Very often, athletes and people who are constantly engaged in physical labor complain of disorders in the functioning of the joints. The most common cause of pain and discomfort is a tear in the meniscus of the knee.

It is quite possible to deal with this problem. Treatment, if a rupture of the meniscus of the knee joint is diagnosed, is expressed in a wide range activities ranging from surgery to folk methods treatment at home.

What is a meniscus

The meniscus of the knee joint is a cartilaginous formation that has the shape of a crescent and is located between the thigh and lower leg in the knee joint. The knee meniscus performs a stabilizing and shock-absorbing function, the horizontal cartilage gap softens the friction of the surfaces, limiting joint mobility, which prevents injuries.

In the process of movement, the meniscus contracts and stretches, changing its shape, as can be seen in the photo. There are two menisci in the joint:

1. lateral meniscus (external),
2. medial meniscus (internal).

Sports doctors say that injuries and bruising are a common problem among:

• skiers,
• skaters,
• figure skaters,
• ballet dancers,
• footballers.

Meniscus disease and the need for surgery in the future may also appear in those who are engaged in strenuous physical labor. The risk group includes men aged 17 to 45 years.

Gap among children dorsal horn inner meniscus or displacement is extremely rare. Until the age of 14, this cartilage formation is very elastic, so damage almost never occurs.

Main shock absorber in the knee joint

Sometimes a rupture of the meniscus of the knee joint or its bruising is observed at an older age. So, at the age of 50-60, degenerative changes in the joints affect the condition.

The rupture of the posterior horn of the medial meniscus occurs under the influence of trauma. This is especially true for the elderly and athletes. Arthrosis is also common cause meniscus injury.

Rupture of the posterior horn of the medial meniscus is always accompanied by damage to the ligament that connects the meniscus to the knee joint.

Thus, the meniscus changes under the influence of:

1. loads,
2. injuries,
3. degenerative age-related changes,
4. congenital pathologies that gradually damage tissues.

In addition, some diseases that damage statics also make their own negative adjustments.

Flat feet can be cited as an example of the consequences of violations.

Orthopedists differentiate damage to the knee meniscus into several types:

• pinching,
• rupture of the posterior horn of the medial meniscus and a rupture of the posterior horn of the internal meniscus,
• separation.

AT last case meniscus treatment is the most difficult process. Education is required to be completely separated from the attachment area. This type injury requires performance surgical operation, it is quite rare.

In most cases, diagnose:

1. injury,
2. pinching,
3. tear,
4. tear of the medial meniscus
5. rupture of the posterior horn of the meniscus.

These injuries are characterized sharp pain in the knee area, inability to perform movements, numbness, difficulty in flexion and extension of the joint. After a few hours, the symptoms of a torn meniscus subside, mobility is restored, and the person can forget about the injury.

The consequences of an injury, damage to the meniscus of the knee joint, eventually make themselves felt, for example, the pain returns again. A rupture of the medial meniscus is a complex injury that requires intervention. The intensity of the pain syndrome depends on the strength and nature of the damage.

Baykov's symptom is known: when the joint is bent to an angle of 90 degrees, and a finger is pressed on this area of ​​the joint space, producing a slow extension of the lower leg, the pain increases very much.

In addition, it is difficult to go up or down the stairs, there is pain when crossing the limbs and situational numbness. In some severe cases, the consequences become extremely dangerous, we are talking about atrophy of the muscles of the leg and thigh.

Professional athletes often suffer from characteristic microtraumas of the meniscus. It can be a bruise, infringement or small tears.

Degrees of meniscus injury and surgery

With cartilage injuries, the diseases become chronic. Sharp pain is not observed, the joint retains its mobility most of the time. However, periodically in the knee area, a person feels discomfort. These may be: slight tingling, numbness, or clicking. Atrophy of the thigh muscles is recorded.

A rupture in the area of ​​the meniscus of the knee joint in severe cases involves the separation of its capsule, and the need for surgery appears. The detached part of the meniscus can be removed partially or completely. If there is a tear or tear, then the patient may be offered a form of surgery such as suturing.

The choice of type of operation depends on the age of the patient, his condition and the nature of the injury. The younger the person, the faster the consequences pass, and the recovery process accelerates.

As a rule, the recovery period takes about 4-6 weeks, during which the person stays on an outpatient basis.

To restore joint mobility, mud therapy and restorative therapeutic exercises can be recommended.

