Posterior horn of the lateral meniscus. Rupture of the posterior horn of the medial meniscus: causes, symptoms and treatment

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.

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

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

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

Anatomical features of the cartilage tissue of the knee

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

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

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

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

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

The nature of its damage 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. Swelling and redness.

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

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

Treatment of cartilage damage

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

Stages of conservative treatment

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

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

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

Stages of surgical treatment

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

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

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

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

Conclusion

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?

The whole truth about: the posterior horn of the meniscus of the knee joint and other interesting information about the treatment.

Rupture of the posterior horn of the medial meniscus is a consequence of an injury that occurs both in athletes or those who lead an active lifestyle, and in people in advanced years suffering from other concomitant diseases (for example, arthrosis).

Rupture of the posterior horn of the medial meniscus

To find out what the features of such damage are, you need to figure out what the meniscus is in general. This concept means a specific cartilaginous layer in the knee joint, which performs shock-absorbing functions. It includes the posterior horn, anterior, body, it is not only medial (internal), but also lateral (external). Here are just an injury to the medial meniscus (more specifically, its posterior horn) is the most dangerous, since it is fraught with serious complications and serious consequences.

Menisci of the knee

Both cartilage layers - external and internal - are C-shaped and differ significantly from each other. So, the lateral meniscus has an increased density, it is quite mobile, due to which it is not injured so often. As for the inner tab, it is rigid, therefore, rupture (or other injuries) of the medial meniscus is much more common.

Anatomical structure of the knee joint

Part of the meniscus includes a capillary network that forms the "red zone". This part, located on the edge, is highly dense. In the center is the thinnest area (“white zone”), in which there are no vessels at all. When a person injures a meniscus, the first thing to do is determine which element was torn. By the way, the "living" area of ​​the meniscus recovers better.

The menisci of the knee joint are cartilaginous formations, lunate in shape.

Note! Once upon a time, doctors believed that removing a torn meniscus could save a person from all troubles. But now it has been proven that both menisci play a very important role in the joint - they protect it, absorb shocks, and the complete removal of one of them leads to early arthrosis.

The main reasons for the appearance

Classification of meniscus tears

Now experts point to only one reason for the appearance of a gap - an acute injury. This is explained by the fact that no other impact on the joint can cause damage to the cartilage responsible for cushioning.

Acute trauma as a cause of rupture

It is also worth noting that there are the following risk factors that predispose to rupture:

• congenital weakness of the joints;
• regular jumping, running on uneven surfaces;
• injuries resulting from degenerative diseases;
• rotational movements performed on one leg without taking it off the ground;
• long-term squatting;
• strenuous walking.

The posterior horn of the medial meniscus may be damaged for reasons other than acute trauma.

Symptoms of damage

In more detail, the signs of a meniscus tear have already been considered in one of the previous articles, so we will focus only on the main points. Usually, an injury occurs when the parts of the joint are in an unnatural position at a particular moment (namely, at the moment of rupture). Less commonly, this happens as a result of cartilage pinching.

Determine the nature of the injury

Note! As a rule, a rupture is accompanied by other joint injuries, which means that in some cases it is a rupture that is not so easy to identify in differential diagnosis.

1. Sharp pain. It is especially acute at the moment of injury and lasts for several minutes. Sometimes, before the onset of pain, you can hear a characteristic click in the knee. After a while, the pain syndrome fades away, a person can walk again, but this is not easy for him.

   The first sign is acute pain

   The next morning, another pain is felt - as if a nail was stuck in the knee - which only intensifies with flexion / extension.

2. Puffiness. Usually it does not appear immediately, but several hours after the injury.
3. "Jamming" of the joint (blockade). This is the main sign of a rupture of the medial meniscus, which occurs after the separated part of the cartilage is clamped by the bones, and the motor functions of the limb are impaired. It is worth knowing that this symptom is also observed with sprains, so the true cause of the pain can only be found out after diagnosis.
4. Intra-articular accumulation of blood (hemarthrosis). This happens if the "red zone" of the depreciation cartilage layer is damaged.

   Hemarthrosis

Today, medicine differentiates between acute rupture and chronic (launched), which is possible due to the use of hardware diagnostics. So, the "fresh" gap has smooth edges, it is accompanied by hemarthrosis. In the case of a chronic injury, the cartilage is multifibered, swelling caused by the accumulation of fluids is observed.

Swelling and swelling of the knee

Features of treatment

If the posterior horn is damaged, then treatment must be started immediately, otherwise it will all develop into a chronic stage. We also note that in the absence of timely treatment, meniscopathy occurs, causing irreversible changes in the articular structure in almost 50% of cases. And this, therefore, can cause gonarthrosis.

Rupture of the posterior horn of the medial meniscus requires immediate treatment

Treatment of the described injury can be conservative and surgical. Consider the features of each of them.

Conservative treatment

Primary damage to the meniscus is treated with therapeutic methods. Of course, in some cases, after an injury, patients require emergency surgery, but often conservative therapy is quite enough. The treatment procedure itself in this case consists of several stages (we repeat - if the gap is not chronic).

Stage 1. Reposition. When blocking the joint, it must be set. Manual therapy or, alternatively, hardware traction is especially effective here.

Reposition

Stage 2. Elimination of edema. To do this, doctors prescribe a course of anti-inflammatory medications.

Anti-inflammatory drugs

Non-steroidal anti-inflammatory drugs in rheumatology

Stage 3. Rehabilitation. The rehabilitation course includes massages, physiotherapy exercises and physiotherapy.

Rehabilitation course

Stage 4. Recovery. The most important, but at the same time the longest stage of treatment. Often, in order to restore the meniscus, chondroprotectors and hyaluronic acid are prescribed. A long course can be from three to six months, it is held once a year.

