common knee injury is a tear in the medial meniscus. Distinguish between traumatic and degenerative ruptures of the menisci. Traumatic injuries occur mainly in athletes, young people aged 20-40 years, if left untreated, they transform into degenerative tears, which are more pronounced in older people.

Based on the localization of the rupture, several main types of meniscal rupture are distinguished: a rupture resembling a watering can handle, transverse rupture, longitudinal rupture, flap rupture, horizontal rupture, damage to the anterior or posterior horn of the meniscus, paracapsular injuries.

Consider a tear in the posterior horn of the medial meniscus. This type of tear is the most common, as most longitudinal, vertical, and watering-handle tears begin with a tear in the posterior horn of the meniscus. With long tears, there is a high chance that part of the torn meniscus will interfere with the movement of the joint and cause pain, up to joint blockage. The combined type of meniscus tears occurs, covering several planes, and most often localized in the posterior horn of the meniscus of the knee joint and in the bulk occurs in older people with degenerative changes in the menisci. In case of damage to the posterior horn of the medial meniscus, which does not lead to longitudinal splitting and displacement of the cartilage, the patient constantly feels the threat of blockade of the joint, but it never occurs. Not so often there is a rupture of the anterior horn of the medial meniscus.

Rupture of the posterior horn of the lateral meniscus occurs 6-8 times less often than the medial one, but carries no less negative consequences. Adduction and internal rotation of the lower leg are the main causes of rupture of the lateral meniscus. The main sensitivity in this kind of damage falls on the outer side of the posterior horn of the meniscus. Rupture of the arch of the lateral meniscus with displacement in most cases leads to limitation of movements in the final stage of extension, and sometimes causes blockade of the joint. A rupture of the lateral meniscus is recognized by a characteristic click during rotational movements of the joint inward.

Rupture symptoms

With injuries such as a torn meniscus of the knee joint, the symptoms can be quite different. There is an acute and chronic, inveterate meniscus tear. The main sign of a rupture is the blockade of the joint, in the absence of which it is quite difficult to determine the rupture of the medial or lateral meniscus in the acute period. After some time, in the subacute period, the rupture can be identified by infiltration in the joint space, local pain, as well as with the help of pain tests suitable for any type of damage to the meniscus of the knee joint.

The main symptom of a meniscus rupture is pain when probing the line of the joint space. Special diagnostic tests have been developed, such as the Epley test and the McMurry test. The McMurry test is produced in two types.

In the first variant, the patient is placed on his back, the leg is bent to an angle of about 90 ° in the knee joint and the hip joint. Then, with one hand, they wrap around the knee, and with the other hand, rotational movements of the lower leg are made, first outward and then inward. With clicks or crackles, we can talk about the infringement of the damaged meniscus between the articular surfaces, such a test is considered positive.

The second version of the McMurry test is called flexion. It is produced as follows: with one hand they clasp the knee as in the first test, then the leg at the knee is bent to the maximum level; after which, the lower leg is rotated outward to identify ruptures of the internal meniscus. Under the condition of slow extension of the knee joint up to about 90 ° and rotational movements of the lower leg with a rupture of the meniscus, the patient will experience pain on the surface of the joint from the back of the inner side.

During the Epley test, the patient is placed on the stomach and the leg is bent at the knee, forming an angle of 90 °. With one hand, you need to press on the heel of the patient, and at the same time rotate the foot and lower leg with the other. If pain occurs in the joint space, the test can be considered positive.

Rupture treatment

Meniscus rupture is treated both conservatively and surgically (resection of the meniscus, both complete and partial, and its restoration). With the development of innovative technologies, meniscus transplantation is becoming increasingly popular.

