The question of what situations require knee surgery on the meniscus is often heard. Definitely difficult to answer. Reviews of people who have experienced various problems with this body show some vigilance before the operation, so they were looking for conservative methods of treatment. In order to more fully reveal the topic of the need for surgery, you need to understand what is the meniscus.
What is the meniscus of the knee?
Cartilaginous pads, which are a kind of shock absorbers and stabilizers, as well as increase its mobility and flexibility, called the knee meniscus. If the joint moves, the meniscus will shrink and change its shape.
The knee joint includes two menisci - medial or internal and lateral or external. They are interconnected by means of the transverse ligament in front of the joint.
The peculiarity of the outer meniscus is greater mobility, and therefore its injuries are higher. The internal meniscus is not as mobile, it depends on the internal lateral ligament. Therefore, if it is injured, then this bundle is also damaged. In this case, surgery is necessary on the knee joint on the meniscus.
Causes of various meniscus injuries
So why do their injuries occur, and in what cases an operation is necessary on the meniscus of the knee joint?
- To the rupture of the cartilaginous pads lead injuries that are accompanied by the movement of the tibia in different directions.
- The meniscus of the knee joint (treatment, surgery, and other methods will be discussed below) may be damaged in the event of excessive extension of the joint when the lower leg is brought in and removed.
- Breaks are possible with a direct impact on the joint, for example, from the impact of a moving object, stress on the step or falling on the knee.
- In case of repeated direct injury, chronic injury to the meniscus may occur, as a result of which a sharp turn may cause a rupture.
- Changes in the meniscus can occur in some diseases, such as rheumatism, gout, chronic intoxication (especially in those people whose work is associated with prolonged standing or walking), with chronic microtrauma.
Meniscus treatment methods, reviews
Not in all cases surgery is indicated, since the damage to this tissue may be different. There are several ways to restore meniscus functionality. For this, physiotherapy procedures are carried out, various medications are used, and traditional medicine recipes are used.
Many patients choose more conservative methods, this is evidenced by their reviews. But they also note the risk of loss of time for recovery. When instead of performing the operation, which was advised by the experts, they chose physiotherapy or treatment with folk remedies, it only got worse. In such cases, the operation was nevertheless carried out, but already more complicated and with a long recovery period. Therefore, it sometimes happens that knee joint surgery on the meniscus is unavoidable. When is she appointed?
When is an operation to be performed on the meniscus of the knee joint?
- When crushing the meniscus.
- If there was a break and offset it. The body of the meniscus is characterized by insufficiency of blood circulation, therefore, in case of a break, independent healing is out of the question. In this case, partial or complete cartilage resection is shown.
- For hemorrhage into the joint cavity, an operation is also shown on the meniscus of the knee joint. Patient testimonials testify about a fairly rapid rehabilitation in this case.
- When there was a complete detachment of the body and horns of the meniscus.
What types of manipulations are used?
Operations are performed for stapling or partial removal of cartilage. Sometimes surgery to remove the meniscus of the knee occurs with the purpose of transplantation of the body. In this case, part of the damaged cartilage is removed and replaced with a transplant. This is not a very dangerous surgical procedure, although some patients, according to their responses, were afraid to resort to using transplants. After such a manipulation, there are few risks, since donor or artificial menisci take root without any special problems. The only disadvantage in this situation is a long rehabilitation. On average, it takes 3-4 months for a successful transplant. After this, the human performance is gradually restored. Anyone who does not want to lose so much time for rehabilitation, resorting to radical methods of restoring broken their cartilage.
Recently, medicine has reached such a level that it is possible to save even a meniscus torn to pieces. To do this, it is necessary not to delay the surgery and in a calm state, with properly organized treatment, spend at least a month on rehabilitation. Here also plays the role of proper nutrition. Patient testimonials can be found opposite: some are prone to replacing cartilage with donor or artificial, while others prefer their own. But in these two cases, a positive result is possible only with the right approach to rehabilitation after surgery.
Use of knee arthroscopy
With arthroscopy, the surgeon can see most of the structures inside the knee joint. The knee joint can be compared to a joint that is formed by the end sections of the tibia and femur. The surfaces of these bones, adjacent to the joint, have a smooth cartilage cover, due to which they can slide when the joint moves. Normally, this cartilage is white, smooth and elastic, three to four millimeters thick. With the help of arthroscopy, you can identify many problems, including rupture of the meniscus of the knee joint. Operation using arthroscopic techniques will help solve this problem. After it, the person will again be able to fully move. Patients note that today it is the best procedure to restore the function of the knee joint.
Knee surgery on the meniscus - duration
For arthroscopy, surgical instruments are inserted through small holes in the joint cavity. The arthroscope and the instruments used in this procedure enable the doctor to examine, remove, or sew the tissues inside the joint. The image through the arthroscope gets on the monitor. The joint is filled with fluid, which makes it possible to see everything quite clearly. The whole procedure lasts no more than 1-2 hours.
According to statistics, among all injuries of the knee joint, half is due to damage to the meniscus of the knee joint. The operation makes the patient feel better, relieves swelling. But, patients say, the result of this procedure is not always predictable. It all depends on the worn or worn out cartilage.
Rehabilitation treatment with conservative methods, reviews
Rehabilitation is required not only after surgery on the meniscus, but also as a result of any treatment of this cartilage. Conservative treatment involves a two-month rehabilitation with the implementation of the following recommendations:
- Do cold compresses.
- Every day to devote time physical therapy and gymnastics.
- The use of drugs anti-inflammatory and analgesic action.
Rehabilitation after surgery
Some other requirements for recovery include surgery on the meniscus of the knee joint. Rehabilitation in this case involves a little more effort, the same is noted by patients. This is due to the fact that there was more serious damage to the meniscus, as well as penetration through other tissues of the body. For recovery after surgery will require:
- Initially, it is necessary to walk with a support in order not to strain the joint - this may be a cane or crutches, the duration of use of which is determined by the doctor.
- After that, the load on the joint slightly increases - movement occurs already with the distribution of the load on the leg joints. This happens 2-3 weeks after surgery.
- Then independent walking with orthoses, special fixers of the joints, is allowed.
- In 6-7 weeks it is necessary to begin medical gymnastics.
With strict adherence to these recommendations, the complete restoration of the knee joint occurs 10-12 weeks after surgery.
What negative consequences can be left after the operation on the meniscus of the knee joint? Reviews indicate that postoperative complications are rare, but they still happen.
- The most common intraarticular infection occurs. It can get into the joint with non-compliance with the rules of asepsis and antisepsis. An already existing purulent focus in the joint can also lead to infection.
- Damage to cartilage, meniscus and ligament are also found. There have been cases of breakage of surgical instruments inside the joint.
- If the wrong approach to rehabilitation after surgery on the knee joint, its stiffness is possible, up to ankylosis.
- Other complications include thromembolism, gas and fat emboli, fistulas, adhesions, nerve damage, hemarthrosis, osteomyelitis, sepsis.
Sports after surgery
Professional athletes are trying to return to class as soon as possible after a meniscus injury and surgery. With a specially developed rehabilitation program, this can be achieved in 2 months, they note. For quick recovery, power simulators (bicycle ergometers), exercises in the pool, certain exercises and so on are used. When rehabilitation comes to an end, you can run on a treadmill, pass the ball, imitate exercises related to a particular sport. Reviews of such patients indicate difficulties in rehabilitation in a similar way, since it is always difficult to develop a sore joint. But after hard work and patience, good and fast results can be achieved.
Proper rehabilitation after surgery on the meniscus of the knee joint leads to full recovery. The forecasts of the doctors are favorable.
The value of therapeutic gymnastics for meniscus injury
Functional and then morphological changes in the knee joint occur not only at the time of the injury itself, but during prolonged immobilization of the limb during the period of therapy. When the injury was received, edema often appears on the skin, which can also be the result of a subsequent complication. In addition, when the meniscus rupture increases interstitial pressure and disrupts the normal work of nerve endings.
Since the myoreceptors are constantly irritated, the effect of hypertonicity of the muscular tissues appears. Prolonged irritation of the receptors located on the tendons leads to a sharp inhibition of motor function. Correctly conducted restorative physical education after the rupture of the knee meniscus allows to eliminate stagnant processes and contracture of the elements of the joint.
Note that additional difficulties for quick recovery are also created by the forced immobilization of the injured limb. It should be remembered that the later restorative exercise will be used after the meniscus of the knee joint is ruptured, the greater the risk of complications. If the limb is immobilized during the week, the muscles lose 20 percent of their abilities.
When the immobilization period is about six weeks, the joint bag becomes rigid and it takes several times more effort to perform a simple movement. In turn, after two months of immobilization, about 40 percent of the elasticity of the ligaments is lost, and the functional abilities of the cartilage tissue are also lost. All this suggests that restorative physical education after the rupture of the menisci of the knee joint should be appointed in the first days of the rehabilitation phase.
The period of immobilization after the rupture of the knee meniscus
Immediately after receiving damage, the joint should be immobilized. This will prevent the displacement of the damaged tissue, as well as create the most ideal conditions for the fusion of cartilage. To immobilize the knee joint, knee pads and orthoses are used.
How to suppress pain?
As we noted above, during the period of immobilization of the injured limb, the main task of the therapy is to suppress pain, as well as eliminate edema and inflammatory processes. For the solution of the task, drugs of the group of corticosteroids, as well as non-steroid drugs with anti-inflammatory properties, are excellent. As an additional means, cooling and anesthetic ointments are used.
Popular methods are also well suited as painkillers. You can safely use compresses of onion gruel, burdock, alcohol, and honey. If arthroscopy was performed, then restorative physical training after the rupture of the knee meniscus should be done every second day. While the knee joint is immobilized, the following actions should be performed:
- General developmental exercises for all muscles of the body.
- Knead healthy limbs.
- Isometric exercises for the muscles of the immobilized leg.
- Hold the limb in the lowered and raised positions.
To enhance peripheral blood flow and eliminate stagnant processes in the immobilized joint, we recommend periodically lowering the leg and then lifting it. At this time, restorative physical education after the rupture of the knee meniscus is necessary to prepare the muscles and the articular ligament apparatus for the upcoming loads.
The rehabilitation period after the rupture of the knee meniscus
All the exercises included in the complex of restorative physical education after the rupture of the knee meniscus during the rehabilitation stage should be carried out sparingly, and the amplitude of movements and the exercise index should be systematically increased.
The first classes have the main purpose of increasing the range of motion. When about 40 percent of the motor capabilities of the knee joint will be restored, exercises must be introduced into the complex to increase muscle strength parameters. The complex of movements must be adjusted by the instructor, depending on the characteristics of the patient and his age.
The training program should be created taking into account the main objectives of rehabilitation after injury:
- The return of man to normal life.
- For sports at the amateur level
- To continue your professional sports career.
Restorative physical education after the rupture of the knee meniscus must include:
- Exercises to improve coordination - will help restore control over the muscles of the injured limb.
Increased flexibility - as a result, the knee joint will be able to completely unbend.
Increased muscular endurance - special attention should be paid to the quadriceps and hind tibialis with hip muscles. They accelerate the process of restoring the supporting abilities of a person.
Strengthening and stretching so that the joint can bend at a right angle. It is necessary to conduct a massage.
- The formation of a normal and natural gait.
Exercises included in the complex of restorative physical education after a meniscus rupture
Now we will offer you an approximate complex of restorative physical education after the rupture of the knee meniscus.
All exercises must be performed while lying down.
- The hands are locked together and located on the head. While inhaling, lift your arms vertically up and then return them to their starting position. You must perform three to four repetitions.
Bend the ankle in the back and plantar directions, and also perform circular movements. The pace is average. It is necessary to make from 15 to 18 repetitions.
The padded ball must be tossed and caught. The number of repetitions is from 15 to 18.
- Take a prone position, resting your elbows on the ground, the back of your head, and your healthy leg bent at the knee joint. Begin slowly raising your pelvis as high as possible. Make sure that the damaged leg remains on the ground, but at the same time bent at the knee. The number of repetitions is from 4 to 7.
