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Osteoarthritis is able to develop for years, sometimes the disease takes a chronic form and makes
itself felt when a person is in old age. It happens that any careless movement damages the inner or
outer meniscus. It is treated, as a rule, such a pathology for a long time. Therefore, senile arthrosis
presents the greatest danger for healthy joints and knee structures. It is necessary to visit the doctor
periodically and, as necessary, to undergo examinations, appropriate procedures. Osteoarthritis
leads to the destruction of the joint, which will affect not only the condition of the knee, but also the
performance of the patient's leg.
There are cases when patients in time did not cure arthrosis( or treated it incorrectly) and became
disabled. Since the knee joint is a complex structure, it is difficult to treat damage of any kind.
The knee is the largest joint. He, despite all sorts of injuries, is capable of recovery. Usually, a
conservative, comp
lex treatment is prescribed. The operation is required in rare cases, when physiotherapy, traditional
medicine and other means are rendered useless.
In addition to this part of the body, there are few soft tissues that could protect it from damage.
This is why knee joint injuries are diagnosed quite often, and one of the most common injuries is
the meniscus rupture.
Meniscus structure
Meniscus is a cartilaginous crescent-shaped formation. It is located between the shin and thigh and
is a kind of lining between the articular ends of the bones.
Meniscus performs a number of functions, the main one of which is motion damping and
protection of the articular cartilage .In addition, it performs a stabilizing function, which is aimed
at increasing the mutual correspondence of all articular surfaces in contact with each other. Also, the
meniscus helps to significantly reduce friction in the joints.
In the knee joint there are two meniscus :
1. external;
2. internal.
The outer meniscus is more mobile, and therefore it is much less damaged than the internal one.
Certain features have a blood supply to the meniscus. The fact is that in newborn children all their
tissue permeated by blood vessels, but already at nine months from the inside the vessels
completely disappear. As the blood flow increases, the meniscus worsens. From this point of view,
two zones are distinguished: white and red.
Damage classification
distinguishes such varieties of the knee joint meniscus:
Separation from the attachment point. This can occur around the body of the meniscus in
the paracapsular region or in the area of the anterior and posterior horns.
Tears of the body of the meniscus. This can occur in the transchondral area, as well as in
the region of the hind and anterior horns.
All possible combinations of such damages.
Excessive movement of the meniscus .It can be a degeneration of the meniscus or rupture
of its ligaments.
Chronic degeneration or trauma of the meniscus , cystic degeneration.
Meniscus tears can also have several varieties of :
longitudinal;
transverse;
flap-shaped;
crushed.
In terms of complexity, has complete and incomplete breaks.
Causes of rupture
This is quite common phenomenon, and this injury is usually received by people who are engaged
in sports , - skiers, tennis players, figure skaters, football players.
Sometimes an meniscus rupture occurs without injury to .Most often this is observed in the
development of inflammation or degenerative processes in the knee joint. Often, this is due to
arthrosis. Sometimes traumatic injuries of menisci are accompanied by rupture of ligaments and
other injuries of the knee joint.
Symptoms of trauma
Symptoms of , characteristic of knee joint meniscus damage at the initial stage of the disease
development: nonspecific inflammation, severe cramped movements, local pain, presence in the
blood cavity or exudate.
Already after 2-3 weeks these manifestations disappear and symptoms appear that are specific to
the meniscus injury:
1. Local soreness.
2. Presence of effusion.
3. Infiltration of the capsule.
4. Tumor soreness in the area of the joint space.
5. Fixed joint, which is associated with a pinching of the meniscus.
6. Character click when bending the joint.
7. Increased temperature in the area of the affected joint.
8. Atrophy of the muscles of the thigh and lower leg - occurs in some cases.
The chronic form of the disease is observed in case of systematic damage to the meniscus. In this
case there are no clearly expressed signs. Sometimes the following manifest themselves:
To avoid trouble you need to know what to do with a leg dislocation. As it turns out the first aid and
the subsequent treatment you can find here.
Symptoms of rupture of the medial and lateral meniscus of the knee joint also have some
differences. So, to the signs of traumatization of the medial meniscus include:
Comprehensive treatment
Conservative therapy
Regardless of the severity of the injury, the victim needs first aid. For this, the patient should ensure
complete rest, apply a cold compress and elastic bandage to the knee joint area. To prevent or
remove swelling, you need to lay your foot just above the chest level.
Conservative methods of in the treatment of a knee joint meniscus tear include the use of non-
steroidal painkillers. These include ibuprofen, meloxicam, diclofenac .
