Rupture of the posterior horn of the medial meniscus of the knee joint - treatment, symptoms, complete analysis of the injury. Treatment of damage to the posterior horn of the medial meniscus Rupture of the posterior horn of the medial meniscus

Menisci in the human body can be found not only in the knees. They are also the cartilaginous lining in the clavicular and jaw joints. But it is the knee joint that constantly experiences increased loads. This is how degenerative changes develop over time. dorsal horn medial meniscus. Also, not only internal, but also external (lateral) cartilage can suffer.

Degenerative-dystrophic changes in the structure of the knee joints

Degenerative changes in the posterior horn of the medial meniscus

Normally, the joints of the knees of the left and right legs are protected from stress by the menisci. Two cartilages fix and cushion bones lower extremities, preventing most damage from normal walking. The meniscus ligaments secure the protective layer to the anterior and posterior protrusions (horns).

Over time, due to dystrophic phenomena and injuries, the menisci are damaged. Most often, the medial one suffers, since it is thinner. Over time, the picture of the disease gradually worsens, until the pathology begins to seriously affect the state of health and the ability to move the patient. There are 5 types of degeneration processes:

1. Meniscopathy. This is a dystrophic phenomenon, which is most often the result of another problem, such as arthritis, gout or osteoporosis. At the same time, the cartilage gradually becomes thinner and ceases to perform its functions.
2. Cystosis. Small tumors form in the cavity of the cartilage, which interfere with the normal movement of the joint and deform the surrounding tissues.
3. Degenerative rupture of the posterior horn of the medial meniscus. Similarly, the anterior or body of the cartilage may also rupture.
4. Rupture of meniscus ligaments. At the same time, the cartilage retains its integrity, but becomes too mobile, which can lead to subsequent injuries and dislocations.
5. Meniscus tear. In this case, the cartilage lining simply shifts from its place, which has an extremely negative effect on the ability to walk.

Doctors also distinguish several degrees of development of the disease, depending on which the doctor will prescribe one or a completely different treatment.

Reasons for the development of pathology

Knee injury as a result of degenerative changes in cartilage

Degenerative changes in the structure of cartilage occur not only due to bruises and fractures, when damaged bones begin to wear down cartilage. Much more often, the cause of such pathological phenomena is a person’s lifestyle or natural processes associated with the structural features of the body:

1. Hyperload. The main stratum of the population suffering from degenerative changes in the meniscus are athletes and dancers. Also at risk are people engaged in heavy physical labor. Separately, it is worth mentioning the problem of excess weight. Every day, extra pounds put extra strain on your knees, little by little damaging the menisci.
2. Improper formation of the musculoskeletal system. Degeneration is a side effect of dysplasia, flat feet and disorders in the development of the ligamentous apparatus. The body tries to compensate for all these problems with an additional load on the knees, which leads not only to meniscus dystrophy, but also to other chronic pathologies.
3. Diseases. Syphilis, tuberculosis, rheumatism and a number of other pathologies different nature impact on knee health. In addition, the treatment of these diseases can also provoke an aggravation of the condition of the joint. So glucocorticoids worsen the condition of the meniscus ligaments.

Damage to the articular cartilage manifests itself sharply only with severe injuries. Otherwise, this is a long process that can be reversed if timely treatment is taken up.

Signs of degeneration

The first symptoms of initial meniscal lesions are unlikely to cause a person to seek medical attention. Usually, signs of degenerative changes in the posterior horn of the medial meniscus appear when walking and running. It is enough to give a serious load on the joint to feel pain. At the same time, a person can still go in for sports and do morning exercises without much discomfort in injured knees. This is how the first stage of the disease begins.

But there are other symptoms according to the gradation proposed by the American sports doctor Stephen Stoller:

1. Zero degree. Completely healthy meniscus.
2. First degree. All damage remains inside the articular bag. Outwardly, you can only notice a slight swelling from the outer front of the knee. Pain occurs only with a strong load.
3. Second degree. Degenerative changes in the medial meniscus 2 tbsp. according to Stoller differ little from the first stage. The cartilage is ready to tear, but all the damage is still inside the joints. The swelling gets worse, as does the pain. When moving, characteristic clicks appear. The joints begin to numb with prolonged immobility.
4. Third degree. Cartilage stretch reaches its maximum possible value and ruptures the meniscus. A person feels severe pain and easily notices swelling above the knee. If there is a complete rupture of the tissues, then loose areas can move and block the joint.

Degenerative lesions of the posterior horn inner meniscus 2 and even 3 degrees can still be treated with conservative methods, if everything is done correctly. And the first guarantee of healing is timely diagnosis.

Knee examination

Degenerative damage to the posterior horn and body of the medial meniscus can be identified by a doctor simply by the characteristic swelling, blockage of the joint, and clicks. But for more accurate diagnosis and identifying the degree of damage to the joint, an additional examination will be required, which is carried out using hardware and laboratory methods:

1. ultrasound. Ultrasound helps to detect the cavities of the articular capsule filled with blood and exudate. Thanks to these data, the doctor can prescribe a further puncture.
2. MRI. The most accurate method showing the complete picture of the disease.
3. Puncture. With a pronounced tumor, the doctor may take a fluid sample to make sure there is no infection in the knee joints.

It can also be carried out additional research using an arthroscope. Through a small puncture in the tissues, a camera will be inserted into the joint, which will allow you to see what the damaged area looks like from the inside.

Healing procedures

In all situations, except for the complete separation of the meniscus, the doctor will insist on a conservative method of treatment. Surgical intervention best saved for last resort. First of all, it is necessary to reduce the mobility of the joint. Depending on the degree of degenerative changes, orthoses or bandages can be prescribed to fix the knee, or completely immobilize it. In addition, complex therapy will be prescribed:

1. Medical treatment. Medications used primarily as an aid. These are painkillers and anti-inflammatory tablets and ointments. The doctor will also prescribe a course of chondroprotectors. These substances will help restore and strengthen the meniscus, using the natural ability to regenerate. Bacterial infections will also require a course of antibiotics.
2. Hardware treatment. UHF, electrophoresis, shock wave therapy, acupuncture, iontophoresis, magnetic therapy and eosokerite improve knee health. The specific list of procedures will depend on the individual history and hospital capacity.
3. Puncture. The procedure is prescribed for a strong tumor that provokes pain syndrome and reduce joint mobility. Excess liquid is pumped out through the puncture. If necessary, drainage can be installed.

If conservative methods of treatment do not help, then it is necessary to wait for remission and go to surgery. The use of an arthroscope is usually sufficient. The only difference from the diagnostic procedure is that microinstruments will be inserted through 2 punctures and an incision. With their help, the doctor will sew up damaged tissue. Then the seams are also applied to soft tissues, and after a week you can already walk, though only with a cane.

Larger injuries may require endoprosthetics. In this case, instead of the collapsed cartilage, artificial substitutes will be installed. They are durable and usually do not require replacement for a couple of decades. Thus, it is possible to correct not only degenerative changes in the meniscus, but also a number of other related chronic pathologies knee joint.

In its structure, the knee joint is complex, since in addition to numerous components, it includes menisci. These elements are necessary to divide the articular cavity into two parts.

During movements, the meniscus plays the role of an internal stabilizer - together with the articular surfaces, it moves in the right direction.

When walking or running, menisci are needed as shock absorbers, as they soften shocks, as a result of which the human body practically does not feel shocks.

However, it is this ability of the menisci that causes them frequent injuries. In 90% of cases of injury, damage to the internal or medial meniscus occurs.

The meniscus is a dense cartilage plate located inside the joint cavity. The knee has two such elements - the lateral and medial menisci. Their appearance resembles a semicircle, and in the context they have the shape of a triangle. The meniscus consists of a posterior section (horns) and a central section (body).

The structure of these plates differs from the tissue of ordinary cartilage. It contains a huge amount of collagen fibers arranged in a strict order. The horns of the meniscus contain the largest accumulations of collagen. This explains the fact that the inner and central parts of the meniscus are more prone to injury.

These structures do not have specific attachment points, therefore, during movements, they are displaced inside the joint cavity. Restrictions in mobility exist at the medial meniscus, they are provided by the presence of an internal collateral ligament and fusion with the joint membrane.

These features often lead to degenerative or traumatic damage to the internal meniscus.

Meniscus injury and its characteristic features

This pathology occurs as a result of an injury to the knee joint. The injury can be direct, such as a sharp blow to the inner surface of the knee joint or a jump from a height. The joint cavity at the same time sharply decreases in volume, and the meniscus is injured by the end surfaces of the joint.

Injury by indirect variant is predominant. A typical mechanism for its occurrence is a sharp flexion or extension of the knee, while the leg is slightly tucked inward or outward.

Since the medial meniscus is less mobile, its separation from the collateral ligament and capsule occurs from a sharp displacement. When displaced, it is subjected to bone pressure, as a result of which it breaks and turns out.

The severity of the symptoms of pathology depends on the degree of damage to the cartilage plate. Displacement of the meniscus, the size of its rupture, the amount of blood flowing into the joint - these are the main changes that an injury entails.

There are three stages of rupture:

1. The mild stage is characterized by mild or moderate pain in the knee joint. Movement disorders are not observed. The pain is aggravated by jumping and squatting. Slightly noticeable swelling above the kneecap.
2. The middle stage is expressed by severe pain in the knee, which is similar in intensity to a bruise. The leg is always in a bent position, and extension is impossible even by force. When walking, lameness is noticeable. From time to time there is a "blockade" - complete immobility. Puffiness increases, and the skin becomes cyanotic.
3. In the severe stage, the pain becomes so acute that the patient simply cannot tolerate it. The most painful area is the kneecap area. The leg is in a motionless half-bent state. Any attempt at displacement leads to increased pain. The swelling is so severe that the affected knee can be twice the size of a healthy one. The skin around the joint is bluish-purple in color.

If the injury occurred in the medial meniscus, the symptoms of injury are always the same, regardless of its degree.

• Turner's symptom - the skin around the knee joint is very sensitive.
• Bazhov's reception - if you try to straighten your leg or press it on the kneecap with inside- the pain intensifies.
• Land's sign - when the patient lies in a relaxed position, the palm freely passes under the knee joint.

To confirm the diagnosis, the doctor prescribes an x-ray to the patient, in which a special fluid is injected into the cavity of the diseased joint.

Today, MRI is widely used to diagnose meniscal injuries, where the degree of damage is determined by Stoller.

Degenerative changes in the meniscus

Changes in the posterior horn of the medial meniscus are often based on various chronic diseases and prolonged microtraumas. The second option is typical for people of hard physical labor and professional athletes. Degenerative wear of the cartilage plates, which occurs gradually, and a decrease in the possibility of their regeneration provokes a sudden damage to the internal meniscus.

Common diseases that cause include rheumatism and gout. With rheumatism, the blood supply is disturbed due to the inflammatory process. In the second case, uric acid salts accumulate in the joints.

Since the nutrition of the menisci occurs due to intra-articular exudate, the processes described above cause them to "starve". In turn, due to damage to collagen fibers, there is a decrease in the strength of the menisci.

This damage is typical for people over forty years of age. Pathology can occur spontaneously, for example, a sharp rise from a chair. Unlike trauma, the symptoms of the disease are rather mild and may not be determined.

1. A constant symptom is a slight aching pain, which increases with sudden movements.
2. A slight swelling appears above the patella, which slowly but gradually increases, while the color of the skin remains unchanged.
3. Mobility in the joint is usually preserved, but from time to time "blockades" occur, which can be provoked by sharp flexion or extension.

In this case, it is difficult to determine the degree of degenerative changes in the medial meniscus. Therefore, X-ray or MRI is prescribed for diagnosis.

Diagnostic methods

For a correct assessment of the changes that have occurred in the cartilaginous plates, the identification of symptoms and the collection of detailed complaints are insufficient measures. The meniscus is inaccessible for direct inspection, as it is located inside the knee joint. Therefore, even the study of their edges by palpation is excluded.

To begin with, the doctor will prescribe a radiography of the joint in two projections. Due to the fact that this method only demonstrates the state of the osseous apparatus of the knee joint, it provides little information to determine the degree of damage to the meniscus.

To assess the intra-articular structures, air is introduced and contrast agents. Additional diagnostics is carried out using MRI and ultrasound.

Despite the fact that Stoller MRI is today a completely new and expensive method, its expediency in terms of studies of degenerative changes is undeniable. The procedure does not require special preparation. The only thing that is needed from the patient is patience, since the study is quite lengthy.

There should be no metal objects on the patient’s body and inside (rings, piercings, earrings, artificial joints, pacemaker, etc.)

Depending on the severity of the changes, according to Stoller, four degrees are distinguished:

1. Zero - a healthy, normal meniscus.
2. The first is that a point signal appears inside the cartilaginous plate, which does not reach the surface.
3. The second is a linear formation, but it does not yet reach the edges of the meniscus.
4. Third - the signal reaches the very edge and violates the meniscus integrity.

The technique of research by ultrasonic waves is based on different tissue densities. Reflecting from the internal knee structures, the sensor signal demonstrates degenerative changes in the cartilage plates, the presence of blood inside the joint and detached fragments. But this signal cannot see through the bones, therefore, when examining the knee joint, the field of its visibility is very limited.

Signs of rupture in case of damage are the displacement of the meniscus and the presence of heterogeneous zones in the plate itself. To additional symptoms include violations of the integrity of the ligaments and joint capsule. The presence of inclusions in the synovial fluid indicates a hemorrhage into the cavity.