A conservative type of treatment is mainly used to heal small tears in the posterior horn of the meniscus. Such injuries are often accompanied by pain, but they do not lead to infringement of the cartilaginous tissue between the articular surfaces and do not cause clicks and rolling sensations. This type of tear is characteristic of stable joints. The treatment is to get rid of such sports activities, where you can not do without quick jerks from the defender and movements that leave one leg in place, such activities worsen the condition. In the elderly, such treatment leads to a more positive result, since degenerative tears and arthritis are often the cause of their symptoms. A small longitudinal rupture of the medial meniscus (less than 10 mm), a rupture of the lower or upper surface that does not penetrate the entire thickness of the cartilage, transverse ruptures of no more than 3 mm often heal on their own or do not appear at all.

Also, meniscus rupture treatment provides for another way. Sewing from the inside out. For this type of treatment, long needles are used, which are passed perpendicular to the line of damage from the joint cavity to the outside of the strong capsular area. In this case, the seams are superimposed one after the other quite tightly. This is one of the main advantages of the method, although it increases the risk of damage to blood vessels and nerves when the needle is removed from the joint cavity. This method is ideal for treating a torn posterior horn of the meniscus and a torn that runs from the body of the cartilage to the posterior horn. If the anterior horn is torn, it may be difficult to pass the needles.

In cases where damage to the anterior horn of the medial meniscus occurs, it is more correct to use the suturing method from the outside to the inside. This method is safer for nerves and blood vessels; in this case, the needle is passed through the meniscus rupture from the outside of the knee joint and further into the joint cavity.

Seamless fastening of the meniscus inside the joint is gaining more and more popularity with the development of technology. The procedure takes little time and takes place without the participation of such complex devices as an arthroscope, but today it does not give even an 80% chance of healing the meniscus.

The first indications for surgery are effusion and pain, which cannot be eliminated by conservative treatment. Friction during movement or blockade of the joint also serve as indicators for surgery. Resection of the meniscus (meniscectomy) used to be considered a safe intervention. Recent studies have shown that most meniscectomy results in arthritis. This fact influenced the main methods of treatment of injuries such as rupture of the posterior horn of the internal meniscus. Nowadays, partial removal of the meniscus and grinding of deformed parts has become more popular.

Sequelae of a torn meniscus

The success of recovery from injuries such as lateral meniscus injury and medial meniscus injury depends on many factors. For a speedy recovery, factors such as the duration of the gap and its localization are important. The probability of complete recovery is reduced with a weak ligamentous apparatus. If the patient's age is not more than 40 years, then he has a better chance of recovery.

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meniscus injury

The medial meniscus changes shape when moving, because the gait of people is so smooth, plastic. The knee joints have 2 menisci:

The meniscus itself is divided into 3 parts:

• the body of the meniscus itself;
• the posterior horn of the meniscus, that is, its inner part;
• anterior horn of the meniscus.

The inner part differs in that it does not have its own blood supply system, however, because. nutrition should still be, it is carried out due to the constant circulation of the articular synovial fluid.

Such unusual properties lead to the fact that if an injury to the posterior horn of the meniscus occurs, then, unfortunately, it is most often incurable, because the tissues cannot be restored. Moreover, a rupture of the posterior horn of the medial meniscus is difficult to determine. And if such a diagnosis is suspected, urgent research is needed.

Most often, the correct diagnosis can be found using magnetic resonance imaging. But even with the help of developed tests, which are based on the extension of the joints, scrolling movements, as well as the sensation of pain, it is possible to determine the disease. There are a lot of them: Rocher, Landa, Baikov, Shteiman, Bragard.

If the posterior horn of the medial meniscus is damaged, a sharp pain appears, and severe swelling begins in the knee area.

When a horizontal rupture of the posterior horn of the medial meniscus has occurred, it is impossible to go down the stairs due to severe pain. If there is a partial tear of the meniscus, it is almost impossible to move: the torn part dangles freely inside the joint, giving pain at the slightest movement.

If not such painful clicking sounds are felt, then the gaps have occurred, but they are small in size. When the ruptures occupy a large area, the torn part of the meniscus begins to move to the center of the damaged joint, as a result, the movement of the knee is blocked. There is a twisting of the joint. When the posterior horn of the internal meniscus has ruptured, it is practically impossible to bend the knee, and the sore leg will not be able to withstand the load from the body.

