Damage to the internal meniscus signs, treatment, rehabilitation
Damaged meniscus is the most common form of knee injury. The knee joint contains two meniscus: the medial (inner) and lateral (outer). Young people have more common traumatic injury of this cartilage, while the degenerative damage to the inner meniscus is more common in older people, and it is observed on the background of the General ageing process and changes in the structure of cartilage of all joints.
Menisci are cartilage located on myselkf tibia. This cartilage is part of the knee and performs several specific functions, including allows to distribute the load, serves for cushioning the joint, and reduces the voltage at the contact of the articular structures, passes along the nerve endings of signals to the brain about in what position is the hip joint.
The reasons for the defeat
The main factors that can lead to a tear or partial damage of the meniscus can be divided into degenerative and traumatic. People aged 10 to 40 years, the most common cause of damage to the meniscus is an injury that is accompanied by rotation of the lower leg. For external rotation of the tibia, as a rule, there is damage to the inner meniscus, and the twist of the tibia inwards, you may experience rupture of the outer meniscus.
Less damage to the meniscus causes a sharp extension of the knee after a long period of his stay in the folded state. There are a number of situations that most often cause traumatic injuries of the meniscus:
Degenerative changes in the structure of the tissues of the knee joint most often cause of damage to the meniscus in people over 40 years. As a rule, in such cases, a predisposing factor is one of the following diseases and pathological conditions:
The elderly damage to this cartilage is much more common, because at this age, you can overlay factors. The meniscus covers a degenerative disease, significantly more susceptible to injury because of the fall of man and other circumstances.
Injury to the internal and external meniscus
Medial and lateral meniscus are injured in different ways, as these two pieces of cartilage in different areas of the joint, although perform one function. Often there is damage to the posterior horn of the internal meniscus. In addition, damage can occur in the center, that is in the middle of a gap of cartilage, while the ends of the tissue remain intact.
Damage to the posterior horn of internal meniscus and the center always occur with a pronounced pain syndrome, not only due to the presence of the gap, but also because of the possibility of displacement of the severed part and pinched between the tibia and the femur. In this case, the horn or the entire meniscus can become inflamed. A gap may occur in the area of the ligaments that fix the organ.
In addition, the rupture of the posterior horn of the internal meniscus can be observed in the pathologically changed tissues. Injuries to the meniscus with the infringement inevitably leads to the fact that the knee joint is locked, and can also occur slipping of the knee and tucking. Damage to the posterior horn of the internal meniscus associated with a number of characteristic symptoms, such as:
- the pain inside the joint;
- the strongest pain in bent leg;
- discomfort in the knee region in a state of rest;
- decreased tone of muscles located in the front part of the thigh;
- a sharp shot when the voltage of the thigh.
A rupture of an internal meniscus of the knee joint accompanied by fluid accumulation in 2-3 hours after the injury. The fluid begins to accumulate due to damage to the elastic membrane inside the joint. After removal of the fluid by puncture, re-accumulation can be observed on the background of recurrence of blockade or involuntary binding of the knee. The accumulation of fluid within the joint is a very dangerous phenomenon, since the presence of pathogenic microorganisms in the cavity filled with fluid, can develop a complication of a purulent abscess.
The rupture of the outer meniscus of the knee is somewhat different from the specific damage to the outside of the cartilage. As a rule, damage to the lateral meniscus is the reverse twisting motion, which contributes to the appearance of lacerations. It should immediately be noted that the gap of the lateral meniscus is most commonly seen in children and adolescents leading an active lifestyle can get injured, accompanied by an unnatural twist of legs.
Under this option, the injury, the blockade and the limitation is very rare. The symptomatic manifestation of damage of the lateral meniscus are less pronounced. Most patients complain of the following symptoms:
- the decrease in muscle tone;
- the appearance of synovitis;
- discomfort in the ligaments;
- pain in the area of the collateral ligaments in flexion of the leg.
In this embodiment, the meniscus injury is not observed violations gait, but when walking there is a characteristic clicking, especially when bending at the knee and internal rotation of the legs. Not always people with such a meniscus tear seek qualified help as the pain and discomfort manifest themselves from time to time.
Degeneration and cystic degeneration of the meniscus
We should also mention degenerative and cystic meniscus, which occupies a leading place among the domestic joint injuries. The appearance of injury to the internal meniscus due to the development of degenerative-dystrophic process is more common in men than in women. As a rule, the lesion is symmetrical in nature, meaning the defect appears on the left and on the right cartilage.