The choice of treatment method is based on changes in the meniscus plate. With a mild and moderate degree of degenerative changes (without violating integrity), a complex of conservative therapy is prescribed. In the event of a complete rupture, surgical treatment is carried out to preserve the function of the limb, in particular, arthroscopy is prescribed - an operation with minimal trauma.

Good afternoon!

IM 42 years old. I live in Kurgan. Approximately 2 years periodically there were pains in the left knee joint. Recently, pain during sudden movements has become daily. He turned for advice to the Ilizarov Medical Center. They did an MRI. Diagnosis: Rupture of the posterior horn of the medial meniscus. synovitis. DOA 1 st, Chondromalacia of the patella 2 st. Increased fluid in the joint cavity. The medial meniscus has a heterogeneous structure, with a linear horizontal section of a hyperintense signal at the level of the posterior horn with a transition to the lower articular surface. Lateral meniscus of heterogeneous structure. The doctor immediately said that only surgery was recommended to me, there were no other options. I would like to know your opinion. Thank you.

Answer to the question:

Hello! Injuries to the menisci of the knee joint lead to pain, disturbances in walking, instability of the body position. Further destruction of these cartilage formations contributes to the progression of arthrosis of the knee joint and leads to long-term disability or even disability.

If part of the meniscus is torn, conservative treatment is possible, but it usually helps only in the initial stage of the disease. With a long course of the disease, surgery is indicated. By itself, a meniscus tear will not "heal", and over time, the disease will only progress.

In the RNC "WTO" them. acad. The Ilizarov department, where arthroscopic treatment of knee meniscal injuries is carried out, has existed for many years. This is a federal institution, well equipped, and doctors have a lot of experience in performing such procedures. Therefore, you should not refuse the operation because of possible doubts about the professionalism of the center's employees.

If the meniscus horn is damaged during arthroscopy, it can either be “sewn” to the undamaged part or removed. It depends on the severity of the damage. In any case, this is a low-traumatic intervention. Removal of a small part of the meniscus leads to only a minimal reduction in the contact surface of the knee joint, and therefore the recovery time after such an operation is short.

The operation is indicated for pain in the knee, repeated blockades ("jamming") of the joint, mobility restrictions in it, inefficiency of the performed drug treatment and LFC. It is also prescribed for a rupture longer than 1.5 cm.

After the operation, a bandage is applied, you can bend the knee immediately. In the first 2 - 3 days, it is recommended to use a cane or crutch, by the 10th day, full load on the joint is already allowed. The length of stay in the hospital is 3-4 days, the ability to work is restored in about a month.

In young patients, doctors often choose the most gentle methods, that is, they do not remove the torn part of the meniscus, but sew it on. Therefore, in the future, the function of the joint is fully restored.

Another important argument in favor of the operation in your case is cost-effectiveness. In the future, long courses of chondroprotectors and other expensive drugs will not be needed. You won't have to take sick leave if your joint pain worsens, and you won't need arthroplasty in the future.

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The menisci are very important structural units of the knee joint. They are curved strips of fibrous cartilage that sit between the bones of a joint. The shape resembles a crescent with elongated edges. It is customary to divide them into zones: the body of the meniscus (middle part); elongated end parts - the posterior and anterior horns of the meniscus.

There are two menisci in the knee joint: medial (inner) and lateral (outer). They are attached to the tibia with their ends. The medial is located on the inside of the knee and is connected to the internal lateral ligament. In addition, it is connected along the outer edge with the capsule of the knee joint, through which partial blood circulation is provided.

The cartilaginous portion of the meniscus adjacent to the capsule contains significant amount capillaries and is supplied with blood. This part of the medial meniscus is called the red zone.

The middle region (intermediate zone) contains a small number of vessels and is very poorly supplied with blood. Finally, the inner region (white zone) has no circulatory system at all.

The lateral meniscus is located in the outer region of the knee. It is more mobile than the medial, and its damage occurs much less frequently.

Menisci perform very important functions. First of all, they play the role of shock absorbers during the movement of the joint. In addition, the menisci stabilize the position of the entire knee in space. Finally, they contain receptors that send operational information to the cerebral cortex about the behavior of the entire leg.

When the inner meniscus is removed, the area of ​​contact of the knee bones decreases by 50-70%, and the load on the ligaments increases by more than 100%. In the absence of an external meniscus, the contact area will decrease by 40-50%, but the load will increase by more than 200%.

The meniscus is a cartilaginous lining that is located between the joints and acts as a shock absorber.

During motor activity, the menisci can change their shape, so that the gait is smooth and does not pose a danger.

The knee joint contains the outer (lateral) and inner (medial) menisci.

The medial meniscus is less mobile, so it is prone to various injuries, among which ruptures should be noted.

Each meniscus can be divided into three parts: anterior horn, posterior horn, body.

The posterior horn of the meniscus, which is the inner part, is distinguished by the absence of a circulatory system. The circulation of synovial fluid is responsible for nutrition.

In this regard, damage to the posterior horn of the medial meniscus is irreversible, because the tissues are not designed for regeneration. The injury is difficult to diagnose, in connection with which magnetic resonance imaging is a mandatory procedure.

Injuries to the meniscus can be due to various diseases and other causes. Knowing all the reasons that increase the risks, you can guarantee the preservation of an ideal state of health.

• Mechanical injury can be obtained due to third-party mechanical impact. The danger is due to the combined nature of the damage. In most cases, several elements of the knee joint are affected at once. The injury can be global and include damage to the ligaments of the knee joint, rupture of the posterior horn of the medial meniscus, rupture of the body of the lateral meniscus, fracture of the articular capsule. In this situation, treatment should be started in a timely manner and should be thoughtful, since only in this case it is possible to avoid unwanted complications and restore all functions.
• Genetic causes suggest a predisposition to various diseases joints. Diseases can be hereditary or be a congenital disorder. In many cases, chronic diseases of the knee joint develop due to the fact that the menisci quickly wear out, lack nutrition, and blood circulation is disturbed in the knee joint. Degenerative lesions may appear early. Damage to the cartilage ligaments and menisci can occur in young age.
• Pathologies of the joints due to transferred or chronic diseases, usually attributed to the biological type of damage. As a result, the risk of injury increases due to exposure to disease-causing microbes. Ruptures of the horn or body of the meniscus, abrasion, tearing of fragments may be accompanied by inflammatory processes.

It should be noted that the above list represents only the main causes.

A common injury to the cartilage plate is a tear, complete or incomplete. Professional athletes and dancers are often injured, and whose specialty is associated with high loads. Injuries occur in the elderly, and as a result of accidental, unforeseen stress on the knee area.

Damage to the body of the posterior horn of the medial meniscus occurs for the following main reasons:

• increased, sports loads (jogging over rough terrain, jumping);
• active walking, prolonged squatting position;
• chronic, articular pathologies in which inflammation of the knee region develops;
• congenital articular pathology.