Symptoms of a knee meniscus injury

If there is a rupture of the meniscus of the knee joint, then the following symptoms will appear:

• pain, which over time will concentrate in the joint space;
• there is weakness of the muscles in the anterior surface of the thigh;
• accumulation of fluid in the joint cavity begins.

As a rule, a degenerative rupture of the posterior horn of the meniscus in the knee occurs in people of pre-retirement age due to age-related changes in cartilage tissue or in athletes whose load falls mainly on the legs. Even a sudden awkward movement can lead to a break. Very often, ruptures of the degenerative form acquire a protracted chronic character. A symptom of a degenerative rupture is the presence of a dull aching pain in the knee area.

Treatment of damage to the medial meniscus

In order for the treatment to be beneficial, it is necessary to correctly determine the severity of the disease and the type of injury.

But first of all, when damage has occurred, it is necessary to relieve pain. In this case, an anesthetic injection and tablets that reduce inflammation help, and cold compresses will help.

You need to be prepared for the fact that doctors will take a puncture of the joint. Then it is necessary to clean the articular cavity from the blood and fluid accumulated there. Sometimes you even have to apply the blockade of the joints.

These procedures for the body are stressful, and after them the joints need rest. In order not to disturb the joints and fix the position, the surgeon applies a plaster or splint. During the rehabilitation period, physiotherapy, fixing the kneecaps will help to recover, it will be necessary to do physiotherapy exercises and walking with various means of support.

Minor damage to the posterior horn of the lateral meniscus or an incomplete tear of the anterior horn can be treated conservatively. That is, you will need anti-inflammatory drugs, as well as painkillers, manual and physiotherapy procedures.

How is damage treated? As a rule, surgery is usually unavoidable. Especially if it is an old medial meniscus of the knee joint. The surgeon is faced with the task of suturing the damaged meniscus, but if the damage is too serious, it will have to be removed. A popular treatment is arthroscopic surgery, thanks to which whole tissues are preserved, only the resection of damaged parts and the correction of defects are performed. As a result, there are very few complications after surgery.

The whole procedure goes like this: an arthroscope with instruments is inserted into the joint through 2 holes in order to first determine the damage, its extent. With ruptures of the posterior horn of the meniscus affecting the body, it happens that the torn fragment is displaced, rotating along its axis. He is immediately returned to his place.

Then make an incomplete biting out of the meniscus. This must be done at the base of the posterior horn, leaving a thin "bridge" to prevent displacement. The next stage is cutting off the torn fragment from the body or the anterior horn. Parts of the meniscus then need to be given the original anatomical shape.

It will be necessary to spend time in the hospital under the supervision of a doctor and undergo rehabilitation recovery.

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As a rule, a meniscus tear haunts 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 methods of treatment.

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

So what is a meniscus tear? To understand this, you need to know, in general, what a meniscus is. This term implies a special fibrous cartilage tissue, which is responsible for cushioning 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 of the posterior horn of the meniscus that is considered the most frequent and dangerous injury, which threatens with complications and serious consequences.

A little about menisci

A healthy knee joint has two cartilage tabs, external and internal, respectively, lateral and medial. Both of these tabs are shaped like a crescent. The lateral meniscus is dense and sufficiently mobile, which ensures its safety, that is, the external meniscus is less likely to be injured. As for the inner meniscus, it is rigid. Thus, damage to the medial meniscus 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 mesh, which forms a red zone. This area is the most dense 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 identify exactly which part of the meniscus has been torn. The best restoration is the living zone of the cartilage.

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

To date, experts speak of only one obvious cause of such an injury as a rupture of the posterior horn of the medial meniscus. An acute injury is considered such a cause, since not any aggressive impact on the knee joint can lead to damage to the cartilage responsible for cushioning the joints.