Treatment with chondroprotectors

Note! The rupture of the posterior horn is accompanied by acute pain, so the patient is also prescribed painkillers. There are quite a lot of them - ibuprofen, paracetamol and others. As for the dosage, it should be prescribed exclusively by the attending physician!

ibuprofen photo

Dosage

In some cases, a cast is applied to the injured knee. The need for gypsum is determined by the doctor in each case. After repositioning the knee joint, immobilization is carried out for a long time at the required angle, and rigid fixation in this case helps to maintain the correct position.

Knee fixation

Surgical treatments

During surgical treatment, specialists are guided by one principle - we are talking about the safety of the organ and its functionality. Surgery is performed only when other methods of treatment are ineffective. First, the organ is tested, it is checked whether it can be sutured (this is often relevant in cases of trauma to the “red zone”).

Table. Types of operations used in meniscus rupture

Arthroscopy

Total knee arthroplasty

Video - Arthroscopy of the medial meniscus

Rehabilitation

One of the most important stages of treatment is the restoration of the functionality of the joint. You need to know that rehabilitation should take place exclusively under medical supervision. A doctor - an orthopedist or a rehabilitation specialist - individually prescribes a set of measures that contribute to a faster recovery of damaged tissues.

During the rehabilitation period, it is good to do a knee massage.

Note! The rehabilitation course can take place at home, it is advisable to do this in a hospital where there is equipment for physiotherapy exercises.

In addition to exercises, during the rehabilitation period, massages and hardware recovery methods are prescribed, associated with dosed loads on the joint. This contributes to the stimulation of muscle tissue and the development of the limb. As a rule, functionality is restored within a few months after the operation, and you can return to your previous life earlier (even a month later).

Rehabilitation measures after knee surgery

knee recovery

The main difficulty of the rehabilitation period is considered to be intra-articular swelling, which makes it impossible to quickly restore functions. Puffiness is eliminated with the help of lymphatic drainage massage.

Note! As a result, we note that with proper and - more importantly - timely treatment, the prognosis of rupture of the posterior horn is very favorable. And this is not surprising, because in modern orthopedics there are many effective methods.

Rupture of the horn of the medial meniscus of the knee joint: treatment and symptoms

Very often, athletes and people who are constantly engaged in physical labor complain of disorders in the functioning of the joints. The most common cause of pain and discomfort is a tear in the meniscus of the knee.

It is quite possible to deal with this problem. Treatment, if a rupture of the meniscus of the knee joint is diagnosed, is expressed in a wide range of actions: from surgical interventions to alternative methods of treatment at home.

What is a meniscus

The meniscus of the knee joint is a cartilaginous formation that has the shape of a crescent and is located between the thigh and lower leg in the knee joint. The knee meniscus performs a stabilizing and shock-absorbing function, the horizontal cartilage gap softens the friction of the surfaces, limiting joint mobility, which prevents injuries.

In the process of movement, the meniscus contracts and stretches, changing its shape, as can be seen in the photo. There are two menisci in the joint:

1. lateral meniscus (external),
2. medial meniscus (internal).

Sports doctors say that injuries and bruising are a common problem among:

• skiers,
• skaters,
• figure skaters,
• ballet dancers,
• footballers.

Meniscus disease and the need for surgery in the future may also appear in those who are engaged in strenuous physical labor. The risk group includes men aged 17 to 45 years.

Among children, rupture of the posterior horn of the internal meniscus or displacement is extremely rare. Until the age of 14, this cartilage formation is very elastic, so damage almost never occurs.

Main shock absorber in the knee joint

Sometimes a rupture of the meniscus of the knee joint or its bruising is observed at an older age. So, at the age of 50-60, degenerative changes in the joints affect the condition.

The rupture of the posterior horn of the medial meniscus occurs under the influence of trauma. This is especially true for the elderly and athletes. Osteoarthritis is also a common cause of meniscal injury.

Rupture of the posterior horn of the medial meniscus is always accompanied by damage to the ligament that connects the meniscus to the knee joint.

Thus, the meniscus changes under the influence of:

1. loads,
2. injuries,
3. degenerative age-related changes,
4. congenital pathologies that gradually damage tissues.

In addition, some diseases that damage statics also make their own negative adjustments.

Flat feet can be cited as an example of the consequences of violations.

How to treat a torn meniscus

Orthopedists differentiate damage to the knee meniscus into several types:

• pinching,
• rupture of the posterior horn of the medial meniscus and a rupture of the posterior horn of the internal meniscus,
• separation.

In the latter case, the treatment of the meniscus is the most difficult process. Education is required to be completely separated from the attachment area. This type of injury requires a surgical operation, it is quite rare.

In most cases, diagnose:

1. injury,
2. pinching,
3. tear,
4. tear of the medial meniscus
5. rupture of the posterior horn of the meniscus.

These injuries are characterized by sharp pain in the knee area, inability to perform movements, numbness, difficulty in flexion and extension of the joint. After a few hours, the symptoms of a torn meniscus subside, mobility is restored, and the person can forget about the injury.

The consequences of an injury, damage to the meniscus of the knee joint, eventually make themselves felt, for example, the pain returns again. A rupture of the medial meniscus is a complex injury that requires intervention. The intensity of the pain syndrome depends on the strength and nature of the damage.

Baykov's symptom is known: when the joint is bent to an angle of 90 degrees, and a finger is pressed on this area of ​​the joint space, producing a slow extension of the lower leg, the pain increases very much.

In addition, it is difficult to go up or down the stairs, there is pain when crossing the limbs and situational numbness. In some severe cases, the consequences become extremely dangerous, we are talking about atrophy of the muscles of the lower leg and thigh.

Professional athletes often suffer from characteristic microtraumas of the meniscus. It can be a bruise, infringement or small tears.

Degrees of meniscus injury and surgery

With cartilage injuries, the diseases become chronic. Sharp pain is not observed, the joint retains its mobility most of the time. However, from time to time, a person feels discomfort in the knee area. These may be: slight tingling, numbness, or clicking. Atrophy of the thigh muscles is recorded.