These causes lead to injuries of the meniscus of varying severity.

Classification

Symptoms of trauma to the cartilage elements depend on the severity of the damage to the cartilage tissue. There are the following stages of internal meniscal damage:

• Stage 1 (easy). Movement of the injured limb is normal. Pain is weak, and becomes more intense during squats or jumps. There may be slight swelling above the kneecap;
• Grade 2 injury is accompanied by severe pain. It is difficult to straighten the limb even with outside help. You can move with a limp, but at any moment the joint can become blocked. Puffiness gradually becomes more and more, and skin covering changes shade;
• damage to the posterior horn of the medial meniscus of the 3rd degree is accompanied by pain syndromes of such intensity that it is impossible to endure. It hurts the most at the location of the kneecap. Any physical activity is impossible. The knee becomes larger in size, and the skin changes its healthy color to purple or cyanotic.

If the medial meniscus is damaged, the following symptoms exist:

1. pain intensifies if you press on the patella from the inside and at the same time straighten the limb (Bazhov's technique);
2. the skin of the knee area becomes too sensitive (Turner's symptom);
3. when the patient lies down, the palm passes under the injured knee without problems (Land's symptom).

After the diagnosis is made, the doctor decides which treatment method to apply.

The meniscus is a cartilaginous tissue that consists of fibers and serves as a shock absorber for the knee joint. It looks like two crescents, their ends are called horns.

The small crescent is the outer (lateral) part of the meniscus, and the large crescent is the inner (medial).

Breaks are of different types:

• vertical and horizontal;
• oblique and transverse;
• degenerative;
• ruptures of the posterior and anterior horns of the meniscus.

But most often there is a rupture of the posterior horn of the inner meniscus, since it is less mobile.

Causes

Degenerative-dystrophic processes do not develop in healthy body. This must be preceded by violations at various levels: local and general.

They have a clear relationship, which distinguishes the development of pathology from traumatic injuries, when only a mechanical effect on the knee joint is sufficient. Undoubtedly, injuries and prolonged excessive stress on the joints are the key points in the formation of degenerative changes, but there are other conditions that contribute to such processes:

• Dysplasia of the knee.
• Obesity.
• Gout.
• Rheumatoid arthritis.
• Rheumatism.
• Osteoarthritis.
• Infectious diseases(tuberculosis, brucellosis, yersiniosis).
• Connective tissue diseases (lupus erythematosus, scleroderma).
• Endocrine pathology(hypothyroidism).
• Systemic vasculitis.

Dystrophic processes in the knee joint are largely due to metabolic, immune, endocrine and vascular disorders, which can occur in conjunction with age-related changes that inevitably appear after 50 years.

Degenerative changes in the menisci develop due to many reasons. In most cases, there is a combined effect of adverse factors.

Now experts point to only one reason for the appearance of a gap - an acute injury. This is explained by the fact that no other impact on the joint can cause damage to the cartilage responsible for cushioning.

It is also worth noting that there are the following risk factors that predispose to rupture:

• congenital weakness of the joints;
• regular jumping, running on uneven surfaces;
• injuries resulting from degenerative diseases;
• rotational movements performed on one leg without taking it off the ground;
• long-term squatting;
• strenuous walking.

Damage to the posterior horn of the medial meniscus is a polyetiological pathological condition that develops under the influence of various factors:

• The impact of kinetic force in the knee area in the form of a blow or fall on it.
• Excessive bending of the knee, leading to tension in the ligaments that fix the menisci.
• Rotation (rotation) of the femur with a fixed lower leg.
• Frequent and long walking.
• Congenital changes that cause a decrease in the strength of the knee ligaments, as well as its cartilage.
• Degenerative-dystrophic processes in the cartilaginous structures of the knee, leading to their thinning and damage. This reason most commonly occurs in the elderly.

Finding out the causes allows the doctor not only to choose the optimal treatment, but also to give recommendations regarding prevention. re-development.

Injury to the posterior horn of the lateral meniscus has a different character in different patients. The causes of injury largely depend on the age of the person. So, in young people under 35, the cause of injury most often becomes a mechanical effect. In older patients, the cause of rupture of the posterior horn is most often a degenerative change in the tissues of the meniscus.

In women, rupture of the posterior horn of the external meniscus occurs less frequently than in men, and the rupture itself is, as a rule, of an organic nature. In children and adolescents, a tear in the posterior horn also occurs - usually due to awkward movement.

Mechanical injury can have two possible causes: direct impact or rotation. Direct impact in this case is associated with a strong blow to the knee.

The foot of the victim at the moment of impact is usually fixed. Damage to the posterior horn is also possible with awkward, sharp bending of the leg at the knee joint.

Age-related changes in the meniscus significantly increase the risk of injury.

The rotational mechanism of injury implies that a meniscus tear occurs in the event of a sharp twisting (rotation) of the ankle with a fixed foot. The condyles of the lower leg and thigh with such rotation are displaced in opposite directions. The meniscus is also displaced when attached to the tibia. With excessive displacement, the risk of rupture is high.

Types of breaks

Most limb injuries occur in inner part(more than 70%). The outer part suffers less frequently (about 20%). And only 5% are cases of damage to both types of meniscus.

There are the following types of breaks:

• vertical gap (longitudinal);
• oblique;
• degenerative;
• transverse (radial);
• horizontally;
• injury to the horns (anterior or posterior).

We will tell you more about the types of meniscus rupture and the types of treatment.

Rupture of the posterior horn of the medial meniscus

As already noted, many people experience combined injuries of the meniscus, including a tear or avulsion of the posterior or anterior horn.

• Detachments or the appearance in the capsule of the knee joint of a part of the meniscus, torn off due to abrasion or damage, are one of the most common cases in traumatology. It is customary to refer to these types of damage the formation of a fragment by tearing off part of the meniscus.
• Tears are injuries in which part of the meniscus is torn. In most cases, ruptures occur in the thinnest parts, which should take an active part in motor activity. The thinnest and most functional parts are the horns and the edges of the menisci.

Depending on the main causative factor that led to the development pathological condition cartilaginous structures of the knee, traumatic and pathological degenerative damage to the posterior horn of the medial meniscus is distinguished.

According to the criterion of prescription of an injury or a pathological violation of the integrity of this cartilaginous structure, fresh and chronic damage to the posterior horn of the medial meniscus is distinguished. Combined damage to the body and the posterior horn of the medial meniscus is also highlighted separately.

Signs of breaks

Damage to the medial meniscus most often occurs with exercise: running on terrain, spinning on one leg, lunges and other situations.

Depending on the clinical manifestations Distinguish acute and chronic rupture of the medial meniscus. A distinctive feature of the first form is intense pain of a sudden nature, localized along the line of the joint gap, where the cartilage layer was presumably damaged.

Other typical symptoms of a torn medial meniscus of the knee include:

• severe limitation of motor ability (if the torn off area blocks the movement of the joint);
• hemarthrosis (bleeding into the joint cavity);
• edema.

Note: With a bent knee, a person does not always feel intense pain. It appears more often when trying to straighten the leg. This is hallmark injury to the inner part of the intercartilaginous lining.

Usually, a rupture of the meniscus of the knee joint occurs due to an unnatural position of the knee or pinching of the cartilage cavity after injury to the knee area.

The main symptoms include:

1. Intensive pain syndrome, the strongest peak of which occurs at the very moment of injury and lasts for some time, after which it may fade away - a person will be able to step on his foot with some restrictions. It happens that the pain is ahead of a soft click. After a while, the pain changes into another form - as if a nail was stuck in the knee, it intensifies during the flexion-extension process.
2. Puffiness that appears after a certain time after injury.
3. Blocking of the joint, its jamming. This symptom is considered the main one during the rupture of the medial meniscus, it manifests itself after mechanical clamping of the cartilaginous part by the bones of the knee.
4. Hemarthrosis, manifested in the accumulation of blood inside the joint when the red region of the meniscus is injured.

The main symptom of a torn meniscus is severe pain in the knee joint. When the posterior horn is torn, the pain is localized mainly in the popliteal region. If you touch the knee with palpable pressure, the pain increases dramatically. It is almost impossible to move due to pain.

information to read

Symptoms

In case of damage to the meniscus of the knee joint, two characteristic periods are distinguished - acute and chronic. The acute period lasts 4-5 weeks and is characterized by a number of painful symptoms.

The moment of damage to the meniscus, as a rule, is determined by the sound, resembling a crack, and a sharp pain in the knee area. In the first period after an injury, cracking and pain accompanies a person during exertion (for example, walking up stairs).

Swelling develops in the knee area. Often, a meniscus tear is accompanied by hemorrhage into the joint.

Rupture of the medial meniscus of the knee joint has a number of characteristic symptoms. Injury to the internal posterior horn of the meniscus causes intense pain in the knee area from the inside. When you press your finger in the area where the meniscus horn is attached to knee ligament appears sharp pain. A tear in the posterior horn causes blockage of movement in the knee joint.

You can determine the gap by making flexion movements. It manifests itself in the form of a sharp pain when the leg is extended and the lower leg is turned outward.

The pain also pierces with strong bending of the leg at the knee. According to the severity of damage to the meniscus of the knee joint are divided into small, moderate and severe degree.

Small tears (partial), including the horns of the meniscus, are characterized by pain and slight swelling in the knee area. Such signs of injury cease to appear after 3-4 weeks.

With a moderate degree of injury, all the considered symptoms of the acute period appear, but they are limited and manifest themselves during physical exertion, such as jumping, moving up inclined planes, and squatting. Without treatment, this form of injury becomes chronic. This degree is characteristic of some ruptures of the anterior and posterior horns of the medial meniscus.

With a severe degree of injury, pain and swelling of the knee become obvious; hemorrhage occurs in the joint cavity. The horn is completely detached from the meniscus, and its parts are inside the joints, which causes a blockade of movements. Independent movement person is difficult. Severe injury requires surgical intervention.

Traumatic breaks.

After this injury, a person may feel pain and notice swelling of the knee.

If you experience pain when descending the stairs, you can suspect a rupture of the back of the meniscus.

When the meniscus is torn, one part can come off, after which it will hang out and interfere with the full functioning of the knee joint. Small tears can cause difficulty moving and painful clicking in the knee joint.

A large tear leads to blockade of the knee joint, due to the fact that the torn and dangling part of the meniscus moves to the very center and begins to interfere with various movements.

Damage to the posterior horn of the medial meniscus in most cases is limited to a violation motor activity knee joint and knee flexion.

In case of injury, sometimes pain sensations are especially strong, as a result of which a person cannot step on his foot. In other cases, the tear may only cause pain when certain movements are performed, such as going up or down stairs.

Acute break.

In this case, a person may suffer from swelling of the knee, which develops in a minimum time and is particularly pronounced.

degenerative breaks.

Many people over the age of forty suffer from degenerative meniscus tears that are chronic.

Strengthening of the pain syndrome and swelling of the knee is not always possible to detect, since their development occurs gradually.

In more detail, the signs of a meniscus tear have already been considered in one of the previous articles, so we will focus only on the main points. Usually, an injury occurs when the parts of the joint are in an unnatural position at a particular moment (namely, at the moment of rupture). Less commonly, this happens as a result of cartilage pinching.

Note! As a rule, a rupture is accompanied by other joint injuries, which means that in some cases it is a rupture that is not so easy to identify in differential diagnosis.

1. Sharp pain. It is especially acute at the moment of injury and lasts for several minutes. Sometimes, before the onset of pain, you can hear a characteristic click in the knee. After a while, the pain syndrome fades away, a person can walk again, but this is not easy for him.

   The next morning, another pain is felt - as if a nail was stuck in the knee - which only intensifies with flexion / extension.

2. Puffiness. Usually it does not appear immediately, but several hours after the injury.
3. "Jamming" of the joint (blockade). This is the main sign of a rupture of the medial meniscus, which occurs after the separated part of the cartilage is clamped by the bones, and the motor functions of the limb are impaired. It is worth knowing that this symptom is also observed with sprains, so about true reason pain can only be recognized after diagnosis.
4. Intra-articular accumulation of blood (hemarthrosis). This happens if the "red zone" of the depreciation cartilage layer is damaged.

Today, medicine differentiates between acute rupture and chronic (launched), which is possible due to the use of hardware diagnostics. So, the "fresh" gap has smooth edges, it is accompanied by hemarthrosis. In the case of a chronic injury, the cartilage is multifibered, swelling caused by the accumulation of fluids is observed.

Diagnostics

To make a final conclusion about meniscopathy, it is necessary to conduct an imaging examination. This includes x-rays or magnetic resonance imaging.

The latter method has significant advantages, since it allows you to accurately assess the state of intra- and periarticular soft tissues, and does not have radiation exposure. According to the results of tomography, the degree of damage to the meniscus is determined (according to Stoller):

• 1 - focal changes that do not reach the surface layer.
• 2 - linear changes that do not reach the surface layer.
• 3 - changes reach the surface of the meniscus.

One can speak of a true break only in the latter case. In addition, the picture clearly shows the dislocation of cartilaginous structures, a change in shape, and the detachment of one of the horns.

With acute pain you can not joke, as well as with all the above symptoms. A visit to the doctor with a rupture of the posterior horn of the medial meniscus or with other types of ruptures of the cartilage tissues of the knee is mandatory. It must be done within a short period of time.

In a medical institution, the victim will be examined and sent to:

1. X-ray, which is used for visible signs gap. It is considered not particularly effective and is used to exclude concomitant bone fracture.
2. Ultrasound diagnostics, the effect of which directly depends on the qualifications of the traumatologist.
3. MRI and CT, which is considered the most reliable way to determine the gap.