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

vigorous jumping or running on uneven ground;

torsion on one leg, without lifting the limb from the surface;

fairly active walking or long squatting;

trauma received in the presence of degenerative diseases of the joints;

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

Symptoms

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

Doctors advise people who are at risk to be aware of and pay attention to symptoms that indicate 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. Before the onset of pain, you may hear a clicking sound. After a while, the sharp 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 was 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 blockade. This symptom is very characteristic of a rupture of the internal meniscus. Blockade of the meniscus occurs at the moment when the detached part of the meniscus is sandwiched between the bones, as a result of which the motor function of the joint is impaired. This symptom is also characteristic of damage to the ligaments, 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 gap 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 rupture of the medial meniscus from a chronic one. Perhaps this was due to hardware diagnostics. Arthroscopy examines the condition of cartilage and fluid. A recent rupture of the internal meniscus has smooth edges and accumulation of blood in the joint. While in chronic injury, the cartilage tissue is multifibered, there is swelling from the accumulation of synovial fluid, and nearby cartilage is often damaged.

A rupture of the posterior horn of the medial meniscus must be treated immediately after injury, as over time, unhealed damage will become chronic.

With untimely treatment, meniscopathy is formed, 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 rupture of the posterior horn of the meniscus must be treated therapeutically. 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 steps (of course, if the disease is not running!):

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

elimination of swelling of the joint. For 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. Usually, 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

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Characteristic signs of a torn internal meniscus

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.

Other typical symptoms of a torn medial meniscus of the knee include:

• severe limitation of motor ability (if the torn off 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.

Degenerative damage to the medial meniscus of the knee joint is a chronic form of pathology.. Common symptoms in this case are:

• pain sensations of varying intensity that occur both during physical exertion and at rest;
• less often - jamming of the joint;
• damage to adjacent cartilage (femur or tibia);
• swelling of the affected area.

Read also the article "Inflammation of the meniscus of the knee joint" on our portal.

Note: the lack of specificity of clinical manifestations often makes it difficult to independently detect pathology. Therefore, if there are suspicious signs, you should consult a rheumatologist.

Basic therapeutic measures

The choice of methods of therapeutic influence depends on the nature of the injury and its severity. Treatment of damage to the medial meniscus of the knee joint is carried out by two main methods:

• conservative (with the help of medications, physiotherapy, physiotherapy exercises);
• radical, i.e. surgical (complete, partial meniscectomy, reconstructive surgery).

Note: in addition to partial or complete removal of the medial meniscus of the knee joint, surgical treatment involves suturing or transplanting the damaged area. However, these methods of solving the problem are not always effective and appropriate.

Non-surgical treatment of the medial meniscus of the knee

Indications for the use of conservative therapeutic methods are:

• minor rupture of the posterior horn of the medial meniscus;
• radial type of injury;
• lack of infringement of the cartilaginous lining between the surfaces of the joint.

Therapy involves, first of all, a decrease in the intensity of physical activity.

Note: you should not completely exclude movement, if there are no strict contraindications, as blood circulation in the joint will be disturbed. Casting and other incorrect techniques can lead to fusion of the ligaments, limited or complete loss of motor function of the knee.

In the acute phase, rest should be provided to the limbs. Intensive pain syndrome is stopped with the help of anesthetics and anti-inflammatory non-steroidal drugs that have an analgesic effect (Ibuprofen, Nurofen and others).

A slight longitudinal rupture of the posterior horn of the medial meniscus (up to 1 cm), transverse (up to 0.3 cm), as a rule, grows together independently and practically does not cause concern. Therefore, it is important to limit, but not completely eliminate the motor activity of the lower extremities.

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 specific technique, the physician must consider factors that benefit and harm the patient.

Reconstructive technique

Reconstructive 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, etc.) are used. Before fixation, pre-treatment of the injured edges is required - excision of the tissue to the capillary network. Then the prepared edges are combined and fixed.

Damage to the posterior horn of the medial meniscus provokes discomfort in the knees. Pain attacks of the lower extremities are the first signs of a violation of the functioning of the cartilage layer. Their cause of manifestation is a rupture of the posterior horn of the medial meniscus, sprain, progression of chronic pathologies. Each case is individual in terms of symptoms, course, and consequences.