Conservative treatment of the meniscus in hospital and at home

For micro-ruptures, chronic injuries and infringements of the meniscus of the knee joint, a more moderate conservative treatment is recommended.

If the meniscus is pinched, then it is necessary to reposition, that is, reduce the joint. The procedure is performed by a traumatologist, chiropractor or orthopedist in a medical facility.

It will take 3-4 procedures to fully reset the joint. There is another type of meniscus repair - traction of the knee joint or hardware traction. This is a long procedure carried out in stationary conditions.

To restore cartilage tissue, intra-articular injections of drugs that contain hyaluronic acid. If there is swelling and the patient suffers from pain, intra-articular injections are necessary:

• nimulida,
• voltarena,
• corticosteroids.

After these measures, long-term drug therapy is indicated to restore the required amount of joint fluid.

The most commonly prescribed are chondroitin sulfate and glucosamine. It is not recommended to self-medicate, exact dosage the drug is prescribed only by a doctor.

As a rule, restorative drugs need to be taken for about three months daily.

Along with the use of drugs, it is necessary to turn to massage and therapeutic exercises so that there is no need for an operation.

Treatment of the meniscus with folk remedies

Various rubbing and compresses are considered especially effective. They reduce pain and return the joint to normal mobility.

Before treating meniscus disease at home, you should consult your doctor. Consideration should be given to the nature of the injury to the meniscus and individual characteristics. For example, honey compress may be contraindicated if the person is allergic to bee products.

Treatment can be done with a compress of fresh burdock leaves. The patella area should be wrapped with a sheet and a restraining bandage applied. The compress should be kept on the body for about 4 hours.

The procedure should be carried out every day, while the meniscus hurts. If fresh burdock is not available, dried leaves can be used after soaking them in a small amount of hot water.

Raw materials must be evenly distributed over the tissue, and then apply a compress to the joint. The compress stays on the damaged joint for 8 hours.

A honey compress on the knee helps relieve pain in the patella area. After some time, the lost mobility of the joint returns.

It is necessary to take in equal proportions natural bee honey and purified alcohol, mix and slightly warm. Apply a warm mixture to the knee area, wrap it well with a woolen cloth and secure with a bandage.

To speed up the recovery process after a meniscus injury, you need to make a honey compress 2 times a day. Keep the compress for at least two hours.

Treatment of meniscus disease with folk remedies lasts, as a rule, several months.

An effective remedy for the meniscus of the knee joint is a tincture of wormwood. Would need large spoon chopped wormwood, which must be poured with a glass of boiling water and insisted for 1 hour.

After that, the liquid is filtered and used for compresses. A cloth soaked in liquid should be applied for half an hour to the damaged joint. A traumatologist will tell you in detail about problems with the meniscus in the video in this article.

Treatment of the meniscus of the knee joint without surgery

Injuries and treatment of the medial meniscus of the knee joint

If we feel pain in the knee, then, as a rule, this means that the meniscus hurts. Since the meniscus is a layer of cartilage, it is most at risk of rupture or damage. Knee pain can indicate several types of damage and meniscal dysfunction. During sprain of the intermeniscal ligaments, chronic injuries, as well as when the meniscus is torn, different symptoms, and the options for dealing with them are also different.

• Damage symptoms
• meniscus tear
  • Rupture of the posterior horn of the meniscus
  • Rupture of the posterior horn of the lateral (outer) meniscus
  • Rupture symptoms
• How is a meniscus tear treated?

Damage symptoms

The meniscus is a cartilage formation that is located in the cavity of the knee joint and serves as a shock absorber of movement, as well as a stabilizer that protects the articular cartilage. There are two menisci in the knee, the outer (lateral) and the inner (medial). Damage to the inner meniscus happens much more often due to its less mobility. Damage to the meniscus of the knee joint manifests itself in the form of pain in this area, limited mobility, and in chronic situations, the development of arthrosis of the knee is also possible.

Swelling of the joint, acute cutting pain, painful crunching and difficult movements of the limbs indicate that you have a damaged meniscus. These symptoms appear immediately after the injury and may indicate other joint damage. More pronounced symptoms of damage appear one month after the injury. With these injuries, a person begins to feel local pain in the gap of the knee joint, weakness of the muscles of the outer surface of the thigh, “blockade” of the knee, and accumulation of fluid in the joint cavity are manifested.