Rest the ground with your hands and a healthy knee joint. Begin to lift the damaged limb. The number of repetitions is from 6 to 9.
From the position on all fours, slowly go down on your heels. The number of repetitions is from 6 to 9.
Sit on a chair and grab your toes and then roll various objects. The number of repetitions is from 14 to 16.
Raise the foot ball with your feet. The number of repetitions is from 6 to 9.
Собирайте в складки полотенце. Число повторов составляет от 5 до 7.
В медленном темпе приседайте, опираясь руками на край стула. Число повторов составляет от 5 до 7.
Станьте около гимнастической лестницы и удерживайте планку на уровне грудной клетки. Begin to perform rolling movements from heel to toe. The number of repetitions is from 13 to 17.
- Put the foot of the injured limb on the padded ball and roll it to the side.
To control the gait you need to move on crutches. At the final stage of the complex of restorative gymnastics, it is necessary to perform breathing and relaxing muscles of movement.
Recovery after rupture of the knee meniscus
This stage should begin only after all the goals of the previous one have been achieved. Now, restorative physical education after the rupture of the knee menisci involves the implementation of more complex movements that are as close to natural as possible. The patient should start working on simulators and perform static-dynamic movements. Also in the complex it is desirable to include classes on the trampoline.
The main objectives of this stage are:
- A further increase in endurance and muscle strength, which involves the introduction of more complex exercises into the complex.
- The knee joint should be bent at an angle of 60 degrees.
- Sensitization of the knee due to balance exercises.
- Further training of muscles for normal life.
- Return to the muscles of the previous volume.
- Formation of the skill of correct landing during jumps.
During this period, we recommend performing the following exercises for different muscular groups.
Sit on a chair, legs bent at the knee joints. Begin to breed them, at the same time bringing your heels together. When doing the exercises with your hands, you need to press on the legs.
- Take a supine position and press the foot against the wall. Begin to move it down, bending the knee joint.
- A burden should be attached to the ankle of the damaged leg. Take a sitting position on the table so that the hips are located on its surface, and your legs hang loosely. Begin to bend / unbend the leg, keeping a pause of ten seconds at the end points of the path.
Turn your back to the wall and, bending the legs at the knee joints, slide it down. At the bottom of the bed trajectory hold a pause for ten accounts.
- Elastic bandage must be secured between the legs of the chair, and then sit on it. Start pressing the bandage with your foot, while pulling it back.
Once again I would like to remind you that restorative physical education should be carried out in a timely manner. Only in this way can the patient recover in a short time. Until the knee joint is fully restored, the foot should not be floated and hot baths should be taken.
For more details on how to train after a meniscus injury, see below:
How to treat damage to the medial and lateral meniscus
Treatment of rupture of the internal or external meniscus of the knee joint without surgery is divided into two periods:
- Treatment of the acute period. The task of this stage is the relief of pain, the removal of edema, and the prevention of further development of meniscus injury. The duration of treatment of the acute period without surgery is 1-2 weeks.
- Rehabilitation (recovery) period - the main stage of treatment of a gap without surgery. In this phase, the collagen fiber structures are restored and the meniscus functions are restored.
First aid in the acute period
The task of first aid in the acute period is to prevent the development of possible complications, to alleviate the severity of the meniscus rupture, to avoid surgery.
- Refrain from physical exertion during the first week after injury. Physical activity during the acute period will contribute to the further development of the meniscus gap.
- Apply a cold compressto the damaged knee joint for 15 minutes every 1 -1.5 hours. Ice helps in a short time to remove swelling of the knee, reduce pain. The cold slows down the metabolic process and prevents the destruction of the collagen fibers of the meniscus. To prevent the occurrence of an “ice burn”, it is necessary to wrap the ice in a wet towel and keep it in the affected area for no more than 15 minutes.
- Use a special bandage during the first 24-72 hours after injury. This will help to cure the knee joint without surgery. Compression bandage compresses blood vessels, thereby reducing the development of swelling in the area of injury. In the absence of a special knee pad, a gauze or elastic bandage can be used. Apply a bandage to the injured knee joint in a converging or diverging direction, as shown in the picture. It is necessary to control the density of the bandage to avoid overpressing the tissues. Immediately remove the bandage when the following symptoms occur: cyanosis of the toes, feeling of “goose bumps” and “needles”, decreased skin sensitivity.
- Raise your injured leg above body level. The elevated position of the lower limb contributes to the outflow of fluid from the damaged area of the knee. Thus, the swelling of the knee joint and pain syndrome is reduced. Keep the limb as high as possible for the first 48 hours after the injury.
A plaster bandage is applied only if a fracture or dislocation of the bones is diagnosed together with a meniscus injury. It is contraindicated to apply gypsum for small ruptures of the meniscus because it impairs circulation in the knee joint, and the process of restoring the fibers of the knee joint cartilage layer slows down. Gypsum provokes the development of pressure sores and contractures of the joint.
Conservative treatment of meniscus injuries consists in taking medications such as NSAIDs, chondroprotectors and vitamins. Regular medication for a long time helps to cure the meniscus gap without surgery.
NSAIDs used to achieve anti-inflammatory and analgesic effect. The mechanism of action is associated with the blockage of prostaglandins, which are involved in the formation of pain and the inflammatory process. NSAIDs block prostaglandins by suppressing two enzymes: cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2).
For the treatment of rupture of the meniscus of the knee joint without surgery, NSAIDs are used in two dosage forms:
- Pills. Preparations in tablet form (compared with local agents) have a pronounced analgesic and anti-inflammatory effect. When taking pills, the following side effects may occur: heartburn, stomach pain, exacerbation of peptic ulcer disease, vomiting, headache, allergic reactions, increased blood pressure, nasal bleeding, and others. Take the pills you need in 30 minutes after a meal. The most used drugs for the treatment of rupture of the meniscus without surgery - Diclofenac, Ketorol, Nimesulide, Nalgezin, Ibuprofen, Meloxicam, Naproxen.
NSAIDs in pill form
- Local remedies for external therapy (gel, ointment). NSAIDs of local use have fewer side effects, but they are inferior in strength to the analgesic effect of tablets. Apply gels and ointments to clean, dry skin. The most common ointments used in the treatment of meniscus injuries without surgery: Dolobene, Indovazin, Voltaren, Ketonal, Ketoprofen, Butadione, Fastum-Gel, Indomethacin, Finalgon. Read more about the treatment with ointments in the article "The best ointments for injury and knee injury - the choice and advice of doctors."
Chondroprotectors - A group of drugs that promotes the regeneration of cartilage surfaces and the synovial membrane, participating in the metabolic processes of articular cartilage. For the treatment of meniscus damage without surgery, chondroitin sulfate is used - Teraflex, Artra, Arthron, Honda, glucosamine in tablet form.
Vitamins in the treatment of rupture of the meniscus of the knee joint without surgery, it is necessary to strengthen the skeletal system, maintain acid-base balance in the cartilage tissue, stabilize mineral metabolism.
Necessary vitamins and trace elements for the treatment of the knee joint after meniscus tear:
- vitamin E - helps to prevent osteochondral damages, limits the formation of free radicals in the tissues of the body,
calcium - plays a key role in the metabolism of the meniscus - reduces inflammation and pain in the knee joint,
vitamin C (ascorbic acid) - protects cartilage tissue (preventing the formation of free radicals by cells), helps to form protein in tendons, ligaments and other tissues,
selenium - An antioxidant that counteracts the potentially dangerous effects of free radicals in the body (can cause the development of arthritis and maintain inflammation in the knee joint),
copper - A mineral that helps maintain the health and functioning of blood vessels, the immune system, bone tissue, joints.
To begin the procedure of warming the legs in the first days after the injury is strictly prohibited. Stimulation of blood circulation in the area of damage causes aggravation of edema and progression of hematoma.
Recipes of traditional medicine help to get rid of the rupture of the knee meniscus without surgery. It is recommended to use the methods of folk treatment. for 10-12 day after meniscus injury. Patients use warming compresses at home. Due to the effects of heat, they cause dilation of blood vessels and increase blood flow to the skin and tissues, thereby reducing pain and activating the regeneration of damaged meniscus fibers of the knee joint, as well as avoiding surgery.
Vodka compress with honey
Take 2 tablespoons of liquid honey (if honey is candied, then heat it in a water bath or in a microwave) and 50 g of vodka. Mix the ingredients and moisten in the formed mixture bandage, folded in 4 layers. Apply a bandage to the injured knee joint, wrap it in a plastic bag, wrap it with a clean towel. Leave a compress for 10-20 minutes. Repeat the procedure 2-3 times a day.
Compress with Dimeskid
Dimexide penetrates deep into tissues, where it activates the metabolism and helps to restore the structures of the meniscus. Dimexide can be diluted with ordinary water, and you can add Novocain or Diclofenac, in order to eliminate pain and inflammation. For the treatment of rupture of the meniscus of the knee joint, 40 ml of 30% Dimexide solution is used. Mix three parts of Dimexide with 7 parts of water. Moisten a bandage in the solution and attach it to the knee joint. Top knee need to wrap with cellophane and a scarf. Detailed instructions on how to prepare a compress from Dimexide solution are available here..
Take 1 tbsp. a spoon of mustard, 1 tbsp. a spoonful of flower honey and 1 teaspoon of vegetable oil. Mix all the ingredients and heat in a water bath until a thick homogeneous structure. Apply the mixture on the injured knee, put a bandage on top and wrap with a cloth or towel. Keep the compress for 20 minutes. Rinse the rest of the mixture with warm water. Do mustard compress 3-4 times a day.
Interesting recipes of compresses for the pathological stretching of ligament fibers, see the article "TOP-10 recipes of compresses - folk remedies for stretching ligaments."
What is a meniscus tear?
The meniscus is a cartilaginous lining in the shape of a moon sickle and is located inside the knee joint. It performs the work of a stabilizer and a shock absorber. There are internal and external menisci. Rupture of the meniscus is the most common injury to the knee. Often, a rupture occurs with the medial meniscus, since it is less mobile than the lateral one and at the same time reliably connects to the internal ligament of the joint.
The reason for the gap meniscus
To know how to protect yourself from injury, you need to remember about the causes that lead to serious consequences. There are many factors that cause the gap of the inner meniscus:
- excess weight,
- rheumatism disease
- gouty arthritis
- age changes
- arthritis of the knee
- excessive loads (gymnastics, weight lifting, professional running),
- weak joints from birth.
Meniscus tear - symptoms
In order to provide first aid to the victim in a timely manner, it is important to know what symptoms the meniscus tear of the knee joint has. Among the main features:
- acute pain
- temperature increase of the affected area,
- click while moving your knee
- pain in sports
- problems with getting on stairs
- pain in the inner part of the knee,
- inactivity or immobility of the affected area,
- inflammation in the synovial membrane of the injured joint,
- inability to bend and unbend the knee,
Can I walk with a gap meniscus?
Often, the victim is interested in whether it is possible to refuse treatment of a meniscus rupture or it will become a threat to health. Experts say that if a knee joint meniscus injury is ignored, there is a possibility of developing a chronic disease. In addition, the damaged area will regularly make itself felt after serious physical exertion, weight lifting and during active exercises. There are also periods of so-called lull, when the pain does not bother for months, but the process of destruction does not stop.
If you continue to ignore the gap of the meniscus, the person will collapse the cartilage tissue, which will lead to the degeneration of the neighboring cartilage, in the most difficult cases, even to the bone tissue. As a result, arthrosis can develop. The pain becomes regular and increases after different loads. Walking is getting harder and harder. In the worst case, a person may face disability.
Read more about recovery after rupture of the knee meniscus.
In severe injuries, especially those combined and complicated by, for example, arthritis, rehabilitation of damage to the meniscus of the knee is accompanied by long courses of recovery, which require an integrated approach.
Terms of rehabilitation (general)
- conservative treatment: 1 - 2 months
- after meniscus resection (surgery): 1.5-3 months.