It is important to consult a doctor for the correct diagnosis, competent treatment of the disease.

According to statistics, damage to the internal meniscus of the knee joint often occurs due to acute injury. But medical practice has identified a number of suggestive causes that cause the disease:

• weak ligaments, joints from the first days of life;
• degenerative pathological processes of the joints;
• obesity;
• work that requires a long stay on the "squat";
• movement "in single file";
• sports training on uneven surfaces;
• age-related deformations of bone tissues;
• sharp movements of the limb (flexion, extension);
• unsuccessful landings when falling from a height.

Whether the doctor, together with the patient, will be able to bring the cartilage to a healthy state depends on the severity of the damage, the type of development of the pathology. An important factor is timely therapy. A neglected disease is eliminated with the use of more time, effort, patience.

According to orthopedists, an unfavorable prognosis is recorded when the depreciation cartilage is completely torn off. If an oblique injury to the white area is diagnosed, it is easier to eliminate the pathology.
Doctors distinguish types of pathologies of the cartilage layer:

• Horizontal rupture of the medial meniscus, complete detachment, crack at a distance of 10-15% is recognized as a complex pathological process that requires surgical action. Professionals of a narrow direction at the time of the operation remove the affected tissue area in order to avoid the destruction of neighboring bone formations, joint relief, and pinching.
• According to statistics, in 50% of patients, tears of the posterior horn are recorded. They can have oblique, longitudinal or transverse, horizontal directions, and the inner one imitates the handle of a watering can.
• When the cartilage is torn or torn, the meniscus may be pinched. The affected area is able to block the joint. The doctor uses closed reduction of the joint in therapy. If it is ineffective, an operating technique is required.

Over the years of treatment, orthopedists and traumatologists are faced with combined lesions of the menisci. The main task of the doctor is to correctly diagnose. The patient must follow all the instructions and recommendations of the attending physician, do not ignore the appointment.

Break shapes

To determine the shape of the affected cartilage, doctors developed criteria. The severity of injury can have three degrees:

1. The first degree is recognized by minimal focal deformities of the meniscus. The general structure and form is undefeated.
2. Damage to the posterior horn of the medial meniscus of the 2nd degree is diagnosed with a partial violation of the general structure and functions of the shock-absorbing cartilage.
3. Rupture of the posterior horn of the medial meniscus of the 3rd degree is classified as severe. The posterior horn of the medial meniscus lends itself to injury, the anatomical structure is significantly disturbed.

The task of the doctor is to determine the main factor that develops the pathology of the cartilage zone of the knee.

Symptoms of damage to the posterior horn of the medial meniscus

Damage to the knee joint can occur in acute or chronic form. An acute pathological process lasts longer than a month, signaling its development with special symptoms.

At the moment of injury, the patient hears a crackling sound. The knee begins to hurt, with time swelling joins. In the early stages of the development of inflammation, clinical signs appear during physical exertion.

The acute form is characterized by restriction or complete arrest of lower limb movements. The collected fluid in the affected area can provoke the effect of a "floating patella".

The chronic form of the disease is characterized by the absence of symptoms. They exacerbate their action during physical exertion, movements of a sharp nature. The chronic form is more difficult to define.

Baykov's symptom is popular for determining the form and severity of the pathology. It is characterized by a sign of severe pain when you press the knee from the outside, when the lower leg is unbent.

You can determine the degree of damage by straightening the lower extremities at the knee. At the time of manipulation, the leg should be located freely on a flat plane. The presence of pathology is diagnosed if the palm of the upper limbs is placed in the perineum of the plane and knee.

Turner's symptom is characterized by increased sensitivity of the skin areas of the knee joints from the inside of the lower leg. The symptom of blockade helps to establish a gap in the jamming of the knee joints. It clearly manifests itself as pain syndromes when the patient moves up the stairs and signals a rupture of the posterior horn of the inner part of the meniscus.

The inflammatory process is accompanied by hyperemia of the skin on the knee. Soft tissues swell, when touched, a noticeable increase in the temperature of the affected area is possible.