Precise signs of damage to the medial meniscus are detected using various surveys. There are special extension tests knee joints(Rocher, Baikov, Landa, etc.), when pain symptoms are felt with a certain extension of the knee. The technology of rotational tests is based on the detection of damage during rolling movements of the knee (Shteiman, Bragard). Meniscal injury can also be identified by MRI, mediolateral tests, and compression symptoms.

Damage to the medial meniscus various treatments which takes into account the type and severity of the injury. With the traditional method of getting rid of damage, it is possible to distinguish the main types of exposure that are used for any injuries.

To begin with, it is necessary to relieve the pain, therefore, first of all, the patient is given an anesthetic injection, then they take a puncture of the joint, remove the accumulated fluid and blood from the cavity, and, if necessary, remove the blockade of the joints.

After these procedures, the knee needs rest, for which a splint or plaster cast is applied. As a rule, one month of immobilization is sufficient, but in difficult situations sometimes even up to 2 months. In this case, it is necessary to apply local cold and nonsteroidal drugs to relieve inflammation. Over time, you can add different types physiotherapy, walking with aids, exercise therapy.

Surgery is required in severe situations, for example, chronic damage to the meniscus of the knee joint. One of the most popular types of surgery today is arthroscopic surgery. This type of surgical intervention has become common due to the careful attitude to tissues. The intervention is only a resection of the damaged area of ​​the meniscus and polishing of defects.

With such damage as a torn meniscus, the surgical operation is performed closed. With the help of two holes, an arthroscope is inserted into the knee joint with instruments to determine the damage, then a decision is made on the possibility of sewing up the meniscus or its partial resection. Inpatient treatment lasts up to approximately 4 days, due to the low invasiveness of this type of operation. At the rehabilitation stage, it is recommended to limit the load on the knee to one month. In special situations, wearing a knee brace and walking with support is recommended. After 7 days, you can start therapeutic exercises.

meniscus tear

The most common injury to the knee joint is a tear in the medial medial meniscus. There are degenerative and traumatic tears menisci. The latter appear, as a rule, in people aged 18-45 years and athletes, with untimely treatment, they turn into degenerative tears, which most often appear in elderly people.

Taking into account the localization of damage, there are several main types of ruptures:

At the same time, meniscus tears are also divided by shape:

• oblique;
• longitudinal;
• transverse;
• degenerative;
• combined.

Traumatic ruptures usually appear in young age and they occur vertically in the longitudinal or oblique direction. Combined and degenerative usually occur in the elderly. Watering can-shaped or vertical longitudinal tears can be incomplete or complete and usually begin with damage to the posterior horn.

Rupture of the posterior horn of the meniscus

This type of tear is the most common, as most of the vertical, longitudinal, and watering hole tears occur in the posterior horn. During a long tear, there is a good chance that part of the torn meniscus will prevent the knee from moving and cause severe pain, up to and including blockage of the knee joint. The combined type of tears passes, capturing several planes, and usually forms in the posterior horn of the meniscus and for the most part appears in elderly people who have degenerative changes in them.

During damage to the posterior horn, which does not lead to displacement of the cartilage and longitudinal cleavage, the person always feels the threat of blockade of the joint, but this never happens. Quite rarely, a rupture of the anterior horn of the knee joint occurs.

Rupture of the posterior horn of the lateral (outer) meniscus

This gap happens 8-10 times less often than the medial one, but it has no less negative consequences. The internal rotation of the lower leg and its movement are the main causes that cause a rupture of the external lateral meniscus. The main sensitivity in these lesions falls on outside at the back horn. Rupture of the arch of the external meniscus with displacement, as a rule, creates a restriction of movements at the final stage of extension, and sometimes can cause blockade of the joint. The rupture of the external meniscus is determined by the characteristic clicking during rotational movements inside the knee joint.

Rupture symptoms

With injuries such as a torn meniscus, symptoms vary. A meniscus tear can be:

• old;
• chronic;
• spicy.

The main sign of a rupture is blockage of the knee joint, in its absence it is very difficult to determine a rupture of the lateral or medial meniscus in the acute period. After a certain time, early period, the gap can be determined by local pain, infiltration in the area of ​​​​the joint space, as well as using pain tests that are suitable for any type of damage.

Pronounced symptom of rupture are pain while probing the line of the gap of the knee joint. There are special tests for diagnosis, such as the McMurry test and the Epley test. The McMurry test is performed in two ways.