A rupture in the area of ​​the meniscus of the knee joint in severe cases involves the separation of its capsule, and the need for surgery appears. The detached part of the meniscus can be removed partially or completely. If there is a tear or tear, then the patient may be offered a form of surgery such as suturing.

The choice of type of operation depends on the age of the patient, his condition and the nature of the injury. The younger the person, the faster the consequences pass, and the recovery process accelerates.

As a rule, the recovery period takes about 4-6 weeks, during which the person stays on an outpatient basis.

To restore joint mobility, mud therapy and restorative therapeutic exercises can be recommended.

Conservative treatment of the meniscus in hospital and at home

For micro-ruptures, chronic injuries and infringements of the meniscus of the knee joint, a more moderate conservative treatment is recommended.

If the meniscus is pinched, then it is necessary to reposition, that is, reduce the joint. The procedure is performed by a traumatologist, chiropractor or orthopedist in a medical facility.

It will take 3-4 procedures to fully reset the joint. There is another type of meniscus repair - traction of the knee joint or hardware traction. This is a long procedure carried out in stationary conditions.

To restore cartilage tissue, intra-articular injections of preparations that contain hyaluronic acid are necessary. If there is swelling and the patient suffers from pain, intra-articular injections are necessary:

• nimulida,
• voltarena,
• corticosteroids.

After these measures, long-term drug therapy is indicated to restore the required amount of joint fluid.

The most commonly prescribed are chondroitin sulfate and glucosamine. It is not recommended to self-medicate, the exact dosage of the drug is prescribed only by a doctor.

As a rule, restorative drugs need to be taken for about three months daily.

Along with the use of drugs, it is necessary to turn to massage and therapeutic exercises so that there is no need for an operation.

Treatment of the meniscus with folk remedies

Various rubbing and compresses are considered especially effective. They reduce pain and return the joint to normal mobility.

Before treating meniscus disease at home, you should consult your doctor. It is necessary to take into account the nature of the meniscus injury and individual characteristics. For example, a honey compress may be contraindicated if a person is allergic to bee products.

Treatment can be done with a compress of fresh burdock leaves. The patella area should be wrapped with a sheet and a restraining bandage applied. The compress should be kept on the body for about 4 hours.

The procedure should be carried out every day, while the meniscus hurts. If fresh burdock is not available, dried leaves can be used after soaking them in a small amount of hot water.

Raw materials must be evenly distributed over the tissue, and then apply a compress to the joint. The compress stays on the damaged joint for 8 hours.

A honey compress on the knee helps relieve pain in the patella area. After some time, the lost mobility of the joint returns.

It is necessary to take in equal proportions natural bee honey and purified alcohol, mix and slightly warm. Apply a warm mixture to the knee area, wrap it well with a woolen cloth and secure with a bandage.

To speed up the recovery process after a meniscus injury, you need to make a honey compress 2 times a day. Keep the compress for at least two hours.

Treatment of meniscus disease with folk remedies lasts, as a rule, several months.

An effective remedy for the meniscus of the knee joint is a tincture of wormwood. You will need a large spoonful of chopped wormwood, which must be poured with a glass of boiling water and insisted for 1 hour.

After that, the liquid is filtered and used for compresses. A cloth soaked in liquid should be applied for half an hour to the damaged joint. A traumatologist will tell you in detail about problems with the meniscus in the video in this article.

If we feel pain in the knee, then, as a rule, this means that the meniscus hurts. Since the meniscus is a layer of cartilage, it is most at risk of rupture or damage. Knee pain can indicate several types of damage and meniscal dysfunction. During sprains of the intermeniscal ligaments, chronic injuries, as well as when the meniscus is torn, different symptoms appear, and the options for dealing with them also differ.

• Damage symptoms
  • How to heal damage?
• meniscus tear
  • Rupture of the posterior horn of the meniscus
  • Rupture symptoms
• How is a meniscus tear treated?

Damage symptoms

The meniscus is a cartilage formation that is located in the cavity of the knee joint and serves as a shock absorber of movement, as well as a stabilizer that protects the articular cartilage. There are two menisci in the knee, the outer (lateral) and the inner (medial). Damage to the inner meniscus happens much more often due to its less mobility. Damage to the meniscus of the knee joint manifests itself in the form of pain in this area, limited mobility, and in chronic situations, the development of arthrosis of the knee is also possible.

Swelling of the joint, sharp cutting pain, painful crunching and difficulty in moving the limbs indicate that you have a damaged meniscus. These symptoms appear immediately after the injury and may indicate other joint damage. More pronounced symptoms of damage appear one month after the injury. With these injuries, a person begins to feel local pain in the gap of the knee joint, weakness of the muscles of the outer surface of the thigh, “blockade” of the knee, and accumulation of fluid in the joint cavity are manifested.

The exact signs of damage to the medial meniscus are identified through various examinations. There are special tests for extension of the knee joints (Rocher, Baikov, Landa, etc.), when pain symptoms are felt with a certain extension of the knee. The technology of rotational tests is based on the detection of damage during rolling movements of the knee (Shteiman, Bragard). Meniscal injury can also be identified by MRI, mediolateral tests, and compression symptoms.

How to heal damage?

Injury to the medial meniscus involves a variety of treatments that take into account the type and severity of the injury. With the traditional method of getting rid of damage, it is possible to distinguish the main types of exposure that are used for any injuries.

To begin with, it is necessary to relieve the pain, therefore, first of all, the patient is given an anesthetic injection, then they take a puncture of the joint, remove the accumulated fluid and blood from the cavity, and, if necessary, remove the blockade of the joints.