Diagnostics

The clinical picture requires special actions in the diagnosis. The doctor, after a visual examination and anamnesis, prescribes additional studies of the internal structures of the joints.

Radiography is widely used. It allows you to determine the deformation in the cartilaginous, bone formations of the knee joint. To clarify the location of the inflammatory process, manipulation is needed in a direct and lateral projection.

Layer-by-layer scanning of tissue zones helps to determine the slightest deformations. Radiation diagnostics has been practiced for a long time and has effective results that allow you to prescribe competent therapy.

The inflammatory process, the amount of liquid masses in the knee cavity is determined when performing an examination by ultrasound. The direction of the doctor for the procedure should not be ignored; with the help of the results, the treatment is aimed at eliminating the cause of the pathology.

Specialists of a narrow profile at the time of diagnosis practice an invasive instrumental technique arthroscopy. A special tube with a built-in video camera is inserted inside the joint. Manipulation allows you to perform therapeutic measures under the visual supervision of the attending doctor.

First aid for rupture of the posterior horn of the medial meniscus

If the depreciation cartilage is damaged, you should be able to provide first aid. The patient should exclude the load on the lower limbs. To do this, you must be in a state of complete rest. Sometimes it is important to immobilize the injured leg as much as possible by placing it comfortably on a flat surface.

The knee should be fixed with an elastic bandage, if possible with an orthosis. Apply cold (ice) to the affected area. If you need to move around, use crutches.

Painkillers will help stop pain attacks, you need to notify the doctor about their use. It is forbidden to carry out therapy on your own. After providing first aid, it is important to immediately contact a medical facility or use the services of an ambulance.

Treatment Methods

Rupture of the posterior horn of the medial meniscus, the treatment of which is prescribed by the doctor after receiving the results of the research, requires a special approach. The doctor takes into account the form and severity of the disease, the individuality of the body, the age of the patient. It is important to carry out therapy in a timely manner in order to exclude the transition of an acute form into a chronic one. In case of complications, a flat area of ​​the tear becomes shaggy, provoking deformation of the cartilaginous structure. Such actions subsequently develop arthrosis. Cases of complete loss of motor work of the knee have been recorded.

Medical treatment

Conservative therapy is positive for primary tears, pinching, if the patient immediately began treatment as prescribed by the doctor. Manipulations take place in stages:

• With the blockade, the joint is repositioned. Practice manual methods. Hardware traction takes longer, but the result pleases the patient.
• Puffiness relief occurs with the use of anti-inflammatory drugs. The course of therapy is determined by the attending doctor. It is forbidden to stop taking funds at the first improvements, such actions often lead to serious consequences.
• The procedure for restoring the cartilaginous region of the meniscus takes a long time. Courses of therapy with chondroprotectors, hyaluronic acid are prescribed every year from three months to six months.
• Injury to the meniscus is accompanied by severe pain attacks of an intense nature. To eliminate the symptom, the patient is recommended to take analgesics. Use medicines should be prescribed by a traumatologist or surgeon. Not every drug is able to have a positive effect on the body.

The final stage is a complex responsible period of rehabilitation, including physiotherapy exercises, physiotherapy, massage.

Treatment by surgery

After a full examination, specialists in narrow areas determine the form of operational manipulation. Arthroscopy is often used, in which an artoscope and saline are injected into the affected cartilage. Manipulation restores the affected formations under the strict supervision of a doctor.

The complex technique of artromia is rarely used; it is required for extensive damage to the knee joints. Doctors practice stitching the affected cartilage areas. The injured areas are removed by partial meniscectomy. Less often, a transplant of someone else's meniscus is performed.

Effects

Complex injuries provoke the arrest of the proper functioning of the knee joints. But do not despair, timely, competent treatment leads to a full recovery. Older people are advised to protect themselves as much as possible from all kinds of traumatic lesions. According to forecasts, this age group is at risk, and recovery occurs much later.