To restore cartilaginous tissue, requires chondoprotectors - they help improve metabolic processes
in the regenerative tissue. These drugs include chondroitin sulfate and glucosamine. To increase the
water-holding characteristics of the cartilage and prevent inflammation, a biologically active
supplement collagen ultra can be prescribed.
For grinding, various ointments - ketoral, alesan, voltaren, dolgite are used. If pain and limited
mobility are observed, Ostenil can be administered inside the joint bag.
Surgery
Indications for surgery for rupture of the meniscus of the knee joint are :
1. rupture and displacement of the meniscus.
2. Blood in the cavity.
3. Milling of the meniscus tissue.
4. Detachment of the body and horns of the meniscus.
5. No effect from drug treatment for several weeks.
In such situations, it may be assigned to surgery, which is carried out by different methods :
meniscectomy or meniscus removal
This operation is shown in the separation of a large portion of meniscus cartilage tissue
decomposition, the development of complications. This procedure refers to a rather traumatic and
leads to the elimination of pain only in 50-70% of cases.
Arthroscopy
meniscus transplantation
indications for such an operation to break the meniscus of the knee is considered crushing the
meniscus and a significant deterioration in the quality of human life. In this contraindication to
transplantation are: elderly age, knee instability, degenerative processes, general diseases.
Bond meniscus special holders
With this procedure fails to seal the meniscus without performing additional cuts. For this,
absorbable fixatives of the first or second generation are used.
Rehabilitation
Of no small importance is the rehabilitation period after the injury. It includes :
1. Perform special exercises for knee joint development.
2. Use of chondoprotectors and non-steroidal anti-inflammatory drugs. Massage,
physiotherapy.
3. .
4. No stress for a year.
Rehabilitation after such an injury includes five steps:
1. Stage 1 of the - its duration is 4-8 weeks. At this stage, you need to try to maximize the
range of motion in the injured joint, reduce swelling.
2. Stage 2 of the - lasts about 2.5 months. It is necessary to completely restore the motor
activity, eliminate puffiness, begin to train weakened muscles.
3. Stage 3 of the - it is necessary to completely restore the motor activity in sports, to restore
the strength of the muscles. At this stage, actively engaged in physical therapy and return to
the usual life.
4. Stage 4 - you must get the opportunity to actively engage in sports without pain, as well as
to increase the muscle strength of the injured leg.
5. 5 stage - it is necessary to restore all the functions of the joint.
Prevention
In order to prevent the from breaking the meniscus , it is necessary to use special knee pads during
sports activities - this will help minimize the risk of injury.
is also recommended to perform special exercises , which will help strengthen muscle strength,
take chondoprotectors and drugs that improve peripheral circulation.
Meniscus rupture is a fairly common injury of the knee joint, which significantly impairs the quality
of life of a person. Therefore, for any damage, it is worth to turn to an experienced traumatologist -
he will be able to make the correct diagnosis and choose the treatment.
osteocure.ru
limitation of freedom of movement of the joint, stiffness, inability to straighten the leg;
sudden full knee mobility blockade;
instability of the knee joint;
increased sensitivity in the area of injury;
pain.
By the nature of the pain, it is possible to determine the localization of the injury. When the internal
meniscus ruptures, shooting pain arises on the inside of the knee. In addition, there is a point
discomfort over the place of attachment. Pain also occurs when turning a bent knee, with excessive
force when bending the leg. There is a weakening of the hip muscles on the front surface. With
partial or complete destruction of the external meniscus, severe pain is felt in the outer part of the
calyx, when the knee is turned inwards. In addition, there are special symptoms specific to these
injuries.
When lifting legs straightened knee becomes clearly visible atrophy of the quadriceps
femoris on the inside and strong tension sartorius( tailor inache- symptom).
Pressing the bent at the right angle of the knee with a passive extension of the leg causes an
increase in pain - this is the symptom of Baykov.
Discomfort and pain intensification is noted with the usual unhurried descent from the stairs.
This phenomenon is called "symptom of the staircase"( or otherwise - Pelman's symptom).
Even during normal walking in a calm pace symptom "click" can be observed, and the
attempt to sit with crossed legs causing discomfort and increased pain.
Rauber - detected on radiographs in 2-3 months after the injury and is sprouting
shiloobraznyh formations on the condyles of the knee.
Polyakova - pain in the kneecap appears when you try to raise the healthy leg from a prone
position, resting on the heel of the patient's back and legs.
Inside the joint, changes also occur. The synovial fluid accumulates in the joint cavity, articular
cartilage is gradually destroyed, exposing the surface of bones in the joint.