When creating a program for a patient after injury to the meniscus, the patient's age, lifestyle, rehabilitation goal (return to a big sport, amateur sport, return to a lifestyle before injury) should be taken into account.
The body, whether it is an injury or surgery, reacts the same way - swelling, muscle spasm and pain. Due to the long immobilization, an atrophy of the thigh muscles occurs. In order to lose muscle volume, experience shows that one to two weeks of inactivity is enough.
The condition of our joint depends on the state of our muscles. Why? Because when walking, running, most of the load is assumed by the muscles, whereas in the absence of well-developed muscles, the entire load falls on the articular surfaces of the knee joint, which causes swelling, pain, stiffness, and so on. Based on the above, it is possible to designate the goals of the passive (and further active) rehabilitation phase after damage to different parts of the meniscus.
PASSIVE STAGE OF REHABILITATION
Since after the operation on the knee joint, after the resection of the meniscus, it is possible to step on the foot and give full support from the first day, the passive rehabilitation stage is a short one.
- Remove edema by physiotherapy, compresses, cold and kinesiotipirovaniya. Term - about 5-10 days.
- Relieve pain (reducing swelling and cramping leads to less pain).
- To regain control of the thigh muscles, to achieve a confident gait.
- Improve the passive range of motion in the joint.
- The overall goal of the passive stage can be called the preparation of the joint and muscles for further rehabilitation in the gymnastics room.
I STAGE OF ACTIVE REHABILITATION
Deadline: 2-4 weeks after surgery.
At this stage, all exercises are performed sparingly with a gradual increase in amplitude and load! Exercises are given in the prone position, sitting and standing.
Goals and objectives of the first stage:
- To regain control of the thigh muscles of the operated leg, through strength and coordination exercises (proprioception).
- Contribute to the development of strength and endurance of muscles to static loads, especially the inner head of the quadriceps femoris, as well as the posterior group of muscles of the thigh and lower leg, which ensure the restoration of leg support.
- To contribute to the achievement of complete extension of the knee joint, by performing exercises on flexibility.
- To reach the angle of flexion in the knee joint from 90? and less, by performing strength exercises and exercises for flexibility and stretching, as well as various massage techniques, which include the mobilization of soft tissues around the knee joint, the patella, etc.
- Formation of the correct gait, which is possible only after achieving the above goals.
An example of the exercises performed at this stage:
Lifting the legs with a weighting agent, lying on his back.
INITIAL POSITION (PI):
Lying on your back, arms at the seams, a healthy leg is bent at the knee joint, a foot on the floor, the second leg is straight 5 cm from the floor, the toe towards you. На больной ноге утяжелитель достоинством в 1 или 2 кг, в зависимости от состояния мышц пациента.
- Slowly lift your leg up to angle 45? (we reproduce the stress of the quadriceps muscle, which we learned even at the stage of passive rehabilitation - THIS IS IMPORTANT).
- Fix the position for 2-3 seconds.
- Take the PI.
- Perform the exercise 15 times 3 sets.
The main thing that should be remembered when performing this task is that the leg should be as straight as possible, we try to tighten the kneecap upward due to the tension of the quadriceps muscle of the thigh, the toe is always pulled over and the exercise should be done slowly without jerking. Observing all the principles of regenerative medicine, rehabilitation of damage to the ligaments of the knee joint will take place with maximum efficiency and without any problems.
Upon reaching the goals and objectives of STAGE I, we move on to STAGE II of the active phase of rehabilitation.
II STAGE ACTIVE REHABILITATION
Deadline: 4-8 weeks after surgery.
At this stage, we propose to perform more complex exercises that are performed mostly standing and are most close to such natural movement as walking, etc. We also include power trainers for straightening and bending legs in the stato - dynamic mode, inertial exercises on a trampoline or barefoot.
Goals and objectives of the second stage:
- Contribute to the further development of strength, power and endurance of the muscles of the thigh and lower leg without pain by performing more complex strength and coordination exercises.
- Reach the knee flexion angle less than 60 ?.
- Contribute to the improvement of the proprioceptive sensitivity of the knee joint by performing exercises on balance on a barefoot or trampoline.
- Prepare muscles for running exercises, by performing summing exercises (various attacks on barefoot, etc.).
- Promote a gradual return to the functional activities characteristic of a particular sport.
- Achieve the correct execution of running.
- Achieve the muscular volume of the operated leg equal to the healthy muscular volume. The difference in volume can be no more than 20%.
- To form the correct motor stereotype of landing after jumping, by performing plyometric exercises with or without interference.
An example of an exercise of stage II aimed at developing the quadriceps muscle of the thigh in the statist-dynamics mode “Leg extension sitting in the simulator”.
INITIAL POSITION: sitting, back straight, waist pressed to the back of the simulator, the legs rest tightly against the rollers, the knee joint has an angle of more than 90 degrees, the hips do not extend beyond the seat.
- Bend - bend the legs at the knee for 30 seconds. During this time, you need to have time to do 20-24 repetitions. There should be 3 such approaches. Rest between sets is 30 seconds.
- Movement should be uniform (without jerks).
- The feeling of burning in the muscle is an indicator of the correctness of the exercise.
Stato-dynamic training is carried out twice a week, one training is tonic, the second - developing. after several weeks, with a positive result of testing the legs, we start running and jumping exercises. The purpose of the running and jumping program is to prevent the injury from recurring. Quite often, re-injury occurs due to the inability to land properly after a jump, the wrong motor stereotype in running can also lead to puffiness and pain in the knee joint. Your rehabilitologist will tell you how to alternate power and cross-country workouts.
Knee meniscus tear - treatment without surgery
Those people who have living conditions associated with constant physical exertion, suffering from excessive weight, as well as older people are at risk, in which the gap meniscus - a fairly frequent phenomenon. In young people, more often, the gap is associated with injury during sports, the elderly develop a degenerative meniscus gap, although they may also suffer from injuries, for example, when falling into ice.
Treatment of rupture of the meniscus without surgery
Meniscus is an important component of the knee joint. It is located at the junction of the bones between them as a layer. Its cartilage structure ensures normal smooth mobility of the joint. Rupture of the meniscus entails a feeling of pain, swelling, partial or complete immobility of the lower limb, so it is important to start treatment immediately after the onset of the problem. With severe damage, it is necessary to resort to surgery, and this gives a good result in a short time. It is possible to cure whether a ruptured meniscus of the knee joint can be cured, and how to do it without surgery.
How to cure a meniscus gap without surgery?
Many people ask whether it is possible to do without an operation if the meniscus is torn. It all depends on the severity of the damage and the significance of the breakdown of cartilage tissue. The methods of non-surgical treatment include the following:
- First of all, it is necessary to provide peace to the patient.
- It is necessary to lift and fix the injured limb in such a position so as not to force the puffiness.
- Apply ice or make a cooling dressing to reduce the swelling and relieve the sensation of pain. Do it during the day for about twenty minutes.
- After a thorough examination and determination of the extent of damage, as well as possible necessary manipulations performed by a specialist, a rigid fixation in the form of a knee band or plaster cast is necessary. This will prevent further damage to the meniscus.
- When moving in order not to strain the sore knee, you can use a cane or crutches.
- As prescribed by the physician, take anesthetics, anti-inflammatory drugs, chondroprotectors.
Subsequently, you need to undergo a rehabilitation course, including:
- physical therapy,
- manual turping
- sometimes acupuncture, acupressure.
Methods for the treatment of rupture of the meniscus of the knee joint without surgery
It should be mentioned that of the two menisci of the knee joint, external and internal, the inner is more susceptible to injury and tearing, since it is more mobile.
The causes of the degenerative rupture may be several, for example, the simultaneous rotation of the joint.
With minor gaps meniscus effective ways can be the following:
- traction, that is, the extension of the joint,
- cold laser application
- use of laser massagers,
- folk remedies.
With any injury to the knee, you need to be patient and do not hesitate with treatment.
Knee meniscus damage, rupture and meniscitis: effective step-by-step instructions
Knee injury: first aid
Any injury, a fall or an awkward movement causes damage to the knee, and the meniscus may rupture or even tear completely. Ignoring such problems and undergoing pain in no case can be, for example, if a patient has late meniscitis revealed - this is almost always a prerequisite for the occurrence of future osteoarthritis of the knee joints. What should be done in the first minutes after damage to the meniscus, before undergoing conservative or surgical treatment?
First, provide the victim with complete rest and eliminate all potential loads on the knee joint. Sick leg is best put higher - on pillows or rollers of clothing. An icy compress should be applied to the bruised and sore spot, then wrap the damaged joint with an elastic bandage and then immediately seek the help of a specialist (orthopedist or traumatologist).
The choice of treatment method on the type of damage
There are 3 main types of meniscus injury:
1. Tearing meniscus. This is a very common injury that occurs in 50% of cases. With this kind of damage, the meniscus between the stuck cartilage is tearing. After the treatment is completed, the meniscus is usually restored and does not lose its functionality, so this type of injury is treated without surgery. For example, such as meniscitis, that is, damage to the semilunar cartilage of the joint.
2. Pinching meniscus. This damage occurs in approximately 40% of cases. The meniscus is wedged between cartilages inside the knee joint. With such damage recommended conservative treatment.
3. The most severe damage that requires long-term treatment and surgery - tearing or rupture of the meniscus. In this case, the meniscus or completely detaches from the place to which it is attached and freely "hangs" inside the cavity of the knee joint, or partially. Separation of the meniscus is in 10-15% of all cases of injury.
Existing treatment methods
When the meniscus is torn or pinched, the first task is to release the pinched meniscus clamped by the cartilage of the knee joint. This should be done even if there is a gap in the meniscus, for example, if the patient is diagnosed with meniscitis. Naturally, such a procedure should be performed only by an experienced traumatologist, manual therapist or orthopedist, who will be able to “wedge out” damage to the knee joint in several sessions and eliminate the trauma of the meniscus, that is, conduct a conservative treatment.
If, due to some circumstances, the specialist doctor is not able to set the meniscus right, then the patient is recommended to have a special conservative treatment - stretching the joint in a special apparatus (hardware traction). This is a long procedure that requires a large number of sessions.
But you should always remember that before prescribing a treatment that relieves pain and swelling, it is necessary to establish the true cause of the disease. This is due to the fact that when the meniscus is pinched, torn, or if its rupture occurs, for example, the edema is of a peculiar character. Only after the doctor confirms the exact cause of the pain can a physiotherapeutic treatment and manual therapy sessions be carried out.
After complete restoration of the joint, the patient is prescribed ultrasound or laser treatment using Hydrocortisone ointment, and also recommends very effective magnetic therapy.
Conservative treatment of meniscus
For minor injuries and good condition of the damaged meniscus to relieve the condition, the patient may well be recommended conservative treatment. If the patient is diagnosed with meniscitis, then it is recommended to walk with a tight elastic bandage or bandage.
Sometimes intra-articular injections of anti-inflammatory drugs and corticosteroids (non-steroidal) are prescribed.
For the full effect of the application of all procedures, visits to the gymnastics rooms, taking chondroprotectors and hyaluronic acid injection into the joint are prescribed.
It is worth answering that chondroprotectors in arthrosis of the knee joint showed themselves particularly well. With regular intake of chondroprotectors, the cartilaginous tissues are restored, the lubricating properties of the intra-articular fluid are improved, and its quantity increases. It is worth remembering that in order to achieve the maximum effect from taking chondroprotectors, they should be taken in sufficient doses and over a long period of time, then the meniscus damage will be imperceptible.
Surgical treatment of damaged meniscus
Surgery to remove the meniscus or to perform splicing using a surgical suture is recommended only after the patient has been diagnosed with a meniscus rupture, or if his condition has not improved, after conservative treatment. And the main task of the surgeon in this case will be the preservation of the meniscus at the maximum opportunity.
Before the operation, the patient is examined, the amount of time elapsed since the day of injury, the stability of the knee joint, the age of the patient, the location and orientation of the gap are taken into account. When ruptures are recommended to do arthroscopic surgery.