Based on the results of the above methods of examination, the selection of treatment tactics is performed.

Arthroscopy also allows for therapeutic manipulations under visual control after additional introduction of special microinstrumentation into the joint cavity.

Treatment

Treatment of a tear in the posterior horn of the medial meniscus (similar to that of the anterior horn of the medial meniscus) depends on the site of the injury and its severity. Based on this, the method is determined - conservative or surgical treatment.

The conservative (therapeutic) method is applicable for small ruptures and a rupture of moderate severity. Such treatment is based on a number of therapeutic interventions and is often effective.

The first event is to provide assistance in case of injury. To do this, it is necessary to provide the victim with peace; apply a cold compress on the inside of the knee; inject an anesthetic; apply a plaster bandage. If necessary, fluid should be punctured.

Usually the conservative method involves long-term treatment for 6-12 months. Initially, reduction (reposition) of the knee joint is performed in the presence of a blockade. Manual methods can be used to remove the blockade. For the first 3 weeks, rest should be ensured, and the knee joint should be immobilized with a plaster splint.

When cartilage is damaged, it is necessary to repair and repair them. For this purpose, a course of taking chondroprotectors and hyaluronic acid is prescribed.

As protectors, the use of drugs containing chondroitin and glucosamine is recommended. Painful symptoms and inflammatory processes must be eliminated by taking non-steroidal anti-inflammatory drugs (diclofenac, ibuprofen, indomethacin) and others.

To eliminate puffiness and accelerate healing, external agents are used in the form of ointments (Amzan, Voltaren, Dolgit and others). The treatment process includes a course of physiotherapy and special therapeutic exercises. good effect gives therapeutic massage.

It is necessary to treat meniscopathy of the knee joint in a complex manner. Apply conservative and operative methods.

Depending on the severity of the disease, the effect of the drugs used may be different. To achieve maximum result, you should follow all the recommendations of the doctor.

And first of all, it is necessary to reduce the load on the sore leg. You can wear an elastic bandage or a knee brace, but completely immobilizing the joint with a cast is fundamentally wrong - this will not improve its function, but will lead to contractures.

Degenerative-dystrophic changes in the menisci require persistent and intensive therapy, which can take quite a long time.

Medical therapy

The pathology of the knee joint, including meniscal damage, requires the use of medications. Drugs are especially needed for acute ruptures, but chronic processes cannot be effectively corrected without drugs.

With dystrophic changes, it is important to normalize the biochemical processes in the body. To improve the condition of the meniscus and reduce symptoms, use the following medicines:

• Non-steroidal anti-inflammatory.
• Chondroprotectors.
• metabolic.
• Vascular.
• Vitamins.

All drugs should be taken according to the recommendations of a specialist. Self-medication is not allowed.

Physiotherapy

They also use the possibilities of physiotherapy to restore the integrity of the meniscus. For this purpose, some procedures are used: electro- and phonophoresis, laser and wave treatment, magnetic, paraffin and balneotherapy.

Which of them are indicated in each case, the doctor will determine. But a pronounced effect from the isolated use of physiotherapy should not be expected - it is used only in combination with other methods.

Physiotherapy

Even with meniscus ruptures, exercise therapy is indicated. It should include exercises aimed at strengthening the thigh muscles - the anterior and posterior groups. This allows you to stabilize the knee and eliminate its instability. But still, you should be careful during classes, exclude sudden movements, especially rotational ones.

Conservative measures are good for small tears, as well as for the elderly, who often have signs of osteoarthritis.

Operation

If the damage to the internal or external meniscus reaches 3 degrees according to Stoller, they are of considerable size and are accompanied by severe symptoms, as well as with the ineffectiveness of previous therapy, that is, all indications for surgical intervention. Only a doctor can determine when the operation should begin, but you should not hesitate with this.

The most common surgical treatment is arthroscopic surgery. This is a minimally invasive technology that can be used to perform a meniscectomy (partial removal), suture, transplant or meniscus arthroplasty.

Pain in the knee may appear due to the development of degenerative processes and rupture of the meniscus. It is important to carry out treatment in a timely manner in order to restore damaged tissues. What is better to use - conservative therapy or surgery - is determined by the clinical situation.

After an accurate diagnosis has been made, it is necessary to begin treatment in a hospital setting.

Minor fractures require conservative treatment. The patient takes anti-inflammatory and analgesic drugs, undergoes manual therapy and physiotherapy.

Serious damage requires surgery. In this case, the torn meniscus must be sutured. If repair is not possible, the meniscus should be removed and a menisectomy performed.

Recently, arthroscopy, which is an invasive technique, has become increasingly popular. It is important to note that arthroscopy is a low-traumatic method, characterized by the absence of complications in the postoperative period.

After surgery, the patient must spend some time in the hospital under medical supervision. AT without fail rehabilitation treatment should be prescribed to promote a full recovery. Rehabilitation includes therapeutic exercises, taking antibiotics and drugs to prevent inflammatory processes.

If symptoms of the third degree of severity are obvious, it is necessary to provide first aid and call an ambulance. Before the doctors arrive, the victim must not be allowed to move. Ice should be applied to relieve pain and avoid severe swelling.

When the paramedics arrive, they will give you an injection of painkillers. After that, it will be possible, without torturing the victim, to impose a temporary splint.

This is necessary to immobilize the knee joint and prevent damage from worsening. You may need to drain fluid and blood from the joint cavity. The procedure is quite painful, but necessary.

How to treat depends on the strength of the gap and localization. The primary task of the doctor is to choose between conservative therapy and surgical.

Options

If the edges of the cartilage are torn and the flaps are blocking movement, surgery will be required. You can’t do without it either if the position of the bones relative to each other is disturbed, or the meniscus is crushed.

The surgeon can carry out the following actions:

• sew up cartilage flaps;
• remove the entire joint or posterior horn;
• fix parts of the cartilage with fixing parts made of bioinert materials;
• transplant this part of the joint;
• restore the shape and position of the knee joint.

In order for the acute form not to become chronic, it is necessary to immediately begin treatment. If treatment is started late, then the tissue begins to acquire significant destruction, turning into tatters. Tissue destruction leads to cartilage degeneration, which in turn leads to knee arthrosis and his immobility.

Stages of conservative treatment

The conservative method is used in the acute non-started stage on early dates the course of the disease. Therapy by conservative methods consists of several stages.

• Relieve inflammation, pain and swelling with non-steroidal anti-inflammatory drugs (NSAIDs).
• In cases of “jamming” of the knee joint, reposition is applied, that is, reduction with the help of manual therapy or traction.
• Physiotherapy.
• Massotherapy.
• Physiotherapy.

• Treatment with chondroprotectors.
• Joint treatment hyaluronic acid.
• Treatment with folk remedies.
• Pain relief with analgesics.
• Plaster cast (on doctor's recommendation).