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The meniscus is the lining of cartilage in the knee joint. It acts as a shock absorber, located between the femur and tibia of the knee, which bears the greatest load in the musculoskeletal system. The rupture of the posterior horn of the medial meniscus is irreversible, since it does not have its own blood supply system, it receives nutrition through the circulation of the synovial fluid.

Injury classification

Damage to the structure of the posterior horn of the medial meniscus is differentiated according to various parameters. According to the severity of the violation, there are:

• 1st degree injury to the posterior horn of the meniscus. Characterized by focal damage to the surface of the cartilage. The overall structure does not change.
• 2 degree. The changes are becoming more pronounced. There is a partial violation of the structure of the cartilage.
• 3 degree. The disease state worsens. Pathology affects the posterior horn of the medial meniscus. There are painful changes in the anatomical structure.

Given the main causative factor that led to the development of the pathological condition of the cartilage of the knee joint, the bodies of the lateral meniscus distinguish between traumatic and pathological damage to the posterior horn of the medial meniscus. According to the criterion of prescription of an injury or a pathological violation of the integrity of this cartilaginous structure, fresh and chronic damage to the posterior horn of the medial meniscus is distinguished. Combined damage to the body and the posterior horn of the medial meniscus is also highlighted separately.

Types of breaks

In medicine, there are several types of meniscus ruptures:

• Longitudinal vertical.
• Patchwork braid.
• Horizontal break.
• Radially transverse.
• Degenerative rupture with tissue crush.
• Oblique-horizontal.

Breaks can be complete and incomplete, isolated or combined. The most common ruptures of both menisci, isolated injuries of the posterior horn are diagnosed less frequently. The part of the inner meniscus that has come off may remain in place or move.

Causes of damage

A sharp movement of the lower leg, a strong outward rotation are the main causes of damage to the posterior horn of the medial meniscus. Pathology is provoked by the following factors: microtraumas, falls, stretch marks, traffic accidents, bruises, blows. Gout and rheumatism can provoke the disease. In most cases, the posterior horn of the meniscus suffers due to indirect and combined trauma.

Especially many injured seek help in winter, during ice.

Injuries contribute to:

• Alcohol intoxication.
• Fights.
• Haste.
• Failure to take precautions.

In most cases, the tear occurs during fixed extension of the joint. Hockey players, football players, gymnasts, and figure skaters are at particular risk. Frequent ruptures often lead to meniscopathy - a pathology in which the integrity of the internal meniscus of the knee joint is violated. Subsequently, with each sharp turn, the gap is repeated.

Degenerative damage is observed in elderly patients with the repetition of microtraumas caused by strong physical exertion during labor activity or irregular training. Rheumatism can also provoke a rupture of the posterior horn of the medial meniscus, since the disease disrupts the blood circulation of tissues during edema. Fibers, losing strength, cannot withstand the load. Rupture of the posterior horn of the medial meniscus can provoke tonsillitis, scarlet fever.

Symptoms

The characteristic signs of a torn posterior horn are:

• Sharp pain.
• Puffiness.
• Joint block.
• Hemarthrosis.

Pain

The pain is acutely manifested in the first moments of injury, lasts for several minutes. Often, the appearance of pain is preceded by a characteristic click in the knee joint. Gradually, the pain subsides, a person can step on a limb, although he does this with difficulty. When lying down, during a night's sleep, the pain intensifies imperceptibly. But by morning, the knee hurts so much, as if a nail had been stuck into it. Flexion and extension of the limb increases pain.

puffiness

The manifestation of puffiness is not observed immediately, it can be seen a few hours after the rupture.

Joint block

Jamming of the joint is considered the main sign of rupture of the posterior horn of the medial meniscus. There comes a blockade of the joint after clamping the separated part of the cartilage by the bones, while there is a violation of the motor function of the limb. This symptom can also be observed with sprains, which makes it difficult to diagnose the pathology.