Due to the fact that the blood supply to the outer third of the meniscus nourishes it well, all breaks and even severe internal damage heal very quickly. There is a great chance for a speedy recovery in those patients who have been diagnosed with a longitudinal gap in the peripheral third of the meniscus.
But regressive processes in the knee, for example, arthrosis of 2 degrees, which develop against the background of horizontal damage and displacement, as well as very complex injuries, heal very poorly. Therefore, the consequences after the procedure of meniscus removal can be very different and highly unpredictable.
Usually, when the meniscus is torn, a meniscectomy is recommended, that is, the removal of the severed part of the meniscus of the knee joint. This operation is performed by the arthroscopic method with the help of tiny holes through which surgical instruments and a video camera are inserted into the joint cavity of the knee, allowing you to see everything that happens inside the joint.
Rehabilitation after surgery
The timing of recovery of the knee after surgery is very different, sometimes it is several days, sometimes several weeks. And the degree of vital activity of the patient during the rehabilitation period strongly depends on what type of operation was performed.
If a meniscectomy was performed, already on the second day after the operation the patient is allowed to walk with a light load, preferably with crutches or a cane.
If, however, an operation was performed on the fusion of the meniscus using a surgical suture, then the patient will have to walk with the help of crutches, and, of course, without a support on the leg, for about a month.
It is also recommended for all patients to additionally fix the knee joint with an elastic bandage or a semi-rigid (soft) kneecap and undergo a course of electrical stimulation of the thigh muscles, a course of massage, physiotherapy procedures and special exercises aimed at restoring the joint after the meniscus is removed or ruptured.
Folk recipes for the treatment of damaged meniscus
Patients often ask different questions about joint diseases: how to cure arthritis or bursitis, how to cure osteochondrosis, how to treat arthrosis of the foot? And the recipes of traditional medicine have shown themselves in these cases from the best side. There are special recipes for meniscus injuries.
Traditional methods of treatment are recommended only if the meniscus has not shifted from its place. But if the displacement or rupture did occur and part of the meniscus does not allow the joint to move, it is impossible to do without surgery and surgery.
Almost all methods of treatment of folk remedies involve compresses on the knee joint, for example, from medical bile. It should be melted, put on the area of the knee joint, it is good to warm and leave it for two hours. The course is 10 days, after which you need to take a 5-day break, and then, repeat the procedure, if necessary.
Another compress - honey and alcohol. It is also applied for two hours, but already within two months.
Very effective for the knee joint compress from the leaves of burdock. They wrap the aching knee, then fasten and warm with a woolen cloth or knee pad. Such a compress should be kept for about eight hours, and the treatment is recommended to continue until all complaints have disappeared.
However, it is not always advisable to start with a conservative treatment, and then turn to surgery as an exceptional measure. Very often, the nature of meniscus tears makes surgical treatment more reliable and effective. And the sequence, first conservative treatment, and then surgery - can significantly complicate the recovery process and worsen the results. All this suggests that any injury to the knee requires an appeal to a professional.
Meniscus recovery methods
In addition to the removal of the meniscus, there are such methods of its restoration as suture and transplantation. The choice of option needs to take into account a variety of factors. In general, it is believed that if the damage to the meniscus is so extensive that the operation would require its complete removal, then the question of its possible restoration should be addressed.
This restoration technique is used if the gap has recently occurred. In order for the meniscus to successfully grow together after stitching, its adequate blood supply is necessary. In other words, the gap should be in the red zone or at least between the white and red zones. If the meniscus is torn in the white zone, then stitching it is meaningless, because of its insolvency, a new gap will occur.
In our time, transplantation of the meniscus is possible. This method of recovery is advisable in case of significant damage to the meniscus, when it no longer performs its functions. Contraindications transplantation:
- obvious degenerative changes in articular cartilage,
- knee joint instability,
- curvature of the leg.
For transplantation, irradiated and frozen menisci are used. Best results are obtained from fresh frozen (donor) menisci. Artificial meniscus endoprostheses are also used.
In general, endoprosthetics and meniscus transplantation are performed very rarely.
After surgery on the joint impose a latch. In the early postoperative period, the doctor prescribes rehabilitation measures:
- thermal procedures,
- therapeutic exercises.
Очень важно выполнение упражнений, восстанавливающих силу и подвижность в коленном суставе. Вначале делаются упражнения с постепенным увеличением объема движений. В дальнейшем эта гимнастика постепенно дополняется укрепляющими занятиями.
During the postoperative rehabilitation period, physical exercises take place in the following sequence:
- Lifting weights, including the load on the knee while walking or standing.
- Moving without crutches.
- Reception driving. A damaged foot should press on the brakes, pedals, or clutch.
- The resumption of the entire range of motion.
- Return to sports or hard physical work.
Treatment of rupture of the meniscus of the knee should be approached very seriously. Often, a short or interrupted treatment first creates a feeling of recovery: the pain goes away, the inflammation and swelling disappear. But if to make the movements repeating the injury mechanism, repeated blockade is possible. Its danger lies in the development of meniscus - changes in the properties and structure of the meniscus. As a result, a dangerous joint disease can develop - a deforming arthrosis. That is why the treatment should be trusted to good specialists and bring to the end.
Knee meniscus tear: symptoms and treatment
Among all the joints of the human body, a particular location has a knee: constant loads during movement and a high risk of injury are combined with an unusually complex structure. Firstly, the joint is formed on the surface of the four bones and has numerous ligaments, and secondly, it has special structures necessary for cushioning movement — the medial and lateral meniscus.
In most cases, pain in the knee is caused precisely by the pathologies of the meniscus, among which injuries take the leading place in people from 15 to 40 years old, and after 50 years - degenerative changes. Extreme damage is rupture.
What is a meniscus and why is it subject to rupture?
The meniscus is a cartilaginous layer between the femoral and tibial condyles, which is necessary for cushioning the joint during movement. The shape of the cartilage resemble the letter "C". The lateral meniscus is firmly attached to the articular surface, while the medial meniscus possesses significant mobility, which causes the frequency of its damage. Active games and sports that require quick reaction and sharp movements are one of the most common causes of meniscus damage in young people. Unsuccessful sharp turn of the leg - and the medial meniscus does not have time to "escape" from the traumatic compression of the condyles. Causes of meniscus rupture in people of mature age are practically not associated with injuries. The soil for them are degenerative changes that occur with age in cartilage tissue. Impaired blood circulation leads to dystrophy and exhaustion, fragility of the meniscus, the formation of cysts.
Symptoms of rupture
By the nature of the causes and predisposing factors, meniscus tears are divided into two types:
- traumatic - it is acute and has very characteristic symptoms,
- degenerative - arising in connection with the destruction of cartilage without characteristic cases in history, occurs mainly in chronic and erased forms, without pronounced clinical manifestations.
Acute damage to the meniscus is characterized by unbearable pain, swelling and impaired mobility of the joint. But such symptoms may indicate a number of injuries - from dislocation to ligament rupture, more characteristic symptoms appear later - after 2-3 weeks. During this time, inflammatory fluid accumulates in the joint cavity, the knee is completely blocked in a half-bent position, the muscles of the front surface of the thigh lose their tone. Often, the meniscus itself can be felt in the joint space: when the exudate accumulates, it displaces and pinches between the condyles.
More reliable data on the nature of the injury of the knee joint meniscus are obtained by the method of pain tests - the attempt of rotation causes intolerable, cutting sensations in the patient. However, accurate data on the type of break and its location can be obtained using special methods, the most informative of which is MRI. With degenerative damage, the symptoms are erased: clicks and prokaty of the joint are felt, soreness is sometimes manifested, and in periods of exacerbations swelling appears and mobility is disturbed, but complete blockade does not occur.
The rupture of the medial meniscus is more often traumatic in nature, due to its anatomical features - high mobility inside the joint, which is why a sharp rotational movement causes the cartilage to become trapped between the condyles.
The most rare form of damage is considered to be the breaking of the posterior horn of the lateral meniscus. The cartilage rigidly fixed by ligaments can only be seriously injured in cases where meniscopathy and degeneration take place, the structure and properties of the “depreciation pad” of the knee are lost.
Meniscus tear is a frequent occurrence for athletes and dancers, associated with the speed of movements and a sharp extension of the knee. At the same time, the cartilaginous disc leaves the articular surface, causing pain and partial blockade of the knee. The consequences of an impairment can affect through the years - a paramenical cyst becomes the cause of thinning and degeneration of the meniscus.
How to treat meniscus tear?
Mobility impairment and swelling of the knee are symptoms that are hardly worth fighting with home remedies, and the consequences in the form of destruction of the meniscus and arthrosis can lead to complete ankylosis - immobility of the joint. In modern medical practice, the most commonly used are conservative methods for treating fractures, only torn and combined forms require immediate surgical intervention.
Treatment of the meniscus of the knee joint begins with the elimination of the patient’s most disturbing symptoms — pain, swelling, and cartilage pinching. A puncture is performed, in which inflammatory fluid is removed through a needle with a trocar, after which the disc is easily repositionable. The intervention is performed under local anesthesia. In some cases, the attending physician makes a decision about the need to immobilize the knee - a plaster bandage is applied for up to three weeks.
The second important step is the elimination of inflammatory processes. The most suitable for the treatment of meniscus injuries are drugs that combine anti-inflammatory effect with analgesic effect (diclofenac, nimesulide, ibuprofen and others). Along with them, steroid drugs (hydrocortisone, prednisone) are also used. The third stage is rehabilitation. For several months, the complexes of physiotherapeutic procedures are used - electrophoresis, massage, heating. Special importance is attached to physical therapy, developed with different loads for the right and left knee, depending on the nature of the injury.
Conservative therapy does not guarantee a full recovery of the meniscus, therefore, patients are also prescribed several courses of treatment with chondroprotectors at half-year intervals. Quite good results are obtained by the use in the conservative treatment of innovative physiotherapeutic methods - shock wave therapy, which accelerates the movement of blood in the capillaries, the supply of nutrients to the rupture zone and the fastest healing process.
Forecast and consequences
Cartilage tissue has a fibrous structure and the lack of its own blood supply system - it receives nourishment and oxygen through nearby tissues. Accordingly, the processes of healing and recovery go slowly in it - it may take years to fully rehabilitate after a meniscus rupture.
Experts state the outcome of the disease based on a number of factors:
- The age of the patient. In a young body, the processes of cell regeneration and reproduction go much faster, therefore in twenty years there are much more chances of a full recovery than in forty
- The condition of the ligaments. With weak ligaments, the meniscus can be displaced many times and occur between the condyles of the bones, which will cause re-injury.
- Localization of the gap. Damages located in the same plane can be stitched and grow together much faster than ripped ones.
- Prescription damage. The earlier you go to a specialist, the more likely it is to be cured by conservative methods.
The lack of adequate treatment and even just total removal of the meniscus have very unpleasant consequences - because the depreciation of the movement is broken, the cartilage tissues of the joint undergo destructive changes, gradually thinning. Arthrosis gradually progresses and after years the cartilage completely disappears from the articular surfaces of the bones. In order to avoid this phenomenon, patients after knee injuries are advised to take chondroprotectors.
The most severe consequences of meniscus rupture are contracture and ankylosis, in which the limb loses mobility. Therefore, treatment of the meniscus gap should be started as early as possible, strictly following all the recommendations of the doctor.
Treatment of the meniscus without surgery is possible, but it will take a long period of time. In addition, rehabilitation after such an injury is necessarily necessary for the patient.
Emergency care when meniscus
Before treating meniscus injuries, it is necessary to diagnose. In addition, the injury can be received in different situations, so it is necessary to carry out emergency care due to rupture or other types of meniscus injuries.
First you need to completely immobilize the knee. Immobilization of this part of the body helps to give peace to the knee, which will cause less pain, and also allow tissues and cells to recover in a normal environment. In addition, it is an additional stress for the patient. Most often, immobilization should be performed exactly in the position of the knee joint when it was blocked. For such a procedure, a bandage is required. You can use a special type of lock - removable splint. Prohibited attempts to eliminate blocking of the joint. These actions can be performed only by a doctor with extensive experience and the required qualifications. With knee injuries, swelling appears. To reduce it, you can apply ice or a wet cold towel. Compress should be applied in the most painful place.
This will help reduce effusion, i.e. such actions help to narrow all the vessels that are located closer to the surface, which prevents fluid from accumulating around the joint. In addition, a cold compress helps reduce the sensitivity of the receptors to pain, so the pain is reduced. Impose a cold can only be 15 minutes. The maximum time to use the ice is half an hour.
Due to severe pain and swelling, it is almost impossible to evaluate all the consequences of the injury, so the victim should not strain his leg. It is better to eliminate all possible loads and comply with bed rest. Only a doctor using special techniques and research will be able to determine the extent of the disease and cure it.
If the patient received a combined injury, you can use painkillers. They are necessary in the case when a person with injury can no longer tolerate pain. Among these drugs, Ketoprofen, Indomethacin, Naproxen, Diclofenac, Promedol are well established.
Self-treatment is strictly prohibited, if you suspect any injury of the meniscus, you should consult a doctor for diagnosis and treatment. The doctor can use traditional conservative treatment with the use of medicines and procedures, as well as surgery, if the patient has a severe case. But in any case, it is impossible to postpone the visit to the doctor. Quite often, patients come with complaints of pain in the knee and restrictions in movement. This may occur after a single injury, or meniscopathy develops due to several lesions of the joint at different times, but without the necessary treatment. In this case, the patient will undergo rehabilitation, developed by an orthopedic traumatologist, much longer.
Diagnosis of the disease
First, you need to conduct a physical examination. To do this, the doctor produces palpation. In addition, the McMurray test is conducted.
With this procedure, the patient should lie on his back. The doctor holds the heel and begins to straighten the limb or bend the leg at the knee. Then the patient should stand in a standing position to squat.
Such actions help identify the location of the spread of the lesion. If swelling can be seen in the injury zone, the doctor should take a liquid for analysis. The rest of the tests that help determine the diagnosis are invasive, x-rays and MRI.
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How does treatment depend on the type of meniscus injury?
Traumatologists distinguish three types of meniscus lesions. The first type is detachment. In this case, the meniscus is partially or completely separated from the place where it joins. In some cases, a piece of tissue is peeled from the meniscus, and then “dangles” in the joint itself. This is the most severe defeat of the meniscus. With such an injury, urgent surgical intervention is necessary. But such damage is extremely rare. According to statistics, they are given only 15 percent of all knee injuries.
In 40 percent of all injuries of the knee joint, a pinch is diagnosed in patients. In this case, the meniscus sticks in the area between the cartilages of the knee joint.
Most often in patients with injuries of the knee find strain. This happens in half of all cases. Tear is a partial form of meniscus tear.
The mechanism for obtaining it is as follows: first, the meniscus is clamped between the cartilages, then from sudden movements, it is slightly torn in some places.
Such a lesion can be cured, because at the same time, the meniscus tissues do not lose their ability to recover, therefore the patient is recommended procedures and special preparations.
Treatment of meniscus of the knee without surgery
Damage to the meniscus is a very common injury resulting from excessive physical exertion and hereditary predisposition. As a rule, a rupture, pinch or tear is diagnosed, the meniscus is less likely to undergo degenerative changes and the formation of cysts.
Treatment when the meniscus of the knee joint is ruptured is conservative and surgical. The method of treatment depends on the diagnosis and the severity of the injury. In certain cases, it is possible to do with traditional methods of treatment - pills, ointments and medical gymnastics, but in case of severe injuries, surgical intervention is inevitable.
Meniscus structure and types of injury
The meniscus is a small cartilage resembling a crescent. It is located between the surfaces of the joints of the tibia and the femur.
The main functions of the meniscus:
- depreciation at movements,
- reduction of joint friction,
- ensuring the necessary contact of the articular surfaces.
The knee joint has two menisci - lateral (external) and medial (internal). The outer, lateral meniscus is more mobile and has a dense structure. He is injured much less frequently than the internal, medial. The medial meniscus is attached to the bone by means of the ligament and is damaged first.
Damage to the meniscus can be different, and depend on the force of the blow, the height of the fall, and also on the exact place where the blow fell:
- rupture of the posterior horn of the medial meniscus of the knee joint - longitudinal, transverse, oblique, degenerative, as well as complete or partial. The front horn suffers less frequently
- tear rear horn, horizontal, and the gap in the attachment to the joint. This meniscus injury is the most dangerous, and requires mandatory surgical intervention. Otherwise, pinching, blockade of the joint and further destruction of nearby cartilage,
- pinching The meniscus is stuck between the cartilages of the patella and interferes with the movement of the joint. Jamming occurs quite often, in almost half the cases,
- a combination of several injuries when there is a gap with pinching, etc.,
- degenerative processes in cartilage, contributing to permanent trauma, the formation of cysts.
Rupture of the meniscus of the knee most often occurs in acute injury, the risk group includes athletes and people engaged in active activities. The provoking factors are:
- age from 18 to 40 years
- genetic features or acquired anomalies due to weakness of the musculoskeletal system,
- degenerative processes in cartilage, when even a minor injury leads to rupture of the meniscus,
- long squatting or energetic walking in small steps,
- excessive exercise in people with a high body weight,
- rotation on one foot, not looking up from the surface,
- fast cross-country running, jumping on a hard and uneven surface.
If the meniscus is torn, two characteristic phases are distinguished - acute and chronic. In the acute phase, the painful symptoms last for about a month. At the time of injury there is a sharp pain, and a crash is heard, then the leg swells. When ascending and descending the stairs, the pain increases, and the knee “squeaks”. Often, when a meniscus ruptures, hemorrhage occurs in the joint.
In the acute phase, the knee joint is almost not bent or completely immobilized. Ввиду накопления жидкости в районе колена может возникнуть явление «плавающего надколенника».
Менискэктомия проводится в случае частичного или полного отрыва мениска, а также раздробления хряща, поскольку консервативное лечение эффекта не даст. Боль при таких повреждениях очень сильная, передвигаться практически невозможно.
The decision to perform the operation is taken by the attending physician, the damaged disc is either completely removed or it is “sutured”.
Stitching is performed only in young patients and strictly according to indications:
- if a meniscus injury occurred recently,
- a rupture occurred in an area that has a good blood supply.
To avoid problems with the knee joint, it is necessary to train the thigh muscle, because it is the main knee extensor. The weaker this muscle, the higher the risk of injury to the knee and meniscus under load. An elementary exercise - raising and lowering a straight leg - perfectly strengthens the thigh muscle. Good nutrition, rich in protein and trace elements, is also a good prevention of diseases of cartilage and joints. But if the injury still occurred, do not self-medicate and consult a doctor as soon as possible.
Meniscus crack: symptoms of tearing and pinching of the knee joint
Knee meniscus rupture is a trauma popular among dancers, tennis players, football players and other athletes involved in team sports. However, such a problem can also be earned by people who are completely far from sports, whose professional activities are in no way connected with physical exertion.
Even elderly patients who have prerequisites for arthrosis, at the very minimum load, are not insured against rupture of the meniscus of the knee joint in the manner of a watering can handle. To understand how the meniscus rupture occurs, you need to understand the structure of this element of the articulation.
The meniscus is a fibrous cartilage plate that performs an important cushioning function in the joint. In addition to the knee joint, which is considered the most difficult in the human body, menisci are present in the temporomandibular and clavicular diarthrosis.
However, rupture or pinching in the area of the meniscus in the knee is the most common and dangerous from the point of view of possible complications.
Structure and function of the meniscus
A healthy knee joint has two cartilage plates:
- Internal - medial.
- External - lateral.
Both mena ska in shape resemble a crescent. The external meniscus is much denser and more mobile than the medial, so it is less susceptible to trauma.
The medial meniscus is adherent with the tibia and the capsule, which makes it more vulnerable. It follows that the rupture of the inner meniscus is the most frequent damage to the cartilage of the knee joint.
Each meniscus consists of three elements: the front and rear horns, the body. Part of the cartilage is penetrated by the capillary network, it forms the red zone of the meniscus. This area is on the edge and is the densest.
The white zone is located closer to the center and is the thinnest, it is completely devoid of blood vessels.
If the trauma occurred in the living part of the cartilage, there is a high probability that the meniscus will recover completely, so the localization of the gap is of great importance for the doctor.
Types of meniscus damage
The area, strength and type of damage to the plate also determines which treatment will be optimal in this case. In terms of the forecast, the one-sided full separation of the meniscus is considered the most unfavorable, the safest - oblique tearing of the white zone.
Types of cartilage damage:
- In 40% of cases of rupture or tearing of the cartilage, the meniscus is pinched. In this case, the damaged part is wrapped and blocks the articulation. If the closed reposition of the joint does not produce results, immediate surgical intervention is required.
- In approximately 50% of cartilage injuries, a partial meniscus rupture occurs. Most often, tears are observed in the rear horn, but they are often in the middle. The front horn is damaged less often. Incomplete damage, in turn, can be longitudinal, oblique, transverse, horizontal and internal - a vertical longitudinal gap in the type of a watering can.
- Complete detachment of the meniscus plate from the place of its attachment is the most severe injury and occurs in 10-15% of injuries of the knee joint.
Causes of rupture of the medial meniscus
In medical practice, there is only one most common cause of this pathology, which includes the gap of the posterior horn of the medial meniscus, and this cause is an acute injury.
In fairness, it should be added that not any aggressive effect on the articulation is accompanied by damage to the depreciation cartilage of the type of a watering can.
The rupture of the posterior horn of the meniscus can be triggered by the following factors:
- Jumping and energetic running on uneven surfaces or with joint instability.
- Torsion on one limb without detaching it from the surface.
- Heavy load with overweight.
- Active walking "in single file" or long squatting.
- Congenital weakness of ligaments and joints.
- Minor injury in degenerative articular pathologies.
Signs of Meniscus Damage
Most often, a sharp rupture of the medial meniscus of the knee occurs when the elements of the knee joint are in an unnatural position.
This can often occur due to injury or pinching of the plate between the femur and tibial bone.
Often, separation of the meniscus is accompanied by other injuries in the knee joint, so the diagnosis of pathology is always difficult.
However, there are characteristic symptoms in which suspicion falls precisely on the rupture of an internal meniscus:
- At the time of injury the pain is very sharp. Before the appearance of pain, the victim may hear a strong crunch or a click in the knee. After some time, intense pain may subside, the patient may even move independently, although with great effort. The day after the injury, there is a “nail” sensation in the knee joint. The pain intensifies when trying to sharply bend or straighten the affected limb. At rest, the pain subsides.
- Jamming or “blocking” of the joint - this symptom when the medial meniscus is ruptured is very frequent. When a part of the meniscus that is torn or completely detached enters the gap between the bones, a blockage occurs, which completely violates the motor functionality of the joint.
- Blood in the joint (hemarthrosis of the knee joint) occurs when the red meniscus area, penetrated by a network of capillaries, is damaged.
- As a rule, 2-3 days after the rupture of the knee occurs.
Treatment of damaged meniscus
If the acute injury of the meniscus plate is not cured immediately, over time it will become chronic.
Meniscopathy will develop - a pathology characterized by degradation of the cartilage surface of the bone, leading to arthrosis of the knee joint - gonarthrosis.
The main purpose of surgical intervention in case of rupture of the meniscus is its maximum safety and restoration of motor function. If conservative measures do not bring positive results, an operation is scheduled.
First of all, the meniscus is tested for the possibility of its stitching. If the capillary zone is damaged, this is quite realistic.
Types of operations for meniscus tear:
- Arthrotomy - this operation should be avoided whenever possible. Such a procedure is carried out today in those medical institutions where modern equipment is not available. The only justification for arthrotomy is an extensive lesion of the articulation, when other surgical procedures are ineffective. Arthrotomy or meniscectomy - the complete removal of the meniscus throughout the world since the late 80s has been recognized as ineffective and harmful.