Stages of surgical treatment

Surgical method it is used only in the most extreme cases, when, for example, the tissue is so damaged that it cannot be restored, or if conservative methods have not helped.

Surgical methods for repairing torn cartilage consist of the following manipulations:

• Arthrotomy - partial removal of damaged cartilage with extensive tissue damage;
• Meniscotomy - complete removal of cartilage tissue; Transplantation - moving the donor meniscus to the patient;
• Endoprosthetics - the introduction of artificial cartilage into the knee;
• Stitching of damaged cartilage (performed with minor damage);
• Arthroscopy - knee puncture in two places in order to carry out the following cartilage manipulations (for example, stitching or arthroplasty).

To treat this kind of injury, like any other, it is necessary immediately after the injury.

Important! If left untreated for a long time, the rupture can become chronic.

Treatment not taken in time can lead to destruction of the cartilage of the knee joint, inflammation, changes in its structure and arthrosis. To avoid these troubles, you should immediately visit a doctor as soon as an injury occurs.

Conservative method of treatment

A tear in the posterior horn of the medial meniscus of the knee is usually treated without surgery. With the exception of severe trauma that requires prompt assistance. Treatment takes place in several stages:

1. If there is a blockade of the joint, then it must be removed. This is done using manual methods or with hardware traction of the joint.
2. Edema is removed by anti-inflammatory drugs (Diclofenac, Indomethacin).
3. Pain relief with painkillers (Ibuprofen, Paracetamol).
4. After relieving pain and inflammation, you need to start exercising. physical therapy to physiotherapy and massage.
5. The longest stage is the restoration of the cartilage that makes up the menisci. For this, preparations containing chondroitin sulfate and hyaluronic acid are prescribed.

It is necessary to take these medicines for a long time, one course can reach up to six months. It is necessary to repeat their intake annually to prevent deterioration of the cartilage.

In some cases, after stretching the joint, plaster is applied. This is done in order to provide the joint with peace and immobility for a certain time. But such a measure is not taken in all cases.

Operative methods of treatment

In the case when the above method of treatment does not have the desired effect on the damaged part, they resort to a surgical method of treatment. If the body of the meniscus itself is damaged, then most often it can be stitched.

There are several types of operations for the treatment of damage to the meniscus horn, but some of them are currently performed extremely rarely, as they are considered ineffective or even harmful. These include, for example, arthrotomy. This is the removal of damaged cartilage tissue, which is carried out with a full opening of the knee.

Surgical methods for the treatment of a torn meniscus of the knee joint are currently aimed at preserving or restoring it. They are of several types:

1. Partial meniscectomy. In this case, the edges of the meniscus are cut off at the site of the lesion, and their remaining part is restored.
2. Arthroscopy. The operation, which is performed through three punctures in the knee joint. One of them introduces the tools necessary for manipulation. In the other, saline enters and washes away unnecessary particles of cartilage, accumulated blood, and so on. A camera is inserted into the third puncture, through which the surgeon can see everything that happens inside the knee, and thereby controls the entire process.
3. Transplantation. The donor's meniscus is transplanted to the patient.
4. Endoprosthetics. An artificial organ is implanted into the knee joint.

Regardless of the method of operation, after it, complete rest of the knee joint and protection from the effects of cold are necessary.

After an objective diagnosis with the determination of localization, the severity of the violation of the integrity of the cartilaginous structures of the joint, the doctor prescribes a comprehensive treatment. It includes several areas of action, which include conservative therapy, surgical intervention, as well as subsequent rehabilitation.

Mostly all events complement each other and are assigned sequentially.
.

Treatment without surgery

If partial damage to the posterior horn of the medial meniscus was diagnosed (grade 1 or 2), then conservative treatment is possible. It includes the use of drugs of various pharmacological groups(non-steroidal anti-inflammatory drugs, vitamin preparations, chondroprotectors), performing physiotherapeutic procedures (electrophoresis, mud baths, ozocerite).

During therapeutic measures, functional rest for the knee joint is necessarily ensured.
.

Surgical intervention

The main goal of the operation is to restore the anatomical integrity of the medial meniscus, which allows to ensure the normal functional state of the knee joint in the future.

Surgical intervention can be performed with open access or with the help of arthroscopy. Modern arthroscopic intervention is considered the method of choice, as it has less trauma, can significantly reduce the duration of postoperative, rehabilitation period.

For small tears, non-surgical treatment is preferred. Good results in the blockade of the joint are given by puncture - the removal of blood helps to "free" the joint and eliminate the blockade. Further treatment consists in undergoing a series of physiotherapy procedures: therapeutic gymnastics, electromyostimulation and massage.

Often, with conservative treatment, drugs from the group of chondroprotectors are also prescribed. However, if there is severe damage to the posterior horn, then this measure will not be able to completely restore the meniscus tissue. In addition, the course of chondroprotectors often lasts more than one year, which stretches the treatment over time.

With significant gaps, surgical treatment may be prescribed. The most commonly used method is arthroscopic removal of part of the meniscus. Complete removal is not practiced, because in the absence of a meniscus, the entire load falls on the knee cartilage, which leads to their rapid erasure.

Surgical treatment

When the meniscus is injured, the following points serve as indications for surgical manipulations:

• severe injuries;
• when cartilage is crushed and tissues cannot be restored;
• severe injuries of the meniscus horns;
• tear of the posterior horn;
• articular cyst.

The following types of surgical procedures are performed in case of damage to the posterior horn of the shock-absorbing cartilage plate:

1. resection of torn elements, or meniscus. This kind of manipulation is performed with incomplete or full anguish;
2. restoration of destroyed tissues;
3. replacement of destroyed tissue with implants;
4. meniscus stitching. Such surgical intervention is carried out in case of fresh damage, and immediate medical attention is sought.

Let us consider in more detail the types of surgical treatment of knee injuries.

Arthrotomy

The essence of arthrotomy is reduced to the complete resection of the damaged meniscus. Such an operation is performed in rare cases when the articular tissues, including blood vessels, are completely affected and cannot be restored.

Modern surgeons and orthopedists have recognized this technique as ineffective, and is practically not used anywhere.

Partial meniscectomy

When repairing the meniscus, the damaged edges are trimmed so that there is a flat surface.

Endoprosthetics

A donor organ is transplanted to replace the damaged meniscus. This type of surgical intervention is not often performed, because the rejection of donor material is possible.

Stitching of damaged tissue

Surgical treatment of this type aims to restore the destroyed cartilage tissue. Surgical intervention this type gives positive results if the injury has affected the thickest part of the meniscus, and there is a possibility of fusion of the damaged surface.

Stitching is performed only with fresh damage.

Arthroscopy

Surgery using arthroscopic techniques is considered the most modern and effective method of treatment. With all the advantages during the operation, trauma is practically excluded.