Degeneration of the tissue of the meniscus is manifested not only by a change in the structure of tissue, but also decrease the elasticity of the fibers, and in addition, deposition of substances such as mucin. The appearance of damage to the meniscus is subjected to degenerative processes, usually occurs on the background of the awkward movements, falls or other household accidents.
In some cases, in direct injury of the knee may be minor damage to the tissues of this region, but after a few of these injuries may develop chronic degeneration of the meniscus. In this case, when any awkward movement of the meniscus will be damaged, so in the future people will be plenty of times to experience all of the symptomatic manifestations of rupture of the inner or outer meniscus.
Often the cartilage is damaged as a result of cystic degeneration. If there is damage to the meniscus in this area there is the appearance of cavity, liquid education, which in medical terminology is called paramedicales cyst. Tissue changed this tumor, lose their elasticity, which significantly increases the possibility of a rupture.
Over time, the region of cystic degeneration of the tissues becomes larger and the swelling of the knee becomes visible to the naked eye.
Diagnosis of internal meniscus
First and foremost it is worth noting that correctly diagnosed the meniscus tear can only be a qualified doctor after a series of tests and diagnostic studies. The fact is that there are many characteristics of meniscus damage, and effective treatment is necessary to determine not only what the meniscus was torn, but the type, form and degree of tissue damage.
At diagnosis in the first place is going a detailed medical history, so in this case, the patient must fully describe the nature of existing symptoms. On the basis of history of trauma may determine whether the meniscus has been damaged. The following is the examination of the foot and palpation of the knee joint. Despite the fact that medical history and conduct external inspection and palpation of the patient’s knee enough to determine the damage to the meniscus, the majority of trauma use additional research, including can be assigned:
- magnetic resonance imaging;
Evidence-based trauma determines how it will pass treatment and rehabilitation of the joint. It should be noted that conservative methods of treatment generally used in the case that damage to the meniscus is fresh, while in chronic injuries most often used surgical methods of influence.
Treatment of injuries
In most cases, conservative treatments are used for minor meniscus, that with a certain amount of therapy can heal yourself, fully restoring its functionality. Not to mention the fact that conservative treatment could not be applied in cases where the cartilage tear meniscus is accompanied by pinching the torn flap. In addition, conservative treatment may not be used in cases where in the joint cavity fluid accumulates, there is a pronounced offset, roll-over or clicking.
Primarily conservative treatment is aimed at reduction of joint mobility and immobilization. It is necessary to reduce physical activity and preventing displacement of the structures of the joint. The optimal duration of immobilization is 14 days. Fixation of the joint is carried out using the bus or getting a cast.
In addition, during the conservative treatment aimed at the regeneration of cartilage tissue, is assigned symptomatic therapy. Symptomatic therapy involves the use of drugs for pain syndrome at the introduction into the joint cavity. In addition, can be assigned to anti-inflammatory, hyaluronic acid, chondroprotectors and a course of NSAIDs. After removing the plaster or splints additionally prescribe a course of physiotherapy, which includes magnetotherapy, UHF, laser treatment and treatment of microcurrents,
If there is a complete meniscus tear or severe damage, shown compulsory surgical intervention. Depending on the characteristics of the damage to the meniscus can be assigned to its transplantation or complete reconstruction. The most commonly held reconstruction, aimed at stitching the torn halves of the cartilage structure. Typically, this surgery is performed in about 1.5 weeks after getting a person injury. During this time, tissues become less inflamed, giving a chance to repair damaged structures.
In the most severe cases, when the meniscus is torn in several areas, can be assigned to total meniscectomy, which involves the body pressure damaged cartilage, but this method is less preferred than transplantation, because in the absence of the meniscus in the knee joint observed accelerated degradation of other parts.
Prognosis and rehabilitation in the presence of a damaged meniscus
With proper diagnosis and treatment of the meniscus, the prognosis is always favorable. However, in order to restore the health of this part of the knee joint, the person with such an injury, it takes several months to limit his mobility and physical activity. People over the age of 40 years, the process of rehabilitation after injury can take longer, because at this age the ligaments already have signs of letting up. In addition, the favorable end result is affected by the extent to which the patient complied with the doctor’s orders regarding recovery.
Within 1-3 months after treatment a patient is sparing regimen of physical activity, performing a series of exercises that have to be agreed with the doctor and the doctor’s visit to inspect and assess the condition of the knee. In some cases, you may be prescribed a full-service Spa and a proper diet.