- Partial (incomplete) meniscectomy - not only the dangling portion of cartilage is removed, but also the procedure of its restoration is performed - the edge is trimmed to an even state.
- Endoprosthetics and transplantation - transplantation of a donor or artificial meniscus. Due to the poor survival rate of implants, this operation is performed very rarely.
- Arthroscopy is the most modern type of surgical treatment for articulations. Differs minimal trauma. The principle of operation is as follows: in certain places of the knee, the doctor performs two small punctures. An arthroscope (video camera) and a saline solution are inserted into one hole, the other is necessary for the entry of various tools and joint manipulations.
Meniscus stitching is an arthroscopic procedure to restore the cartilage plate. The operation is effective only in the lively, thickest area of cartilage, equipped with a network of blood capillaries.
If the damage is fresh, the probability of a meniscus accretion is very high.
Recovery after surgery
Rehabilitation of the damaged meniscus is a very important factor in the struggle for full recovery. During this period, the patient must be under the supervision of medical personnel.
The doctor will prescribe the most optimal set of recovery measures. The patient may spend the recovery period and at home, but his stay in the hospital is best. The most basic method of postoperative rehabilitation is massage and a course of physiotherapy exercises. Applied and modern hardware techniques with a metered load, which provide the development of joints and stimulation of muscle tissue.
The complete recovery of the knee after arthroscopy takes on average about two to three months. Within a month after surgery, the patient can return to the usual rhythm of life. When the posterior horn of the inner meniscus ruptures, the treatment prognosis is favorable when timely and correct therapeutic measures have been taken.
In modern orthopedics for this there is a huge amount of effective tools. For severe concomitant knee injuries, the outcome may be less favorable. If the cartilage plate is not removed for a long time, a serious complication can develop in the knee - arthrosis.
Human joints are a very complex structure that allows you to perform almost any movement with our body. It is thanks to them that we can move, bend and unbend our limbs. On the one hand, the joint is a very mobile and complex anatomical object, but on the other - it allows you to withstand very large physical loads before being damaged. In this topic, we will pay special attention to the meniscus of the knee joints, what it is, and how to treat them in the event of their injury.
Meniscus of the knee
To ensure the mobility of the knee joint in its cavity are cartilage structures that serve as stabilizers and shock absorbers, this is the meniscus. Thanks to such an arrangement, the knee perfectly endures heavy physical exertion and is not limited in movement.
Normally, the knee joint has 2 similar structures, internal and external (medial and lateral), they are interconnected by a transverse ligament in the anterior section.
The outer one is more susceptible to trauma as it has greater mobility and it is located at the edge of the joint. If suddenly there is a rupture of the meniscus of the knee joint, the operation must be performed as soon as possible.
Types of knee joint damage
What kind of injury can impair the integrity of the articulation? There is a lot of such damage, pathology occurs:
- If at the moment of injury the shin bones move to different directions (for example, the foot to the left and the knee to the right).
- Against the background of strong knee over-bending.
- With a strong physical impact on the knee area (the collision of a man and a car).
- With a simple fall on the bent leg.
- With a previously injured knee, an abnormal or incomplete recovery of the meniscus occurs and another awkward movement of the leg can damage it again.
- Against the background of the course of certain diseases (gout, rheumatism), the cartilage plate is destroyed.
High risk of cartilage injury in people who spend a lot of time standing on their feet, in athletes and weightlifters (frequent microtrauma).
All of the above situations can most likely lead to a violation of the integrity of the knee joint. How to recognize that a person has damaged such a cartilage?
Any excessive physical impact on our body is accompanied by the appearance of severe pain, damage to the knee is no exception. The peculiarity of the joint injury is that if the integrity of any of its structures is violated, there is a sharp limitation of the mobility of the limb. Additionally, there is a pronounced swelling of the articulation, a local increase in temperature and stiffness (especially in the morning or evening).
Joint treatment can be conservative (drugs), operative and popular. Most people prefer to be treated with pills and ointments, but this is not always the best solution. Depending on the injury and the extent of damage, surgical treatment is sometimes more preferable and effective.
Surgery is the ultimate way to cure a patient. The operation is performed if the following criteria are available:
- Large gap.
- Crush cartilage tissue.
- The gap into several large and small parts.
- Conservative treatments are not effective.
Only after a thorough examination of the patient is sent for surgery.
The meniscus surgery can be performed with open access (dissection of the skin, ligaments and other structures to get to the required area) or endoscopic (meniscus arthroscopy is performed). Method 2 is much safer and today is the "gold standard". Its main advantages are:
- Lack of trauma. Instead of large incisions, small punctures are made and, thus, get to the desired zone.
- Good review and diagnosis. Modern devices allow to evaluate the joint cavity with the help of a small, mobile camera.
- Excised dissection of the articular bag. It is here that articular fluid accumulates and is stored, which lubricates the joint.
- Damage to adjacent tissues and structures is excluded.
- At the time of the operation there is no need to fix the leg in one position. The more mobility is preserved, the easier it is at the rehabilitation stage.
- Removing the meniscus of the knee joint in this way reduces the time spent in a hospital bed and in the hospital as a whole.
In progressive countries, this method of treatment of patients with damaged joints is chosen.
How is arthroscopy performed?
The patient is prepared for the operation (anesthesia is done), the required leg area is sterilely isolated from the body and the surgical field is formed. Then, 2 punctures are made into the joint cavity. The arthroscope itself (a small metal tube) is inserted into the first one, it transfers the image to the monitor to the surgeon, thanks to it a physiological solution is injected into the joint (this is necessary to increase the joint cavity, which will allow more mobile manipulators). The second hole serves as a guide for other tools (for scissors, scalpel, clamping, etc.). After arthroscopy of the meniscus, the surgeon assesses how much work needs to be performed and what operating tactics to follow:
- Restoration of damaged cartilage plate. Perform if the injury was received not long ago (no more than 48 hours ago). If there is a small meniscus gap, the operation is performed as follows: the edges of the meniscus are brought together and sewn with a special stitch. Additionally, the entire structure is fixed to the joint capsule to limit mobility.
- Partial or complete resection of the meniscus of the knee joint. This procedure is performed with the total destruction of cartilage tissue, with its complete dysfunction. Partial removal of cartilage, its destroyed structures, and the whole, intact part remains without intervention (partial replacement of the meniscus). Complete removal of the meniscus of the knee joint is much more difficult and more traumatic. Select all damaged structures and remove them. This is replaced by all prosthetic or other cartilage tissues that can perform a similar function.
- Transplantation of a new cartilage plate. This is a method of transplanting cartilage tissue from a donor (frozen identical tissues) or transplanting synthetic material.
After surgery on the meniscus of the knee joint there is a risk of complications. What undesirable effects may occur:
- Bleeding from damaged vessels. It can be noticed and eliminated at the stage of operational intervention.
- Damage to adjacent ligaments. A very serious complication that can lead to complete joint dysfunction.
- The accession of the infectious process. The joint capsule is a very favorable place for the development of inflammation.
- Injury to nerve endings and roots.
- An operation on the meniscus of the knee joint may result in the rejection of an installed implant. In this case, surgical manipulations will be directed to re-audit and replace cartilage.
- An incomplete revision of the articular sac may lead to the omission of certain parts of the broken cartilage. In the future, the symptom of "articular mouse" may develop. This is a symptom in which there is a sharp restriction of the mobility of the knee due to the penetration of the free part of the cartilage into the joint space during movement.
В зависимости от возникших осложнений восстановление после операции на мениске должно включать сочетание лекарственных и физических способов лечения, длительное наблюдение и дальнейший контроль за самочувствием больного.
Восстановление после артроскопии мениска продолжается не меньше 2 месяцев. Combine the use of drugs (painkillers, anti-inflammatory, chondroprotectors, and others), physiotherapy and gymnastic exercises. For successful and effective postoperative rehabilitation it is necessary:
- Use additional support when walking. It may be a cane or crutches.
- Gradually increase the load on the sore leg. Daily workouts should restore muscles and ligaments.
- After some adaptation of the organism to new structures, it is necessary to keep them in good shape, using orthoses. These are specialized products that protect and fix the knee in the correct position.
- It is necessary to start a full-fledged gymnastics from 6–7 weeks.
Rehabilitation after removal of the meniscus occurs a little further, since the body needs to adapt to the foreign tissue. Often it happens that the body does not perceive the installed implant and its rejection begins. This is a very terrible complication, as its own defense mechanisms begin to work against us. To prevent such situations, the patient is trying to transplant his own tissue or special synthetic prostheses. If the meniscus resection is partial, then the patient is observed for a long time for a timely response to possible rejection.
Further rehabilitation after surgery on the meniscus of the knee joint consists in observing a gentle treatment for the knee, in keeping to a diet, in regular exercise of gymnastics and physical therapy (helping to restore muscle tissue). To ensure a good blood supply to the limb, it is recommended to attend massage, physiotherapy and manual therapy sessions. After resection of the meniscus, you are under the supervision of a doctor for a long time and note all your sensations in the knee.
The knee joint withstands many different loads daily. Not surprisingly, knee pain is a common complaint for patients. Often the discomfort is triggered by any damage to the meniscus.
Torn ligament, meniscus, chronic injuries have a similar clinical picture, but the treatment is significantly different. Independently identify the cause of pain in the knee is difficult. Trust a professional - consult a doctor. Only on the basis of diagnostic manipulations, the doctor will make the correct diagnosis, prescribe the appropriate therapy.
- What is the meniscus of the knee
- Probable causes of rupture
- Characteristic symptoms
- Degrees of damage
- Conservative treatment
- Drug therapy
- Gymnastics and exercises
- Folk remedies and recipes
- When can not do without surgery
- Prevention Guidelines
What is the importance of rehabilitation?
In arthroscopy, surgeons inject an irrigation fluid into the articular cavity, which is used to delimit the joints and organize the space for the operation. Sometimes this fluid can leak into the surrounding soft tissue and cause hemorrhage and swelling.
It is not surprising that after the operation, tissue swelling occurs, the patient experiences severe pain. During surgery, nerve endings and blood vessels are damaged, which contributes to the development of the inflammatory process.
Pain and swelling cause a person to fear moving limbs. The patient may develop arthrosis. Therefore, the essence of rehabilitation after resection of the meniscus is as follows:
- eliminate painful sensations
- accelerate the process of tissue regeneration,
- normalize the release of joint fluid
- to restore the motor function of the knee.
Recovery from arthroscopy of the meniscus consists of a series of medical procedures:
- drug therapy,
Only a doctor can determine the feasibility of a particular therapeutic procedure, so do not neglect the advice of a specialist.
Early and late postoperative period
Early recovery after surgery on the meniscus is intended for:
- eliminate the inflammatory process,
- improve blood circulation,
- prevention of muscle atrophy.
Immediately after surgery, the knee joint is immobilized. Doctors prescribe nonsteroidal drugs that are taken as local anesthetics.
In the event of fluid accumulation in the joint, a puncture should be done to prevent infectious processes. Anti-bacterial agents are mandatory.
After resection of the meniscus, the doctor prescribes chondroprotectors, which help restore damaged cartilage tissue. But these medicines must be taken at least 3 months. Specialists often prescribe drugs in the form of injections.
In the postoperative period, physiotherapy is necessary. Exercise therapy is an important component of the rehabilitation course.
Late postoperative period also has its own characteristics. Surgery on the meniscus involves a gradual increase in stress on the joint. Within 20 minutes, patients do special exercises 3 times a day. Exercise therapy is carried out until the complete disappearance of painful symptoms.
Exercises after removal of the knee meniscus include:
- Active movements of various nature with the use of safety net.
- Roll back and forth.
- Exercises that promote endurance.
During the rehabilitation period massage is allowed. But it is important to understand that immediately after the operation, the above medical procedure is prohibited if the tissue rupture was stitched. After all, such manipulation can cause damage to the articular capsule. Massage the lower leg and thigh area to improve tissue regeneration.
Doctors believe that the best rehabilitation program has been developed in the sanatoriums, therefore, they recommend to their patients to improve their health there.
The duration of the recovery period depends on the severity of the damage. Additionally, it is important to familiarize yourself with existing types of surgery in case of meniscus rupture.
If the meniscus is damaged, doctors use the stapling method. The operation is performed using arthroscopy.
Patients are in the clinic for no more than 2 days in case of surgery. Postoperative therapy lasts no more than 3 weeks. It is important to follow a number of recommendations during the rehabilitation period:
- 2 days after the operation, it is already possible to walk using the support. But only a doctor can determine the extent to which walks are permissible.
- Within 21 days after surgery, you should move with crutches. You need to try not to bend the knee.
- During the following month, an orthosis should be worn. The doctor already allows at this stage to bend the knee.
- After 2 months, you can already walk without support.
- After six months, the doctor may allow you to practice some sports.
A full recovery is quite possible within a year if you follow the recommendations of specialists.
Meniscus resection is a more benign type of operation for the knee, since rehabilitation takes place in a shorter time than in the case of the stitching procedure.
It is necessary to consider how the process of recovery after meniscectomy normally proceeds:
- On the 3rd day, in order to prevent muscle atrophy, a series of exercises is carried out. The complex is developed individually, focusing on the physiological features of each patient, as well as the presence of positive dynamics of clinical symptoms after surgery. Exercises can be adjusted in the process of rehabilitation therapy.
- At the beginning of the 2nd week, stitches are removed.
- Over the next 2 weeks, the knee is subjected to motor loads. During this rehabilitation period, patients use crutches. They are discharged from the hospital, so all medical procedures should be carried out at home until the complete disappearance of painful symptoms.
- After 1.5 months, patients can safely go to work.
- After 2 months, people are allowed to play sports.
The positive result of the operation and the duration of the rehabilitation period largely depend on the type of surgery chosen, the professionalism of the doctor, the state of health of the patient and his age. Therefore, in order to avoid disastrous consequences, undergo a thorough diagnostic examination and responsibly approach the recovery program after the operation.
What is the meniscus of the knee
The menisci of the knee are formations of cartilage tissue that are located in the articular cavity. They are needed to cushion and protect the joint from stress. There are two types of meniscuses: external and internal, respectively, lateral and medial. The inner meniscus is less mobile, which is why its rupture is diagnosed much more often than damage to the external meniscus, which is more mobile.
Menisci are designed for the stability of the musculoskeletal system of the knee joint, a kind of protection against various injuries:
- damping function - its main task. During the movement of a person, the meniscus takes on the necessary shape, thereby reducing the dynamic and statistical stress on the joint,
- reduce friction, protects ligaments from abrasion,
- stabilize the work, maintain the optimum range of motion, limit the excessive mobility of the knee joint.
Rupture of the meniscus leads to excessive mobility of the knee joint, pain, neglected cases contribute to the emergence of other diseases, such as arthrosis.
Doctors distinguish two types of meniscus tears: traumatic and degenerative. The first is characteristic of professional athletes who constantly load the knee joint. The second type is characteristic of elderly patients. In the absence of proper treatment of a traumatic type of rupture, the pathology can develop into a degenerative appearance. In any case, visit the doctor, get treatment.
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Probable causes of rupture
Damage to the meniscus most often occurs for such reasons:
- after a strong blow to the knee, during other traumatic situations,
- falls with a sharp turn of the shin out or in (often seen in soccer players),
- excessive extension of the knee from a bent position, especially at a fast pace,
- Repeated direct injury of the meniscus leads to chronic injury to the knee joint,
- the course of other ailments of the musculoskeletal system: rheumatism, arthrosis, gout,
- chronic intoxication of the body (alcoholic, drug).
Chronic pathologies present a serious health risk to the patient: a not fully cured meniscus gap, compression of the knee area, permanent tramatization. Against the background of unfavorable factors, the cartilage becomes fragile, begins to exfoliate, microcracks and erosion appear. As a result, the structure of the meniscus is destroyed, it can no longer perform its functions.
Doctors identify several factors contributing to the occurrence of pathology:
- obesity. Excess weight creates an additional load, which increases the chances of a meniscus tearing,
- standing or standing,
- individual patient characteristics: overly mobile joints, weak ligaments.
In any situation, you must immediately visit the doctor, delaying a trip to a specialist can make it impossible for a person to walk.
The clinical picture in acute and chronic course of pathology differs significantly from each other.
At the beginning of the meniscus gap, the following symptoms are observed:
- essential limitation of movements: the patient cannot bend and flex the knee,
- acute pain syndrome that accompanies the victim constantly,
- if the injury struck the blood vessels, the occurrence of hemarthrosis is noted (blood accumulates in the articular cavity),
- meniscus injuries are manifested by sharp pains in the entire leg: a person cannot even step on the foot.
The absence of medical care for three weeks leads to the transition of the acute to the chronic stage, which entails a change in the clinical picture:
- there is a sharply expressed pain in the area of the injured knee, discomfort is present at the level of the joint space,
- the appearance of effusion (fluid that is released from the blood vessels of the damaged meniscus) is observed,
- total stiffness of the joint in the knee,
- it is difficult for a person to move, especially, to descend and climb stairs,
- there is an atrophy of the muscles of the thigh, lower leg,
- the knee joint increases significantly in volume,
- a characteristic click is clearly heard during knee flexion,
- local temperature increases, reducing the nutrition of the soft tissues of the knee leads to pallor of the skin.
Important! Damage to the meniscus is difficult to diagnose. A full examination is carried out only on professional equipment by a specialist. Independently fight the pathology is dangerous to health.
Degrees of damage
The choice of treatment method depends on the area, strength and type of meniscus gap. The doctor determines whether the cartilage can be saved, is there a chance to do without surgery.
There are several types of meniscus tears:
- pinching meniscus noted in 40% of all cases. Pathology occurs on the background of separation, further rupture of the cartilage, the damaged part is lifted, blocking the motor activity of the joint. Most commonly used is a closed reduction, in the absence of positive results, urgent surgical intervention is required,
- partial meniscus tear diagnosed in half of all victims. The tear is most often noted in the posterior horn, there are cases of a defect in the middle of the meniscus, breaks in the front are extremely rare. Incomplete rupture of the meniscus is divided into longitudinal, horizontal, transverse and internal damage. In most cases, surgery is not required, excellent results show conservative therapies,
- full meniscus gap - the most dangerous pathology, occurs in 10% of all cases. It is imperative that an operation be performed, during which a “dangling” part of the fabric that interferes with the normal movement of the joint, damaging all nearby areas, is simply removed.
Until recently, it was believed that the removal of the meniscus is a complete solution to all problems. In the course of numerous studies, it turned out that the meniscus performs important functions (it absorbs and protects the joint cartilage from damage). Removing such an important part leads to the development of arthrosis. Therefore, doctors remove only the damaged part of the meniscus, trying to keep as much tissue as possible.
Depending on the degree of meniscus damage, the doctor chooses a conservative or surgical treatment. Immediately after the injury, the patient must be given first aid: keep the victim calm, a cold compress will help relieve pain, an elastic bandage will prevent further damage to the meniscus. Additionally, the patient's foot is placed above the level of the chest, which prevents the occurrence of hemarthrosis.
Conservative methods of therapy are very popular, are used with an incomplete rupture of the meniscus.
- NSAIDs are used to relieve the inflammatory process, relieve puffiness. Special ointments are applied to the affected knee area: Ketoral, Dolgit, Voltaren and others,
- with limited mobility, they cope with the injection of a drug called Ostenil into the knee joint. The positive effect is felt after the first injection, the long-term result is achieved by a course of five injections,
- pain relieves topical analgesic drugs.
Gymnastics and exercises
- Lie on your back, bend your knee, start to straighten it slowly, resting your heel on the floor. Repeat similar manipulations with the other leg at least 10 times,
- in a prone position, raise straight legs 15 cm from the floor, arms should lie along the body. Hold this position for ten seconds, slowly lower the legs. Repeat such manipulations as you can,
- under the knee, hold the small ball, try to bend and unbend the leg without dropping the ball.
Therapeutic exercises are previously negotiated with the doctor.
Folk remedies and recipes
Recipes of traditional medicine:
- finely rub a small onion, add a tablespoon of sugar, distribute the resulting mass over the sore knee, wrap with food film, a scarf, keep the compress all night,
- chop the clean leaves of burdock in a blender, apply the resulting mass in a thick layer on the affected knee, wrap with polyethylene. Keep a compress no more than 8 hours. Medical manipulations spend every day for one week,
- Combine a tablespoon of honey, the same amount of medical alcohol. Place the product on the knee, wrap in elastic alcohol for one hour. Repeat the treatment three times a week to obtain the desired effect.
When can not do without surgery
Surgical intervention is indicated in the following cases:
- with a complete rupture and displacement of the meniscus,
- при раздавливании мениска,
- при наличии кровоизлияния в область мениска,
- полный отрыв тела, рогов мениска (разрыв тела редко заживает самостоятельно, может вовлекать близлежащие ткани в патологический процесс).
In most cases, resort to complete or partial resection of the meniscus.
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Follow the link and read about what is arthroscopy of meniscus and in what cases the operation is performed.
Practical advice will help to avoid pathology in the area of the knee joint:
- carefully go down and climb the stairs
- exercise carefully, even walk,
- go swimming, ride a bike. These sports have a beneficial effect on the joints, strengthen them,
- for heavy physical exertion, wrap your knees with bandages or use special kneecaps,
- always maintain your optimal weight.
Damage to the meniscus is always unpleasant and painful. Be sure to consult your doctor, get treatment. Adhere to preventive measures, avoid static work.
Video about treatment options for meniscus tear without surgery:
Knee injury: first aid
Any injury, a fall or an awkward movement causes damage to the knee, and the meniscus may rupture or even tear completely. Ignoring such problems and undergoing pain in no case can be, for example, if a patient has late meniscitis revealed - this is almost always a prerequisite for the occurrence of future osteoarthritis of the knee joints. What should be done in the first minutes after damage to the meniscus, before undergoing conservative or surgical treatment?
First, provide the victim with complete rest and eliminate all potential loads on the knee joint. Sick leg is best put higher - on pillows or rollers of clothing. An icy compress should be applied to the bruised and sore spot, then wrap the damaged joint with an elastic bandage and then immediately seek the help of a specialist (orthopedist or traumatologist).
How does the treatment occur without knee meniscus surgery?
If the decision is made to treat the meniscus without surgery, then apply an integrated approach. Use several techniques that allow you to restore damaged cartilage tissue. For this purpose, appoint:
- Anti-inflammatory drugs - they help relieve swelling, pain.
- Chondroprotectors - supply all the necessary substances to restore the integrity of cartilage tissue and its strengthening. These drugs have to take quite a long time from 0.5 to 1 year.
- Physical therapy - helps to restore mobility, reduce sensitivity, strengthen the ligaments and muscles surrounding the joint.
- Massages and grinding with the use of medicinal ointments - provide a quick supply of nutrients to the joint, help to restore mobility.
Treatment of a meniscus gap without surgery is also accompanied by wearing tight bandages and bandages, which are designed to protect the damaged joint, to protect it from new injuries, and also to fix in one position. Physician appointments are usually supported by exercise. They should be performed at home, but regularly. The purpose of such exercises is to develop a joint, strengthen muscles. If there is a desire to cure the meniscus without surgery, the patient will have to change their lifestyle somewhat. Abandon sudden movements, get rid of excess weight, monitor your diet.
When conservative treatment does not help, then a decision is made about surgical treatment. In modern clinics, it is carried out by the method of arthroscopy, which is accompanied by a tiny incision, a quick rehabilitation period and a short stay in a medical institution. But even about such a modern solution, it is not always possible to avoid complications, which are associated primarily with infections, perforation of bones and nerves, excessive bleeding.
What to do to do without surgery?
A lot depends on the patient. Some diseases can be easily treated without surgical interventions. For this you need:
- Seek medical attention at the first symptoms of the disease. Deceptive improvements only mask the course of the disease, and do not at all indicate magical healing. The sooner measures are taken, the more effective they will be.