To perform the operation, several incisions are made in the articular cavity. small size, through which the instrumentation is introduced along with the camera. Through the incisions, during the intervention, a saline solution is supplied.

The technique of arthroscopy is remarkable not only for its low traumatism during the procedure, but also for the fact that you can simultaneously see the true state of the damaged limb. Arthroscopy is also used as one of the diagnostic methods when making a diagnosis after damage to the meniscus of the knee joint.

When thinking about surgery, people often worry about things that don't deserve attention and miss important things. To understand whether the operation is useful or not, reviews will help.

megan92 2 weeks ago

Tell me, who is struggling with pain in the joints? My knees hurt terribly ((I drink painkillers, but I understand that I am struggling with the consequence, and not with the cause ... Nifiga does not help!

Daria 2 weeks ago

I struggled with my sore joints for several years until I read this article by some Chinese doctor. And for a long time I forgot about the "incurable" joints. Such are the things

megan92 13 days ago

Daria 12 days ago

megan92, so I wrote in my first comment) Well, I'll duplicate it, it's not difficult for me, catch - link to professor's article.

Sonya 10 days ago

Isn't this a divorce? Why the Internet sell ah?

Yulek26 10 days ago

Sonya, what country do you live in? .. They sell on the Internet, because shops and pharmacies set their margins brutal. In addition, payment is only after receipt, that is, they first looked, checked and only then paid. Yes, and now everything is sold on the Internet - from clothes to TVs, furniture and cars.

Editorial response 10 days ago

Sonya, hello. This drug for the treatment of joints is really not realized through pharmacy chain to avoid overpricing. Currently, you can only order Official website. Be healthy!

Sonya 10 days ago

Sorry, I didn't notice at first the information about the cash on delivery. Then, it's OK! Everything is in order - exactly, if payment upon receipt. Thanks a lot!!))

Margo 8 days ago

Has anyone tried folk methods joint treatment? Grandmother does not trust pills, the poor woman has been suffering from pain for many years ...

Andrew a week ago

What kind of folk remedies I have not tried, nothing helped, it only got worse ...

How dangerous is the rupture of the posterior horn of the medial meniscus of the knee joint, the treatment of damage to the horns of the meniscus - these issues are of interest to patients. Movement is one of the most beautiful gifts that human nature has endowed. Walking, running - all types of movement in space are made thanks to complex system, and largely depend on such a small cartilage pad, which is otherwise called the meniscus. It is located between the knee joints and serves to be a kind of shock absorber when any movement of a person occurs.

meniscus injury

The medial meniscus changes shape when moving, because the gait of people is so smooth, plastic. The knee joints have 2 menisci:

The meniscus itself is divided into 3 parts:

• the body of the meniscus itself;
• the posterior horn of the meniscus, that is, its inner part;
• anterior horn of the meniscus.

The inner part differs in that it does not have its own blood supply system, however, because. nutrition should still be, it is carried out due to the constant circulation of the articular synovial fluid.

Such unusual properties lead to the fact that if an injury to the posterior horn of the meniscus occurs, then, unfortunately, it is most often incurable, because the tissues cannot be restored. Moreover, a rupture of the posterior horn of the medial meniscus is difficult to determine. And if such a diagnosis is suspected, urgent research is needed.

Most often, the correct diagnosis can be found using magnetic resonance imaging. But even with the help of the developed tests, which are based on the extension of the joints, scrolling movements, as well as the sensation of pain, it is possible to determine the disease. There are a lot of them: Rocher, Landa, Baikov, Shteiman, Bragard.

If the posterior horn of the medial meniscus is damaged, a sharp pain appears, and severe swelling begins in the knee area.

When did horizontal break posterior horn of the medial meniscus, unable to descend stairs due to severe pain. If there is a partial tear of the meniscus, it is almost impossible to move: the torn part dangles freely inside the joint, giving pain at the slightest movement.

If not such painful clicking sounds are felt, then the gaps have occurred, but they are small in size. When the tears occupy a large area, the torn part of the meniscus begins to move to the center of the damaged joint, resulting in blocking of the knee movement. There is a twisting of the joint. When the posterior horn of the internal meniscus has ruptured, it is practically impossible to bend the knee, and the sore leg will not be able to withstand the load from the body.

Symptoms of a knee meniscus injury

If there is a rupture of the meniscus of the knee joint, then the following symptoms will appear:

• pain, which over time will concentrate in the joint space;
• there is weakness of the muscles in the anterior surface of the thigh;
• accumulation of fluid in the joint cavity begins.

As a rule, a degenerative rupture of the posterior horn of the meniscus in the knee occurs in people of pre-retirement age due to age-related changes cartilage tissue or in athletes in whom the load falls mainly on the legs. Even a sudden awkward movement can lead to a break. Very often breaks degenerative form become protracted chronic. A symptom of a degenerative rupture is the presence of a dull aching pain in the knee area.

Treatment of damage to the medial meniscus

In order for the treatment to be beneficial, it is necessary to correctly determine the severity of the disease and the type of injury.

But first of all, when damage has occurred, it is necessary to relieve pain. In this case, an anesthetic injection and tablets that reduce inflammation help, and cold compresses will help.

You need to be prepared for the fact that doctors will take a puncture of the joint. Then it is necessary to clean the articular cavity from the blood and fluid accumulated there. Sometimes you even have to apply the blockade of the joints.

These procedures for the body are stressful, and after them the joints need rest. In order not to disturb the joints and fix the position, the surgeon applies a plaster or splint. During the rehabilitation period, physiotherapy, fixing the kneecaps will help to recover, it will be necessary to do physiotherapy exercises and walking with various means of support.

Minor damage to the posterior horn of the lateral meniscus or an incomplete tear of the anterior horn can be treated conservatively. That is, you will need anti-inflammatory drugs, as well as painkillers, manual and physiotherapy procedures.

How is damage treated? As a rule, surgery is usually unavoidable. Especially if it is an old medial meniscus of the knee joint. The surgeon is faced with the task of suturing the damaged meniscus, but if the damage is too serious, it will have to be removed. A popular treatment is arthroscopic surgery, thanks to which whole tissues are preserved, only the resection of damaged parts and the correction of defects are performed. As a result, there are very few complications after surgery.

The whole procedure goes like this: an arthroscope with instruments is inserted into the joint through 2 holes in order to first determine the damage, its extent. With ruptures of the posterior horn of the meniscus affecting the body, it happens that the torn fragment is displaced, rotating along its axis. He is immediately returned to his place.

Then make an incomplete biting out of the meniscus. This must be done at the base of the posterior horn, leaving a thin "bridge" to prevent displacement. The next stage is cutting off the torn fragment from the body or the anterior horn. Parts of the meniscus then need to be given the original anatomical shape.

It will be necessary to spend time in the hospital under the supervision of a doctor and undergo rehabilitation recovery.