After these procedures, the knee needs rest, for which a splint or plaster cast is applied. As a rule, one month of immobilization is enough, but in difficult situations, the period sometimes reaches up to 2 months. In this case, it is necessary to apply local cold and non-steroidal agents to relieve inflammation. Over time, you can add different types of physiotherapy, walking with support, physiotherapy exercises.

Surgery is required in severe situations, for example, chronic damage to the meniscus of the knee joint. One of the most popular types of surgery today is arthroscopic surgery. This type of surgical intervention has become common due to the careful attitude to tissues. The intervention is only a resection of the damaged area of ​​the meniscus and polishing of defects.

With such damage as a torn meniscus, the surgical operation is performed closed. With the help of two holes, an arthroscope is inserted into the knee joint with instruments to determine the damage, then a decision is made on the possibility of sewing up the meniscus or its partial resection. Inpatient treatment lasts up to approximately 4 days, due to the low invasiveness of this type of operation. At the rehabilitation stage, it is recommended to limit the load on the knee to one month. In special situations, wearing a knee brace and walking with support is recommended. After 7 days, you can start therapeutic exercises.

meniscus tear

The most common injury to the knee joint is a tear in the medial medial meniscus. There are degenerative and traumatic meniscal tears. The latter appear, as a rule, in people aged 18-45 years and athletes, with untimely treatment, they turn into degenerative tears, which most often appear in elderly people.

Taking into account the localization of damage, there are several main types of ruptures:

• transverse;
• in the form of a watering can;
• patchwork;
• paracapsular;
• longitudinal;
• damage to the posterior or anterior horn;
• horizontal.

At the same time, meniscus tears are also divided by shape:

• oblique;
• longitudinal;
• transverse;
• degenerative;
• combined.

Traumatic ruptures appear, as a rule, at a young age and they occur vertically in a longitudinal or oblique direction. Combined and degenerative usually occur in the elderly. Watering can-shaped or vertical longitudinal tears can be incomplete or complete and usually begin with damage to the posterior horn.

Rupture of the posterior horn of the meniscus

This type of tear is the most common, as most of the vertical, longitudinal, and watering hole tears occur in the posterior horn. During a long tear, there is a good chance that part of the torn meniscus will prevent the knee from moving and cause severe pain, up to and including blockage of the knee joint. The combined type of tears passes, capturing several planes, and usually forms in the posterior horn of the meniscus and for the most part appears in elderly people who have degenerative changes in them.

During damage to the posterior horn, which does not lead to displacement of the cartilage and longitudinal cleavage, the person always feels the threat of blockade of the joint, but this never happens. Quite rarely, a rupture of the anterior horn of the knee joint occurs.

Rupture of the posterior horn of the lateral (outer) meniscus

This gap happens 8-10 times less often than the medial one, but it has no less negative consequences. The internal rotation of the tibia and its movement are the main causes that cause a rupture of the external lateral meniscus. The main sensitivity in these lesions falls on the outer side of the posterior horn. Rupture of the arch of the external meniscus with displacement, as a rule, creates a restriction of movements at the final stage of extension, and sometimes can cause blockade of the joint. The rupture of the external meniscus is determined by the characteristic clicking during rotational movements inside the knee joint.

Rupture symptoms

With injuries such as a torn meniscus, symptoms vary. A meniscus tear can be:

• old;
• chronic;
• spicy.

The main sign of a rupture is blockage of the knee joint, in its absence it is very difficult to determine a rupture of the lateral or medial meniscus in the acute period. After a certain time, in the early period, the gap can be determined by local pain, infiltration in the area of ​​​​the joint gap, as well as using pain tests that are suitable for any type of damage.

A pronounced symptom of a rupture is pain during probing the line of the gap of the knee joint. There are special tests for diagnosis, such as the McMurry test and the Epley test. The McMurry test is performed in two ways.

In the first case, the patient is laid on his back, the leg is bent at the hip and knee joint to a right angle. Then they grab the knee with one hand, and with the other hand they perform rotational movements of the lower leg, first outward, and then inward. When cracking or clicking, it is possible to consider the infringement of the injured meniscus between the surfaces of the joint, this test is positive.

The other way is called bending. It is carried out in this way: with one hand they grab the knee, as in the first version, after the leg is bent as much as possible at the knee. The lower leg is then rotated outward to determine the tear. Under the condition of slow extension of the knee joint to approximately 90 degrees and rotational movements of the lower leg, then during the rupture of the meniscus, the patient will feel pain on the surface of the joint from the inside back side.

During the Epley test, the patient is placed on the stomach and the leg is bent at the knee, creating an angle of 90 degrees. With one hand, it is necessary to press the person on the heel, and with the second, rotate the lower leg and foot. When pain occurs in the joint space, the test is positive.

How is a meniscus tear treated?

The rupture can be treated either surgically (resection of the meniscus, both partial and its restoration, and complete), or conservatively. With the advent of new technologies, meniscus transplantation has become increasingly popular.

Conservative treatment is usually used to treat minor lesions of the posterior horn. Very often, these injuries are accompanied by severe pain, but do not lead to pinching of the cartilage tissue between the surfaces of the joint and do not create a sensation of rolling and clicking. This type of damage is characteristic of strong joints.

The treatment consists in liberation from such sports, in which sharp jerks and movements that leave one leg in place are indispensable, these activities aggravate the condition. In the elderly, this treatment leads to a better outcome, since arthritis and degenerative tears are often the cause of their symptoms.

A slight longitudinal tear (less than 1 cm), a tear of the upper or lower surface that does not penetrate the entire thickness of the cartilage, transverse injuries of no more than 2.5 mm usually heal on their own or do not bother.

Also, the treatment of the gap provides another option. Sewing from the inside out. For this method of treatment, long needles are used, which are inserted perpendicular to the rupture line from the joint cavity to the outer part of the strong capsular area. And the seams are made quite tightly, one by one. This is the main advantage of this treatment option, although it increases the risk of nerve and vascular damage during the withdrawal of the needle from the joint cavity. This method is excellent for treating damage to the posterior horn and a tear that runs from the cartilage itself to the posterior horn. During damage to the anterior horn, difficulties may arise in the passage of the needle.

In cases where a rupture of the anterior horn occurs, it is best to use the suturing method from the outside to the inside. This option is safer for blood vessels and nerves, in this case the needle is passed through the gap on the outside of the knee joint and then into its cavity.

With the development of technology, seamless fastening inside the joint is gradually gaining popularity. The process itself takes a little time and takes place without the participation of such complex devices as an arthroscope, but now it still does not have even a 75% chance of successful healing of the meniscus.

The main indications for surgery are pain and effusion, which cannot be eliminated using conservative methods. Blockade of the joint or friction during movement are also indications for surgical intervention. Resection of the meniscus (meniscectomy) was once considered a safe operation. But with the help of recent research, it turned out that meniscectomy most often leads to the development of arthritis. This fact influenced the main methods of treatment of posterior horn rupture. Today, grinding of damaged parts and partial removal of the meniscus is very popular.

The success of recovery after injuries such as a torn medial and lateral meniscus will depend on many factors. For a quick recovery, factors such as the location of the damage and its age are important. The probability of a full-fledged treatment is reduced if the ligamentous apparatus is not strong enough. If the patient's age is not more than 45 years, then he has a better chance of recovery.

A characteristic feature of the knee joints is their frequent susceptibility to various injuries: damage to the posterior horn of the meniscus, violations of the integrity of the bone, bruises, hematomas and arthrosis.

Anatomical structure

The origin of various injuries in this particular place of the leg is explained by its complex anatomical structure. The structure of the knee joint includes the bone structures of the femur and tibia, as well as the patella, a conglomerate of the muscular and ligamentous apparatus, and two protective cartilages (menisci):

• lateral, in other words, external;
• medial or internal.

These structural elements visually resemble a crescent with the ends pushed forward slightly, called horns in medical terminology. Due to their elongated ends, cartilaginous formations are attached to the tibia with high density.

The meniscus is a cartilaginous body that is found in the interlocking bony structures of the knee. It provides unhindered flexion-extension manipulations of the leg. It is structured from the body, as well as the anterior and posterior horns.

The lateral meniscus is more mobile than the inner meniscus, and therefore it is more often subjected to force loads. It happens that he does not withstand their onslaught and breaks in the region of the horn of the lateral meniscus.

Attached to the inside of the knee is a medial meniscus that connects to the lateral ligament. Its paracapsular part contains many small vessels that supply blood to this area and form a red zone. Here the structure is denser, and closer to the middle of the meniscus, it becomes thinner, since it is devoid of the vascular network and is called the white zone.

After a knee injury, it is important to accurately determine the location of the meniscus rupture - in the white or red zone. Their treatment and recovery are different.

Functional Features

Previously, doctors removed the meniscus through surgery without any problems, considering it justified, without thinking about the consequences. Often, the complete removal of the meniscus led to serious diseases, such as arthrosis.

Subsequently, evidence was presented for the functional importance of leaving the meniscus in place, both for bone, cartilage, articular structures, and for the general mobility of the entire human skeleton.

The functional purposes of the menisci are different:

1. They can be considered as shock absorbers when moving.
2. They produce an even distribution of the load on the joints.
3. Limit the span of the leg at the knee, stabilizing the position of the knee joint.

Break shapes

The characteristic of injury to the meniscus depends entirely on the type of injury, location and shape.

In modern traumatology, several types of ruptures are distinguished:

1. Longitudinal.
2. Degenerative.
3. Oblique.
4. Transverse.
5. Rupture of the anterior horn.
6. Horizontal.
7. Breaks in the posterior horn.

• The longitudinal form of the gap occurs partial or complete. Full is the most dangerous due to the complete jamming of the joint and immobilization of the lower limb.
• An oblique tear occurs at the junction of the posterior horn and the middle of the body part. It is considered "patchwork", may be accompanied by a wandering pain sensation that passes from side to side along the knee area, and is also accompanied by a certain crunch during movement.
• Horizontal rupture of the posterior horn of the medial meniscus is diagnosed by the appearance of soft tissue edema, intense pain in the area of ​​the joint gaps, it occurs inside the meniscus.

The most common and unpleasant knee injury, based on medical statistics, is considered to be a rupture of the posterior horn of the medial meniscus of the knee joint.

It happens:

1. Horizontal or longitudinal, in which the tissue layers are separated from each other with further blocking of the motor ability of the knee. A horizontal rupture of the posterior horn of the internal meniscus appears internally and extends into the capsule.
2. Radial, which manifests itself on oblique transverse tears of the cartilage. The edges of the damaged tissue look like tatters on examination.
3. Combined, including a double lesion of the meniscus - horizontal and radial

The combined gap is characterized by:

• ruptures of cartilaginous formations with tears of the thinnest particles of the meniscus;
• breaks in the back or front of the horn along with its body;
• separation of some particles of the meniscus;
• the occurrence of ruptures in the capsular part.

Signs of breaks

Usually, a rupture of the meniscus of the knee joint occurs due to an unnatural position of the knee or pinching of the cartilage cavity after injury to the knee area.

The main symptoms include:

1. Intensive pain syndrome, the strongest peak of which occurs at the very moment of injury and lasts for some time, after which it may fade away - a person will be able to step on his foot with some restrictions. It happens that the pain is ahead of a soft click. After a while, the pain changes into another form - as if a nail was stuck in the knee, it intensifies during the flexion-extension process.
2. Puffiness that appears after a certain time after injury.
3. Blocking of the joint, its jamming. This symptom is considered the main one during the rupture of the medial meniscus, it manifests itself after mechanical clamping of the cartilaginous part by the bones of the knee.
4. Hemarthrosis, manifested in the accumulation of blood inside the joint when the red region of the meniscus is injured.

Modern therapy, in conjunction with hardware diagnostics, has learned to determine what kind of rupture has occurred - acute or chronic. After all, it is impossible to discern the true cause of, for example, a fresh injury, characterized by hemarthrosis and smooth edges of the gap, with human forces. It is strikingly different from a neglected knee injury, where with the help of modern equipment it is possible to distinguish the causes of swelling, which consist in the accumulation of a liquid substance in the joint cavity.

Causes and mechanisms

There are many reasons for the violation of the integrity of the meniscus, and all of them most often occur as a result of non-compliance with safety rules or banal negligence in our daily life.

Gap shapes

Injury occurs due to:

• excessive loads - physical or sports;
• twisting of the ankle region during such games, in which the main load goes to the lower limbs;
• excessively active movement;
• prolonged squatting;
• deformations of bone structures that occur with age;
• jumping on one or two limbs;
• unsuccessful rotational movements;
• congenital articular and ligamentous weakness;
• sharp flexion-extensor manipulations of the limb;
• severe bruises;
• falls from a hill.

Injuries in which there is a rupture of the posterior horn of the meniscus have their own symptoms and directly depend on its shape.

If it is acute, in other words, fresh, then the symptoms include:

• sharp pain that does not leave the affected knee even at rest;
• internal hemorrhage;
• joint block;
• smooth fracture structure;
• redness and swelling of the knee.

If we consider a chronic, in other words, an old form, then it can be characterized:

• pain from excessive exertion;
• crackling in the process of motor movements;
• accumulation of fluid in the joint;
• porous structure of the meniscus tissue.

Diagnostics

Acute pain is not to be trifled with, as well as with all the symptoms described above. A visit to the doctor with a rupture of the posterior horn of the medial meniscus or with other types of ruptures of the cartilage tissues of the knee is mandatory. It must be done within a short period of time.

In a medical institution, the victim will be examined and sent to:

1. X-ray, which is used for visible signs of rupture. It is considered not particularly effective and is used to exclude concomitant bone fracture.
2. Ultrasound diagnostics, the effect of which directly depends on the qualifications of the traumatologist.
3. MRI and CT, which is considered the most reliable way to determine the gap.

Based on the results of the above methods of examination, the selection of treatment tactics is performed.

Medical tactics

Treatment of a rupture of the posterior horn of the medial meniscus of the knee joint should be carried out as soon as possible after injury in order to prevent the transition of the acute course of the disease into a chronic one in time. Otherwise, the even edge of the tear will begin to fray, which will lead to violations of the cartilaginous structure, and after that - to the development of arthrosis and a complete loss of motor functions of the knee.

It is possible to treat a primary violation of the integrity of the meniscus, if it is not of a chronic nature, by a conservative method, which includes several stages:

• Reposition. This stage is distinguished by the use of hardware traction or manual therapy to reduce the damaged joint.
• The stage of elimination of edema, during which the victim takes anti-inflammatory drugs.
• The rehabilitation stage, which includes all restorative procedures:
• massage;
• physiotherapy.
• Recovery stage. It lasts up to six months. For complete recovery, the use of chondroprotectors and hyaluronic acid is indicated.

Often, the treatment of the knee joint is accompanied by the application of a plaster bandage, the need for this is decided by the attending physician, because after all the necessary procedures, it needs long-term immobility, which helps the application of plaster.

Operation

The method of treatment with the help of surgical intervention solves the main problem - the preservation of the functionality of the knee joint. and its functions and is used when other treatments are excluded.

First of all, the damaged meniscus is examined for stitching, then the specialist makes a choice of one of several forms of surgical treatment:

1. Artromia. A very difficult method. It is used in exceptional cases with extensive damage to the knee joint.
2. Stitching of cartilage. The method is performed using an arthroscope inserted through a mini-hole into the knee in case of a fresh injury. The most favorable outcome is observed when cross-linking in the red zone.
3. Partial meniscectomy is an operation to remove the injured part of the cartilage, restoring its whole part.
4. Transfer. As a result of this operation, someone else's meniscus is inserted into the victim.
5. Arthroscopy. Traumatization with this most common and modern method of treatment is the most minimal. As a result of the arthroscope and saline solution introduced into the two mini-holes in the knee, all the necessary restorative manipulations are carried out.

Rehabilitation

It is difficult to overestimate the importance of the recovery period, compliance with all doctor's prescriptions, its correct implementation, since the return of all functions, painlessness of movements and complete recovery of the joint without chronic consequences directly depend on its effectiveness.

Small loads that strengthen the structure of the knee are given by properly assigned hardware recovery methods - simulators, and physiotherapy and exercise therapy are shown to strengthen internal structures. It is possible to remove edema with lymphatic drainage massage.

Treatment is allowed to be carried out at home, but still a greater effect is observed with inpatient treatment.

Several months of such therapy ends with the return of the victim to his usual life.

Consequences of trauma

Ruptures of the internal and external menisci are considered the most complex injuries, after which it is difficult to return the knee to its usual motor functions.

But do not despair - the success of treatment largely depends on the victim himself.

It is very important not to self-medicate, because the result will largely depend on:

• timely diagnosis;
• correctly prescribed therapy;
• rapid localization of injury;
• the duration of the gap;
• successful recovery procedures.

Often, after injury to the structures located in the knee joint, a rupture of the posterior horn of the medial meniscus is diagnosed. To avoid negative consequences and complications after an injury, it is important to start treating the injury. If the damage is partial, it will be possible to correct the situation with the help of conservative therapy. When a complete rupture and destruction of cartilage is diagnosed, surgical intervention is indispensable.

Causes of damage

If damage to the posterior horns of the meniscus is diagnosed, most likely, a complex fracture of the limb occurred with damage to the integrity of the ligamentous apparatus, bone, and soft tissues.

The medial meniscus is an inactive, cartilaginous formation located on the inside of the knee joint. Much less often, a rupture of the outer cartilage is diagnosed, which is located on the outside of the knee, it is called lateral. However, in addition to injuries, a rupture of the internal meniscus is provoked by:

• A degenerative disease of the musculoskeletal system, due to which the bone structures become fragile and prone to fractures.
• Unsuccessful landing on feet when jumping from a great height.
• Chronic, untreated damage to the internal meniscus of the knee joint.
• Congenital diseases that negatively affect the condition of the articular joints.

Rupture of the posterior horn of the medial meniscus is a consequence of an injury that occurs both in athletes or those who lead an active lifestyle, and in people in advanced years suffering from other concomitant diseases (for example, arthrosis).

To find out what the features of such damage are, you need to figure out what the meniscus is in general. This concept means a specific cartilaginous layer in the knee joint, which performs shock-absorbing functions. It includes the posterior horn, anterior, body, it is not only medial (internal), but also lateral (external). Here are just an injury to the medial meniscus (more specifically, its posterior horn) is the most dangerous, since it is fraught with serious complications and serious consequences.

Both cartilage layers - external and internal - are C-shaped and differ significantly from each other. So, the lateral meniscus has an increased density, it is quite mobile, due to which it is not injured so often. As for the inner tab, it is rigid, therefore, rupture (or other injuries) of the medial meniscus is much more common.

Part of the meniscus includes a capillary network that forms the "red zone". This part, located on the edge, is highly dense. In the center is the thinnest area (“white zone”), in which there are no vessels at all. When a person injures a meniscus, the first thing to do is determine which element was torn. By the way, the "living" area of ​​the meniscus recovers better.

Note! Once upon a time, doctors believed that removing a torn meniscus could save a person from all troubles. But now it has been proven that both menisci play a very important role in the joint - they protect it, absorb shocks, and the complete removal of one of them leads to early arthrosis.

The main reasons for the appearance

Now experts point to only one reason for the appearance of a gap - an acute injury. This is explained by the fact that no other impact on the joint can cause damage to the cartilage responsible for cushioning.

It is also worth noting that there are the following risk factors that predispose to rupture:

• congenital weakness of the joints;
• regular jumping, running on uneven surfaces;
• injuries resulting from degenerative diseases;
• rotational movements performed on one leg without taking it off the ground;
• long-term squatting;
• strenuous walking.

The posterior horn of the medial meniscus may be damaged for reasons other than acute trauma.

Symptoms of damage

Treatment of the described injury can be conservative and surgical. Consider the features of each of them.

Conservative treatment

Primary damage to the meniscus is treated with therapeutic methods. Of course, in some cases, after an injury, patients require emergency surgery, but often conservative therapy is quite enough. The treatment procedure itself in this case consists of several stages (we repeat - if the gap is not chronic).

Stage 1. Reposition. When blocking the joint, it must be set. Manual therapy or, alternatively, hardware traction is especially effective here.

Stage 2. Elimination of edema. To do this, doctors prescribe a course of anti-inflammatory medications.

Stage 3. Rehabilitation. The rehabilitation course includes massages, physiotherapy exercises and physiotherapy.

Rehabilitation course

Stage 4. Recovery. The most important, but at the same time the longest stage of treatment. Often, in order to restore the meniscus, chondroprotectors and hyaluronic acid are prescribed. A long course can be from three to six months, it is held once a year.

Note! The rupture of the posterior horn is accompanied by acute pain, so the patient is also prescribed painkillers. There are quite a lot of them - ibuprofen, paracetamol and others. As for the dosage, it should be prescribed exclusively by the attending physician!

In some cases, a cast is applied to the injured knee. The need for gypsum is determined by the doctor in each case. After repositioning the knee joint, immobilization is carried out for a long time at the required angle, and rigid fixation in this case helps to maintain the correct position.

Surgical treatments

During surgical treatment, specialists are guided by one principle - we are talking about the safety of the organ and its functionality. Surgery is performed only when other methods of treatment are ineffective. First, the organ is tested, it is checked whether it can be sutured (this is often relevant in cases of trauma to the “red zone”).

Table. Types of operations used in meniscus rupture

Video - Arthroscopy of the medial meniscus

Rehabilitation

One of the most important stages of treatment is the restoration of the functionality of the joint. You need to know that rehabilitation should take place exclusively under medical supervision. A doctor - an orthopedist or a rehabilitation specialist - individually prescribes a set of measures that contribute to a faster recovery of damaged tissues.

Note! The rehabilitation course can take place at home, it is advisable to do this in a hospital where there is equipment for physiotherapy exercises.

In addition to exercises, during the rehabilitation period, massages and hardware recovery methods are prescribed, associated with dosed loads on the joint. This contributes to the stimulation of muscle tissue and the development of the limb. As a rule, functionality is restored within a few months after the operation, and you can return to your previous life earlier (even a month later).

The main difficulty of the rehabilitation period is considered to be intra-articular swelling, which makes it impossible to quickly restore functions. Puffiness is eliminated with the help of lymphatic drainage massage.

Note! As a result, we note that with proper and - more importantly - timely treatment, the prognosis of rupture of the posterior horn is very favorable. And this is not surprising, because in modern orthopedics there are many effective methods.

Rupture of the posterior horn of the lateral meniscus or its anterior counterpart occurs as a result of trauma. This happens in people who are in the following risk groups:

• professional athletes (especially footballers);
• people who lead a very active lifestyle and engage in various extreme sports;
• elderly men and women suffering from various types of arthrosis and similar diseases.

What is an injury to the anterior or posterior horn of the internal meniscus? To do this, you must at least in general terms know what the meniscus itself is. In general terms, this is a special cartilaginous structure consisting of fibers. It is needed for cushioning in the joints of the knees. There are similar cartilaginous structures in other places of the human body - they are provided with all its parts, which are responsible for flexion and extension of the upper and lower extremities. But damage to the posterior or anterior horn of the lateral meniscus is considered the most dangerous and most common injury, which, if not treated in time, can lead to various complications and make a person disabled.

Brief anatomical description of the meniscus

The knee joint of a healthy organism incorporates the following cartilage tabs:

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

Both of these structures are shaped like a crescent. The density of the first meniscus is higher than that of the posterior cartilaginous structure. Therefore, the lateral part is less exposed to injury. The inner (medial) meniscus is rigid and most often the injury occurs when it is damaged.

The very structure of this body consists of several elements:

• cartilaginous body of the meniscus;
• anterior horn;
• its rear counterpart.

The main part of the cartilaginous tissue is girdled and permeated with a network of capillary vessels, which form the so-called red zone. This whole area has an increased density and is located on the edge of the knee joint. In the middle part is the thinnest part of the meniscus. There are no vessels in it and it is called the white zone. In the initial diagnosis of an injury, it is important to determine exactly which area of ​​the meniscus has been damaged and torn. Previously, it was customary to completely remove the meniscus if damage to the posterior horn of the inner layer was diagnosed, which allegedly contributed to the relief of the patient from complications and problems.

But at the current level of development of medicine, when it is precisely established that the internal and external meniscus perform very important functions for the bones and cartilage of the knee joint, doctors try to treat the injury without resorting to surgical intervention. Since the meniscus plays the role of a shock absorber and protects the joint, its removal can lead to the development of arthrosis and other complications, the treatment of which will require additional time and money. Damage to the anterior horn of the meniscus is rare, since its structure has an increased density and better resists various loads.

For such injuries, conservative treatment or surgery is usually prescribed if damage to the anterior horn of the lateral meniscus has led to the accumulation of blood in the knee joint.

Causes of cartilage rupture

Damage to the posterior horn of the medial meniscus is most often caused by an acute injury, since when a force is applied to the knee joint, it does not always lead to a rupture of the cartilage tissue, which is responsible for the cushioning of this area. Doctors identify a number of factors that contribute to getting a cartilage rupture:

• excessively active jumping or running over rough terrain;
• twisting the human body on one leg, when her foot does not come off the surface;
• frequent and prolonged squatting or active walking;
• the development of degeneration of the knee joint in certain diseases and limb injury in this condition;
• the presence of congenital pathology, in which there is a weak development of ligaments and joints.

There are different degrees of damage to the meniscus. Their classification is different in different clinics, but the main thing is that they are all determined by generally recognized signs, which will be discussed below.

Symptoms of damage to the posterior horn of the internal meniscus

Signs of such an injury to the medial meniscus are as follows:

• sharp, sharp pain occurs when an injury occurs. It can be felt within 3-5 minutes. Before that, a clicking sound is heard. After the pain has disappeared, the person will be able to move around. But this will cause new bouts of pain. After 10-12 hours, the patient will feel a sharp burning sensation in the knee, as if a sharp object had penetrated there. When bending and unbending the knee joint, the pain intensifies, and after a short rest it subsides;
• blockade of the knee (“jamming”) occurs when the cartilage tissue of the inner meniscus is torn. It can manifest itself at the moment when a torn piece of the meniscus is clamped between the tibia and femur. This results in the inability to move. These symptoms also bother a person if the ligaments of the knee joint are damaged, so the exact cause of the pain syndrome can only be found out when making a diagnosis in the clinic;
• when blood enters the joint, traumatic hemarthrosis may occur. This occurs when a meniscus rupture occurs in the red zone, when blood vessels are damaged;
• after several hours from the moment of injury, swelling of the knee joint may occur.

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Chronic damage to the posterior horn of the medial meniscus of the 2nd degree from an acute injury should be clearly distinguished. This is possible today with the use of hardware diagnostics, which allows you to carefully examine the state of cartilage and fluid in the knee joint. A grade 3 meniscus tear leads to a pool of blood in the inside of the knee. At the same time, the edges of the cliff are even, and in case of a chronic disease, the fibers are scattered, there is edema, which occurs from damage to the nearby cartilage, and the penetration into this place and the accumulation of synovial fluid there.

Treatment of an injury to the posterior horn of the internal meniscus

The rupture of the tissues of the knee joint should be treated immediately after the injury, because over time, the disease from the acute stage can turn into a chronic disease. If treatment is not started on time, meniscopathy may develop. This will lead to changes in the structure of the knee joint and degradation of cartilage tissue on the bone surfaces. This situation is observed in half of the cases of rupture of the posterior horn of the internal meniscus in patients who, for various reasons, started the disease and sought medical help late.

The rupture can be treated by the following methods:

• conservative way;
• surgical intervention.

After making an accurate diagnosis, the doctors eliminate the primary rupture of the meniscus horn with the help of a therapeutic course. In most cases, conservative treatment gives good results, although about a third of such injuries require surgery.

Treatment with conservative methods consists of several, fairly effective stages (if the injury is not started):

• manual therapy and traction with the help of various equipment, which are aimed at repositioning, that is, repositioning the knee joint during the development of blockade;
• the use of anti-inflammatory drugs that doctors prescribe to the patient to eliminate swelling of the knee;
• a rehabilitation course in which treatment is carried out using therapeutic, restorative gymnastics, physiotherapy methods and massage appointments;
• prescribing a course to the patient, in which treatment is carried out with chondroprotectors and hyaluronic acid. This lengthy process can last from 3 to 6 months for several years, but is important for the restoration of the meniscus structure;
• since the injury of the posterior horn of the meniscus is accompanied by a strong pain syndrome, the doctors continue the treatment using painkillers. For this purpose, analgesics are usually used, for example, Ibuprofen, Paracetamol, Indomethacin, Diclofenac and other drugs. They can only be used as prescribed by the attending physician in a dosage that is determined by the course of therapy.