- Wear the right shoes. Inconvenient shoes and boots increase the load on the joint, increasing the wear of cartilage tissue.
- Follow all the recommendations of the doctor.
- Adjust the diet - you will have to reduce the consumption of foods that have a bad effect on the condition of the joints: fried and fatty foods, soda, pastry dough, alcohol. Eat raw vegetables, fruits, dairy products.
- Do not tolerate the pain. If you hurt to step on your foot, do not need to do this. Use crutches or a stick to relieve your knee.
- Avoid self-medication and all kinds of "folk remedies" without a doctor's recommendation.
Treatment without a rupture of the meniscus of the knee joint is a long process, since such disorders are restored slowly and reluctantly. The process is further complicated by the fact that the supply of nutrients to the intracellular cartilage is limited due to its remoteness from large vessels, so that healing sometimes takes months, or even years. It is not excluded that the joint will not be fully restored, so for the rest of your life you will have to be extremely careful and not to allow re-injury of the knee.
A large role is played by the age of the patient. It really makes sense for young people to treat the meniscus without surgery. But the elderly have not only to go under the surgeon's knife, but also to resort to artificial prostheses in order to restore knee mobility. Due to age-related features, their metabolism and tissue regeneration occurs slowly.
The cost of non-surgical treatment is significantly lower than that produced with surgical intervention. The final price depends on the drugs used, methods of rehabilitation and ranges from 10 to 50 thousand rubles. For arthroscopy will have to pay in the range of 15-40 thousand rubles, not counting the cost of rehabilitation and receiving remedial drugs.
Damage to the meniscus can be caused by a blow to the knee area, an awkward movement, or rotation of the lower leg. In case of injury, you should immediately seek professional help. Let us see if treatment is possible without surgery if the meniscus of the knee joint is ruptured, and whether folk techniques help with such a dangerous injury.
Causes of injury
Almost any disease or injury can be prevented if you know the cause of the problem. Therefore, to figure out how to treat the meniscus at home, you need to have information about the causes of injury.
The meniscus is located inside the knee joint, and serves as a natural shock absorber during movements of various kinds (walking, jumping, descending, climbing stairs). Thanks to the meniscus, the overall load on the joint is reduced.
Damage to the cartilage plate affects mainly a certain category of people (professional athletes, dancers). Injury can be obtained in old age due to ongoing changes in the structure of articular tissues.
There are the following causes of meniscus damage:
- increased loads associated with sports training or hard, physical labor,
- pathological changes of the articular structure, obtained at birth,
- associated diseases (rheumatism, arthritis),
- age articular deformity.
Any of these causes may cause damage to the limb of the knee area.
Recovery of the meniscus without surgery is possible if we provide timely treatment for injury. To do this, it is important to know the signs of the injury.
The following points speak about traumatizing the meniscus:
- severe acute pain
- the appearance of swelling of the injured area,
- click on the injury site,
- possible stiffness of the joint
- problems with certain motor activity (walking up the steps, movement when bending, straightening the limb),
- the appearance of joint fluid in the cavity.
When help does not come immediately, the injury will turn to a chronic disease, and treatment of the meniscus without surgery will become impossible.
When diagnosing damage to the meniscus, depending on the degree of injury, the treatment method is chosen (traditional or operative). Primary care actions include the following points:
- ensuring rest to the victim,
- applying a cold compress to the injured area,
- pain relief by injection or medication
- overlay splints.
Subsequent actions of traditional treatment include a course of medication, physiotherapy, the use of special ointments that eliminate joint stiffness.
Surgery is carried out in the following situations:
- complete separation of the meniscus or its displacement,
- blood filling of the articular cavity
- complete separation of the body or horns,
- inability to eliminate articular blockade,
- drug treatment has not brought results.
If surgical intervention is indicated, it depends on the type of rupture. There are various ways to fix the problem:
- complete excision of the meniscus or its detached part,
- joint repair is performed mainly by young people and professional athletes,
- arthroscope application
- the use of special clamps to fasten the damaged meniscus.
In some situations, they resort to transplantation when the meniscus itself, or its components, is replaced.
Treatment without surgery
To cure the meniscus of the knee joint without surgery is possible in the following cases:
- if as a result of the injury there was a pinching,
- there was a partial strain.
If the meniscus partially ruptures, then surgery can be avoided by going through two treatment options (acute with a short phase). Therapeutic measures that allow treatment of the meniscus gap without surgery include the following points:
- on the day when the injury occurred, it is necessary to fix the damaged area of the knee, to ensure the rest of the limb. For this purpose, apply a tight bandage, or use a tire,
- on a site with strong painful symptoms impose a compress with ice, or a cold towel. Compresses need to be done several, within 15 minutes.
These activities must be performed in order to further dispense with the operation when the meniscus is torn.
To ensure the rest of the injured limb, it is necessary to arrange a cushion or pillow under the knee. Comfortable position with injury - lying or sitting.
If the meniscus is damaged, doctors do not advise self-healing. Treatment without surgery in case of damage to the meniscus of the knee joint is justified; they got into the day of injury to seek professional medical care.
The only thing that can be done from home is to apply a fixing bandage, to take painkillers for severe pain syndromes. Choose from such drugs as Ibuprofen, Aspirin.
Treatment without surgery, meniscus of the knee joint aims to eliminate pain, as well as the removal of inflammation, accompanied by swelling. In spite of the performance of home procedures, it is necessary to carry out a course of physical therapy prescribed by a doctor, in combination with a medical technique.
Treatment without surgery for damage to the meniscus, including special gymnastic exercises and massage sessions. Important: even if the treatment is performed at home, you should periodically receive medical advice.
Medical procedures are combined with the passage of a course of drugs that help restore the structure of damaged tissue during injury. To cure the meniscus without surgery, apply special ointment with creams. Basically, products containing Diclofenac and Ketoprofen, or drugs, where the active substance is Ibuprofen, are used.
The specialist will monitor the course of the disease and the recovery period, and, if necessary, will appoint additional measures to cure the meniscus rupture without surgery. Observing medical recommendations, and performing the prescribed procedures, you can do without surgical intervention.
Meniscus tear - arthroscopy
Often the victims are interested in whether to perform an operation when the meniscus is torn. Often, as an effective treatment, experts advise arthroscopy. This method is popular due to the fact that, if necessary, from the usual research can go to the operation. Arthroscopy has the following advantages:
- performed under conduction anesthesia
- not very traumatized tissue
- has a good cosmetic effect
- after intervention, the knee joint is quickly restored,
- after the operation you do not need to put a plaster,
- you can walk with a load on the leg,
- no need for crutches.
Knee meniscus tear - treatment without surgery
If a person is diagnosed with a meniscus rupture, conservative treatment may be one of the most effective. Three types of meniscus rupture are separated, for which such treatment is indicated:
When the meniscus is broken, non-surgical treatment goes through two phases - acute and short. To remove puffiness and pain syndrome, phytotherapy is applied, and also a complex of necessary measures is carried out:
- On the first day you need to fix the knee. You can use a tight bandage or splint. Orthoses and calipers on the joint is also a good option.
- Put ice or wet cool towel on the place where the pain is felt. You need to apply several times for fifteen minutes.
- Lie down or sit down with a pillow under your knee. The patient is shown peace.
Meniscus tear - home treatment
It is not recommended to treat injury to the knee joint at home, as it can be harmful to health. You should immediately call an ambulance or go to the hospital yourself, where they will make an x-ray and prescribe an effective treatment. Often, doctors recommend a bandage on the knee with a meniscus injury. However, if the victim has severe pain, he can use drugs to break the meniscus:
Meniscus gap - folk remedies
When the meniscus is torn, even folk remedies are often used. One option for this kind of help.
Preparation and use:
- The components need to be mixed and melted in a water bath.
- The mixture is cooled and placed on the problem area.
- From above the knee is wrapped with polyethylene and a wool scarf.
- Keep the compress for two hours.
- The procedure is done twice a day until the pain is relieved.
Preparation and use:
- Using a grater chop onions.
- Sugar is added to the mush.
- All components are mixed until complete dissolution.
- The mixture is laid on gauze and applied to the knee.
- Top fix with polyethylene.
- Compress hold all night.
- The procedure is done every day for a month.
What is dangerous about the gap meniscus?
If a person has a torn meniscus of the knee joint, mobility is limited, and only potent drugs can save from constant pain. Other injury hazards include:
- Failure to treat the damage can lead to osteoarthritis of the knee joint.
- The occurrence of such injuries as bone fractures, ligament rupture, bone displacement.
- Mechanical instability of the knee joint. While walking or running, a blockade of the joint may occur and the victim cannot even bend the leg.
Trauma to the meniscus of the knee - consequences
If the damage treatment is prescribed correctly, then the patient has every chance of recovery. The consequences of injury will depend on the degree, efficiency of diagnosis. Not very favorable prognosis for recovery in people older than forty years, since the ligamentous apparatus at this age is still weak. However, not only this category of victims may have complications of meniscus rupture. Arthrosis of the knee may be the most dangerous consequence.
Exercise therapy at meniscus rupture
After operations or conservative treatment, a person’s working ability may resume after a month, and in some cases after three months. In order to recover from a meniscus rupture as soon as possible, doctors recommend using physical therapy. Such exercises for knee after meniscus injury are considered effective:
- Lie on the stomach, legs straighten. Slowly lift the affected leg. In the air, it must be kept no more than thirty seconds. The exercise must be repeated up to four times.
- Lie on your stomach and stretch your arms. A healthy leg must be bent ninety degrees. To lift the bent leg from a floor and on weight to keep ten seconds. Do the same with a sore foot. Bend at the angle at which there is no pain. Need to repeat twice.
When the meniscus of the knee joint is ruptured, treatment with folk remedies is used. Try to use recipes of tincture and a special mixture to alleviate the condition of the victim:
It is important to understand that treatment of the meniscus of the knee with folk remedies is possible if the doctor has allowed the diagnosis after the diagnosis.
You can also prepare other tinctures related to folk remedies in the treatment of the meniscus. Для приготовления отваров и настоев используют такие растения, как полынь, чеснок, крапива, березовые листья, фиалку.
Попробуйте приготовить настойку на основе чеснока:
- понадобится чеснок (2 зубчика), яблочный уксус (6 %),
- чеснок измельчают и смешивают с уксусом,
- mixed components pour water (0.5 l), leave to infuse for a week.
To preserve the properties of homemade tincture, you must store it in a dish with dark walls. With proper storage, the healing properties of the mixture can last up to 8 months.
Wormwood tincture is prepared as follows:
- take wormwood (dry plant 1 tbsp. l.), and boiling water (200 ml),
- pour boiling water over the grass and leave for an hour
- infusion strain.
In the resulting tool is moistened with a piece of gauze or a wide bandage, and the bandage is applied to the knee. Aged compress 40 minutes. The procedure must be performed up to 4 times a day to eliminate pain.
You can apply camphor or essential oil (eucalyptus, cloves, menthol). For the treatment of meniscus without surgery folk remedies suitable aloe juice. To prepare the oil mixture, the listed oils are taken and mixed in the same ratio. The mixture is slightly warmed, then gently rubbed into the damaged area. From above the bandage from flax is imposed. Such compresses can be applied up to 4 times per day. The oil composition not only eliminates pain, but also has an anti-inflammatory effect on the affected limb.
Burdock is an excellent component that helps in the treatment of an injured knee joint. Fresh, washed leaves of burdock can be applied to the damaged area, and leave for 4 hours. For nighttime compresses, the burdock leaves are first steamed and then applied to the sore spot. Do not forget to fix the sheet. It is advisable to stock up on burdock leaves for the winter.
Important: it is impossible to completely cure the meniscus at home. Any home treatments using folk remedies help only to relieve pain, while at the same time alleviating the condition of the victim. Home methods will not restore a damaged meniscus. Therefore, the use of folk remedies is possible only in combination with a conservative treatment prescribed by a doctor.