Diagnosis
Symptoms of a meniscus rupture are similar to those of other knee diseases. X-ray helps to
eliminate diseases that have similar symptoms.
To make it, you need to take a tablespoon of liquid honey and medical alcohol.
Ingredients should be mixed and melt in a water bath.
Next, it is recommended to cool the mixture a bit, so as not to burn yourself, and put it on a
sore knee.
On top, you need to wrap your leg with polyethylene and a woolen shawl.
Keep the compress two hours in the morning and in the evening.
Perform the procedure daily until complete recovery.
It is necessary to take a fresh leaf of the plant and wrap it with a knee, attaching a bandage
or a handkerchief.
After 3-4 hours the sheet needs to be changed.
In winter, you can use and dry burdock leaves, previously soaking them in warm water. The
procedure will last no longer 4, but 8 hours.
Make wraps daily until the pain disappears.
Treatment of the meniscus with onion
The onion mixture successfully helps to get rid of the disease.
To cook it, you need to grate two small onions and add a dessert spoonful of sugar to the
gruel.
The prepared drug must be wrapped in several layers of gauze, attach to the knee, and top
with a film and stand all night.
Wrapping is recommended for a month.
You need to add a teaspoon of apple cider vinegar and a similar amount of honey in a glass
of warm water.
Drink daily for 10 days.
Then you can repeat the course after a 3-day break.
To make it, you need to grind the garlic( 2 heads) and add it to apple cider vinegar( 0,5l).
Pour the medicine into a dark bottle and insist for a week.
The medicine must be rubbed into the affected area twice a day by massaging movements
for 10-15 minutes.
Carry out the procedure until the pain disappears completely in the knee.
Treatment of the meniscus with herbs
To prepare a medicinal tincture, you need to take a tablespoon of birch buds, leaves of
violets and nettles.
All components must be crushed, mixed and poured into 500 ml of boiling water.
The medicine should be insisted for 30 minutes and filtered through a sieve or gauze.
Take 1/4 cups 4 times a day.
Prevention and useful advice on how to avoid inflammation and meniscus injury
^
Preventive measures to avoid damage to the meniscus are to prevent injury when running or
walking. It is advisable for athletes to wear knee pads or use elastic bandage. An equally effective
method of prevention is to strengthen the body through exercise and a balanced diet.
Before any physical activity, you need to warm up and warm up your muscles. To avoid injury, you
need to work on strengthening the quadriceps muscle of the thigh, which works when extending the
knee joint. A very effective exercise is the slow descent and lifting of the straight leg, performed in
a standing position.
You can strengthen the cartilaginous tissue with a balanced diet. To do this, include in the daily diet
of protein foods, foods containing calcium, magnesium and potassium. Often athletes use various
nutritional supplements that have a positive effect on joints: collagen, glucosamine or chondroitin.
In general, an active lifestyle and a correct diet will not only strengthen the knee menisci, but also
increase the vital forces of the body.
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General characteristic of
During leg movements, the meniscus changes shape depending on the directions in which they are
shifted, While the inner is much more mobile than the outer one.
Blood to the meniscus comes from the arteries located in the capsule of the joint. Their internal part
does not have access to blood, but the zone closest to the capsule is best supplied with it. In case of
damage, this part is best treated and treated, in contrast to the internal one, which is the worst after
the rupture. This plays a significant role in how the treatment will be treated.
Meniscus lesions can be either separate or combined with each other. As the statistics show, the
most damage occurs in the inner meniscus. Less common with external problems. The most rare
cases relate to disruption of the ability to work and the disease of both menisci simultaneously. The
cause of the problem, which all athletes are afraid of - the rupture of the internal meniscus of the
knee joint - can be a sharp bending of the legs during the jump or unsuccessful movement.
Symptoms of diseases
The first symptoms of meniscus damage are similar to those of any other joint disease. If there is a
break in the meniscus, then this problem can be identified only 2 weeks after the injury. Symptoms
of the rupture are:
severe pain, spreading over the surface of the knee from the outside or inside;
decrease in the level of cellular nutrition of muscles;
pain during sports;
elevated temperature in the area of damage;
joint increase;
click when bending.
Due to the fact that many of these symptoms of the meniscus of the knee joint are found and with
other problems with the knee, it is necessary to consult a doctor and conduct a full examination to
establish an accurate diagnosis. The inner meniscus is most often torn( longitudinally or
transversely), detached from the capsule or squeezed. The outer meniscus, thanks to its mobility,
only squeezes. Therefore, the symptoms of damage to the medial meniscus from lateral injuries can
be fundamentally different.