Hemarthrosis (accumulation of blood inside a joint)

Intra-articular accumulation of blood is detected when the "red zone" of the cartilage layer, which performs a shock-absorbing function, is damaged. According to the time of development of pathology, there are:

• Acute break. Hardware diagnostics shows sharp edges, the presence of hemarthrosis.
• Chronic rupture. It is characterized by swelling caused by the accumulation of fluids.

Diagnostics

If there is no blockage, diagnosing a meniscal tear in the acute period is very difficult. In the subacute period, a meniscus tear can be diagnosed based on the manifestation of local pain, compression symptoms, and extension symptoms. If a meniscus rupture has not been diagnosed, the swelling, pain, and effusion in the joint will disappear during treatment, but with the slightest injury, careless movement, the symptoms will manifest themselves again, which will mean the transition of the pathology to a chronic form.

It is not uncommon for patients to be diagnosed with a knee bruise, parameniscal cyst, or sprain.

x-ray

Radiography is prescribed to rule out damage to the bones of fractures and cracks. X-rays are not able to diagnose soft tissue damage. To do this, you need to use magnetic resonance imaging.

MRI

The research method does not harm the body, like radiography. MRI makes it possible to consider layered images of the internal structure of the knee. This allows not only to see the gap, but also to obtain information about the extent of its damage.

ultrasound

Allows visualization of knee tissue. With the help of ultrasound, the presence of a degenerative process, an increased volume of intracavitary fluid is determined.

Treatment of damage to the posterior horn of the meniscus

After injury, it is necessary to immediately immobilize the limb. It is dangerous to treat a victim of a blockage on your own. The complex treatment prescribed by the doctor includes conservative therapy, surgery, and rehabilitation.

Therapy without surgery

With partial damage to the posterior horn of the medial meniscus of 1-2 degrees, conservative therapy is carried out, including drug treatment and physiotherapy. Of the physiotherapy procedures successfully applied:

• Ozokerite.
• Electrophoresis.
• Mud cure.
• Magnetotherapy.
• Electrophoresis.
• Hirudotherapy.
• Electromyostimulation.
• Aerotherapy.
• UHF therapy.
• Massotherapy.

Important! During the treatment of rupture of the posterior horn of the medial meniscus, it is necessary to ensure the rest of the knee joint.

Surgical methods

An effective method of treating pathology is surgical intervention. During surgical therapy, doctors are aimed at the preservation of the organ and its functions. When the posterior horn of the meniscus is torn, the following types of operations are used:

• Cartilage stitching. The operation is performed using an arthroscope - a miniature video camera. It is injected at the site of the knee puncture. The operation is performed with fresh ruptures of the meniscus.
• Partial meniscectomy. During the operation, the area of ​​damage to the cartilage layer is removed, and the rest is restored. The meniscus is cut to a smooth state.
• Transfer. A donor or artificial meniscus is transplanted.
• Arthroscopy. 2 small punctures are made in the knee. An arthroscope is inserted through the puncture, along with which saline enters. The second hole makes it possible to perform the necessary manipulations with the knee joint.
• Arthrotomy. Complicated meniscus removal procedure. The operation is performed if the patient has an extensive lesion of the knee joint.

A modern method of therapy, characterized by a low rate of trauma

Rehabilitation

If the operations were carried out with a small amount of interventions, a short period of time will be required for rehabilitation. Early rehabilitation in the postoperative period includes elimination of the inflammatory process in the joint, normalization of blood circulation, strengthening of the thigh muscles, limiting the range of motion. Therapeutic exercises are allowed to be performed only with the permission of the doctor in different positions of the body: sitting, lying, standing on a healthy leg.

Late rehabilitation aims to:

• Elimination of contracture.
• Correction of gait
• Functional restoration of the joint
• Strengthening the muscle tissue that stabilizes the knee joint.

The most important

Rupture of the posterior horn of the medial meniscus is a dangerous pathology. To reduce the risk of injury, precautions should be taken seriously: do not rush when moving up the stairs, exercise muscles with physical activity, regularly take prophylactic chondroprotectors, vitamin complexes, and use knee pads during training. You need to constantly monitor your weight. In case of injury, a doctor should be called immediately.