Meniscal tears of the most common knee injury - up to 75% of closed injuries of the knee joint. Most often the injury occurs in men. Knee meniscus cartilage are pads that act as shock absorbers in the joints, as well as stabilize the knee joint. When the movements of the knee menisci are compressed, their shape changes.
Knee menisci are two: outer (lateral) the inner (medial).
In front of the joint they are connected transverse ligament.
The outer meniscus is more mobile than the inner, so it is traumatic injuries occur less frequently.
The inner meniscus less mobile and connected to the internal lateral ligament, which often causes it is combined with a ligament lesion.
Side of the joint meniscus fused with the capsule of the joint and have a blood supply from the arteries capsule. The internal parts are in the depths of the joint and not have its own blood supply and nutrition of their tissues is carried out by circulation of synovial fluid. Therefore, damage to the meniscus close to the joint capsule fuse is good, and breaks inside, deep in the knee joint is not fused at all. Meniscus injuries occur at sharp movements with legs bend at the knee, but with a fixed stop. Less commonly, meniscal tears occur during the squat, and jump. Often the trauma that led to the rupture of the meniscus may be small.
Distinguish meniscus detachment from the point of attachment to the capsule of the joint and the body break the meniscus. When you break the meniscus torn part retains its connection with the body of the meniscus. This gap is called a meniscus rupture of type "handle the watering can." More likely to have meniscal tears and combined injuries.
Traumatic injuries can be combined with meniscus and other injuries of knee joint structures: the lateral and cruciate ligaments of the joint capsule. Torn meniscus part, connected with the body of the meniscus can move into the joint cavity and impinge between the articular surfaces of the femur and tibia. There is a blockade of the joint, manifested by a sudden sharp pain and limitation of motion in the joint. Especially often this blockage occurs when the internal meniscus rupture in an "watering can handle."
The patient complains of severe pain, impaired movement of the knee. Sometimes accompanied by a bleeding torn meniscus in the knee joint (hemarthrosis), but may occur more frequently reactive inflammation of the inner lining of the joint - synovitis. The patient keeps the foot flexed, because the pain is aggravated by extension, especially if there was a blockade of the joint. When palpation revealed pain in the projection of the damaged meniscus, sometimes palpable elastic roller that rolls on the outer surface of the joint space with unbending in sustave.Etot symptom is a symptom of clicking or rolling.
To eliminate the damage of bone structures is carried out X-rays. Meniscal tears in the pictures are not visible because menisci are transparent to X-rays. Fully help to establish the diagnosis with contrast radiographs of the joint, but more modern methods are magnetic resonance tomography or endoscopic arthroscopy (examination of the inner surface of the joint with the arthroscope). As first aid is carried out anesthesia is applied and the patient transported by bus to the trauma hospital.
Treatment of lesions of menisci.
Performed arthrocentesis with the introduction of novocaine. Then reduce a strangulated meniscus special techniques with the patient lying on an orthopedic table. At the same time trauma surgeons performed the reverse movement, a movement that led to the injury. When the meniscus is in its place, the movement in the joint restored. After reduction to the damaged meniscus impose leg plaster cast, bent at a certain angle the knee joint.
Term immobilization of 3 weeks, and then assigned to physical therapy and exercise therapy. If the patient has recurrent joint blockade of a condition called long-standing damage to the meniscus. This usually occurs and inflammation of the inner lining of the joint - synovitis, there is a constant pain in the joint, aggravated by walking, especially when descending the stairs. Sometimes there is a "loose body".
Loose body - the body is free in the joint cavity, which is formed due to the separation piece of articular cartilage, the meniscus, edge osteophytes (bony overgrowth). This condition causes frequent blockade of the joint and the "loose body" must be removed surgically.
In traumatic injuries of menisci, if you can not lift the blockade of the joint, joint blockades occur frequently, the patient was constantly concerned about pain in the joints, there are difficulties in walking require surgery. To date, the best solution is arthroscopic surgery. With the endoscopic technique, first inspect the inside of the joint, shall decide on the amount of the operation. Then the damaged meniscus removed. After surgery on his leg impose a tight bandage or plaster Longuet. An important condition for recovery is the early exercise physiotherapy.