A visual example of the femur and meniscus
Symptoms in case of damage to the medial meniscus:
in the red-red zone - the meniscus is disconnected from the capsular attachment;
in the red-white zone - damage in the paracapsular region;
in the white-and-white area - damage in the site, deprived of blood vessels.
The doctor operates the knee
Meniscus lesions often occur due to direct injury, for example, when a joint strikes a solid object.
But repeated injuries can lead to a chronic pathology, and in the worst case - a break in the
meniscus. Meniscus can degenerate with rheumatism or gout. If various injuries occur
simultaneously, it can cause a defect in other parts of the joint: ligaments, capsules, cartilage.
One of the most common diseases associated with the joint is the knee joint meniscus cyst. Cyst is
the formation of fluid inside its cavity. Most often occurs in middle-aged people. In addition, there
is a high chance of developing meniscus cyst in young people. With the appearance of a cyst, the
chance of rupture of the meniscus increases several times. The main symptom is swelling in the
area of the anterolateral surface, which increases during flexion of the knee. The cyst of the outer
meniscus can lead to a degenerative condition of bone tissue and arthrosis.
The deforming arthrosis in the tibia is called the Rauber-Tkachenko symptom - it can only be
determined with the help of an X-ray. If the cyst is formed in the medial meniscus, then the swelling
can be found in the inner part of the knee joint. The cyst is determined by performing magnetic
resonance imaging or sonication.
Diagnosis
Before the treatment of the knee joint meniscus, a thorough diagnosis should be carried out.
Diagnosis involves the collection of anamnesis, examination of the patient, various instrumental
methods of examination. Since menisci are invisible to X-rays, it is used to exclude the possibility
of other damages. Using MRI( magnetic resonance imaging), you can visualize both the meniscus
and other intraarticular structures, after which, based on the information received, the doctor makes
a diagnosis. In addition to MRI, methods such as ultrasound( ultrasound) and CT( computed
tomography) are used.
It is necessary to diagnose
with the help of an MRI, it is possible to clearly say which lesions the meniscus received. The
tomogram clearly shows whether it is pinched, torn or torn. The information received is important,
it gives an idea of the future course of treatment.
Diagnosing recent meniscus problems can cause difficulties. Instead of the correct diagnosis,
doctors can refer the patient to treatment for sprains or an ordinary bruise. After the initial
treatment, pain and clicks go away, but with repeated trauma the disease becomes chronic. In this
case, symptoms may appear, previously not manifested.
Meniscus treatment
On the question of how to treat the knee joint meniscus, you can find many answers, the main thing
is to find an effective one. Depending on the degree of severity of the meniscus damage, as well as
age and many other factors affecting the patient, the doctor chooses one of two treatment methods:
operative or conservative. Regardless of further treatment, during the provision of first aid to the
victim, a cold compress is applied, which is tied with a bandage. With an elementary displacement
of the meniscus, an experienced doctor can quickly identify and fix the problem. First, for a period
of up to 3 weeks, the patient is impregnated with gypsum, and after its removal, the treatment
process is completed with restorative therapy.
With conservative treatment, knee joint puncture is performed. After removing a certain amount of
blood, the blockade of the joint is eliminated. Next, a set of physiotherapy procedures is appointed,
which will be discussed below. This technique is suitable for patients suffering from meniscus
fractures, which are located in the area of blood supply.
Chondroprotectors are taken to return the cartilaginous tissue to its normal state. The intake of this
drug helps only in the early stages of the disease, since the chondroprotector is not able to
completely repair the completely destroyed cartilage. Do not forget that the treatment course is not
fast - its average duration reaches one and a half years. Sometimes the period of taking the medicine
is extended to 3 years. To determine the daily dose of the drug should consult with a doctor.
Chondroprotectors do not cause side effects, but since they contain a high level of glucose, diabetic
patients should take the drug with extreme caution. The drug is contraindicated for young children,
pregnant women and people who have allergic reactions to this drug. Among the most common are
the following chondroprotectors:
Surgical intervention
Operation on the knee joint meniscus is necessary if:
the meniscus is crushed;
a hemorrhage occurred in the joint cavity;
there was an absolute separation of the meniscus.
The most common operation of the meniscus is arthroscopy. Even with the most complex disorders,
arthroscopic surgery is performed with minimal surgical intervention. During the operation, an
endoscopic device is used, consisting of: a monitor, a stable light source and a video camera. A fluid
supercharger is also used. During the procedure, the joint cavity is constantly washed with saline
solution.
Among the advantages of arthroscopy is the following: