Damage to the posterior horn of the medial meniscus: causes of gap
Rupture of the posterior horn of the lateral meniscus or anterior counterpart arises as a result of injury. This happens in people who fit into the following risk groups:
- professional athletes (especially football players);
- people leading a very active lifestyle and engaged in various kinds of extreme sports;
- men and women of advanced age suffering from different types of arthritis and similar diseases.
What is a lesion of the anterior or posterior horn of the internal meniscus? To do this, at least in General terms, to know what is the meniscus. In General this is a special, consisting of fibers of the cartilage structure. It is necessary for depreciation in the joints of the knees. Similar cartilaginous structure is, in other places of the human body — they are equipped with all the parts of it which are responsible for bending and straightening the upper and lower extremities. But the damage to the back or anterior horn of the lateral meniscus is considered the most dangerous and the most frequent injury that when not treated can lead to various complications and make a person disabled.
A brief anatomical description of the meniscus
The knee joint of a healthy body is composed of such cartilage tabs:
- external (lateral);
- internal (medial).
Both of these structures are shaped like a Crescent moon. The density of the first meniscus is higher than the corresponding figure at the back of the cartilage structure. Therefore, lateral part less subject to injury. Internal (medial) meniscus rigid and most often the injury occurs when it is damaged.
The structure of this body consists of several elements:
- the cartilaginous body of the meniscus;
- front horn;
- its rear counterpart.
The main part of the cartilaginous tissue surrounded and permeated by a grid of capillary vessels, which form so-called red zone. This whole area has a high density and located at the edge of the knee joint. In the middle is the thinnest part of the meniscus. It has no blood vessels and it is called the white zone. With a primary diagnosis of injury it is important to determine which region of the meniscus was injured and suffered a tear. Before it was decided to completely remove the meniscus if it was diagnosed with damage to the posterior horn of the internal layer, which allegedly contributed to the deliverance of the patient from complications and problems.
But with the current level of development of medicine, it is considered that the internal and external meniscus perform a very important function for the bones and cartilage of the knee joint, doctors try to treat the injury without resorting to surgery. Since the meniscus acts as a shock absorber and protects the joint, its removal can lead to the development of osteoarthritis 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 a higher density and better resists to various stresses.
Such injuries usually administered conservative treatment or surgery if damage to the anterior horn of the lateral meniscus has led to the accumulation of blood in the knee joint.
Causes of rupture of the cartilage tissues
Damage to the posterior horn of the medial meniscus most often caused by acute trauma, as in the violent impact on the knee joint does not always leads to the breakdown of cartilage, which is responsible for attenuation of the site. Doctors have identified several factors that contribute to getting tear of the cartilage:
- excessive jumping or running over rough terrain;
- twist of the human body on one leg, when her foot does not come off from the surface;
- frequent and prolonged sitting or squatting active walking;
- the development of degeneration of the knee joint in some diseases and trauma of the limbs in this state;
- the presence of congenital disorders in which there is poor development of the ligaments and joints.
There are different degrees of damage to the meniscus. Their classification is different in different clinics, but most importantly, they are all determined according to generally accepted indications, as will be described below.
Symptoms of damage to the posterior horn of the internal meniscus
The signs of such an injury of the medial meniscus the following:
- there is a sharp, sharp pain in the injury. It can be felt in 3-5 minutes. Before this, hear a clicking sound. After the pain is gone, people will be able to move. But it will cause new bouts of pain. After 10-12 hours the patient will feel a sharp burning sensation in the knee, as if to penetrate sharp object. By bending and unbending of the knee joint pain increases, and after a short rest subsides;
- blockade of the knee («jamming») occurs when rupture of the cartilage of the inner meniscus. It can occur at a time when a torn piece of meniscus is clamped between the tibia and the femur. This results in the inability to move. These symptoms are bothering a person, and damage to the ligaments of the knee joint, so the exact cause of the pain syndrome can be found only at diagnosis in the clinic;
- when the penetration of blood inside the joint may be traumatic hemarthrosis. This occurs when the occurrence of a meniscus tear in the red zone, when damaged blood vessels;
- after a few hours from the time of injury may manifest swelling of the knee joint.
It should be clearly distinguish chronic damage to the posterior horn of the medial meniscus 2 degrees of acute injury. This is now possible when using the hardware diagnostics, which allows you to carefully inspect the condition of cartilage and fluid in the knee joint. A meniscus tear grade 3 leads to the accumulation of blood in the internal parts of the knee. While the edge is smooth, and in chronic disease the fibers are scattered, there is a swelling that arises from damage of nearby cartilage, and the infiltration and accumulation of synovial fluid there.
Treatment of an injury of the posterior horn of the internal meniscus
The tissue of the knee should be treated immediately after the injury because over time the disease out of the acute phase can become chronic disease. If treatment is not started in time, may develop miniscope. This will lead to changes in the structure of the knee joint and degradation of the cartilage surfaces of the bones. This situation is observed in half of the cases of rupture of the posterior horn of the internal meniscus in patients who for different reasons started the illness and later sought medical help.
Treatment of break you can spend using the following methods:
- conservative method;
After the accurate diagnosis of primary rupture horn of the meniscus doctors eliminate with the help of the therapeutic course. In most cases, conservative treatment gives good results, although in about a third of cases receiving such injuries need surgical intervention.
Conservative treatment consists of several, quite effective stages (if the injury is not running):
- manual therapy and traction with the help of various instruments that aim to reposition, that is, reduction of the knee joint during the development of the blockade;
- the use of anti-inflammatory drugs that doctors prescribe to the patient to eliminate the swelling of the knee;
- the rehabilitation rate at which the treatment is carried out with the use of therapeutic, rehabilitative exercises, physiotherapy and massage appointment;
- the purpose of the course to the patient, wherein the treatment produces a chondroprotectors and hyaluronic acid. This long process may last from 3 to 6 months for several years, but it is important to restore the structure of the meniscus;
- because trauma to the posterior horn of the meniscus is accompanied by severe pain, the treatment the doctors keep using pain-relieving medications. For this purpose, commonly used analgesics, e.g. Ibuprofen, Paracetamol, Indomethacin, Diclofenac and other drugs. You can use them for the intended purpose only doctor in a dosage which is determined by the course of therapy.
Treatment of the meniscus is occasionally carried out with application of gypsum. Apply it to the patient or not, is decided only by specialist.
This is usually done after reduction of the joint by manual method, because then the meniscus must be in a certain position for 2-3 weeks. This can only be done with a plaster lining.
Surgery is injury of the meniscus
During the operation the doctors follow the main principle — to preserve the body and its functions to facilitate patient rehabilitation period. If conservative methods of bridging the gap meniscus ineffective, the treatment continues by using surgical methods. First, a test of the ability to mend torn cartilage. This is usually done when the damage in the so-called red zone.
With other types of injury horn of the medial meniscus it is possible to produce this type of operations:
- the removal of torn cartilage — arthrotomy. It is quite a complex operation, which does not always lead to the cure of the patient. Many surgeons have completely abandoned the use of such intervention. But with extensive lesions of the meniscus and total knee joint it must be done;
- complete removal of cartilage or meniscectomy today is almost never used as it is considered inefficient and harmful.
- removal of part of the cartilage tissue with subsequent restoration of remaining is called partial meniscectomy. When her surgeon trims and smooths edges of the cartilage;
- transplantation and arthroplasty are carried out by transplanting the patient’s donor meniscus or artificial counterpart. This treatment allows you to completely restore the function of the knee joint;
- today, medicine is evolving towards the production of non-traumatic person operations. For surgery on the meniscus arthroscopy is considered to be. Its implementation is carried out using 3 small punctures on his knee. In one of them give birth to a miniature video camera and saline solution, but through others perform surgical procedures inside the knee joint. This method allows you to quickly discharge patients after rehabilitation;
- to repair damage in a dense part of the meniscus (white zone) very effectively stitching the damaged cartilage.
Rehabilitation of patients after treatment
It is needed to restore functional ability of the joint. It is held only under the supervision of the attending podiatrist. It selects the optimum rehabilitation treatment based on the individual characteristics of the patient. All activities must ultimately lead to full restoration of the damaged joint and the ability to work.
The main thing — it is time to start treatment , preferably immediately after receiving the injury on the meniscus, and then the guaranteed successful recovery of the patient.