In the first case, the patient is laid on his back, the leg is bent at the hip and knee joint to a right angle. Then they grab the knee with one hand, and with the other hand they perform rotational movements of the lower leg, first outward, and then inward. When cracking or clicking, it is possible to consider the infringement of the injured meniscus between the surfaces of the joint, this test is positive.

The other way is called bending. It is carried out in this way: with one hand they grab the knee, as in the first version, after the leg is bent as much as possible at the knee. The lower leg is then rotated outward to determine the tear. Under the condition of slow extension of the knee joint to approximately 90 degrees and rotational movements of the lower leg, then during the rupture of the meniscus, the patient will feel pain on the surface of the joint from the inside back side.

During the Epley test, the patient is placed on the stomach and the leg is bent at the knee, creating an angle of 90 degrees. With one hand, it is necessary to press the person on the heel, and with the second, rotate the lower leg and foot. When pain occurs in the joint space, the test is positive.

How is a meniscus tear treated?

The tear may be treated or surgically(resection of the meniscus, both partial and its restoration, and complete), or conservative. With the advent of new technologies, meniscus transplantation has become increasingly popular.

Conservative treatment is usually used to treat minor lesions of the posterior horn. Very often, these injuries are accompanied by severe pain, but do not lead to pinching of the cartilage tissue between the surfaces of the joint and do not create a sensation of rolling and clicking. This type of damage is characteristic of strong joints.

The treatment consists in liberation from such sports, in which sharp jerks and movements that leave one leg in place are indispensable, these activities aggravate the condition. In the elderly, this treatment leads to a better result, since arthritis and degenerative tears are often the cause of their symptoms.

A slight longitudinal tear (less than 1 cm), a tear of the upper or lower surface that does not penetrate the entire thickness of the cartilage, transverse injuries of no more than 2.5 mm usually heal on their own or do not bother.

Also, the treatment of the gap provides another option. Sewing from the inside out. For this method of treatment, long needles are used, which are inserted perpendicular to the rupture line from the joint cavity to the outer part of the strong capsular area. And the seams are made quite tightly, one by one. This is the main advantage of this treatment option, although it increases the risk of nerve and vascular damage during the removal of the needle from the joint cavity. This method is excellent for treating damage to the posterior horn and a tear that runs from the cartilage itself to the posterior horn. During damage to the anterior horn, difficulties may arise in the passage of the needle.

In cases where a rupture of the anterior horn occurs, it is best to use the suturing method from the outside to the inside. This option is safer for blood vessels and nerves, in this case the needle is passed through the gap on the outside of the knee joint and then into its cavity.

With the development of technology, seamless fastening inside the joint is gradually gaining popularity. The process itself takes a little time and takes place without the participation of such complex devices as an arthroscope, but now it still does not have even a 75% chance of successful healing of the meniscus.

The main indications for surgery are pain and effusion, which cannot be eliminated using conservative methods. Blockade of the joint or friction during movement are also indications for surgical intervention. Resection of the meniscus (meniscectomy) was once considered a safe operation. But with the help of recent research, it turned out that meniscectomy most often leads to the development of arthritis. This fact influenced the main methods of treatment of posterior horn rupture. Today, grinding of damaged parts and partial removal of the meniscus is very popular.

The success of recovery after injuries such as a torn medial and lateral meniscus will depend on many factors. For a quick recovery, factors such as the location of the damage and its age are important. Probability full treatment decreases with insufficiently strong ligamentous apparatus. If the patient's age is not more than 45 years, then he has a better chance of recovery.

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Anterior horn

Treatment of a torn anterior horn of the medial (inner) meniscus

The medial meniscus differs from the lateral one in a larger circumference and a greater distance between the horns (approximately twice). The anterior horn of the medial meniscus is attached in the region of the anterior edge of the articular part of the tibia - in the so-called intercondylar fossa. Outside surface the meniscus tightly connects to the articular capsule, and the inner one to the medial lateral ligament.

Normally, the anterior horn of the meniscus has a smooth surface, and its edges are quite thin. The blood supply to the menisci is mainly localized in the anterior and posterior horns, however, the blood vessels extend only 5-7 mm from the edge of the meniscus.

Statistics

According to available data, injuries of the medial meniscus account for 60 to 80 percent of all knee injuries. Rupture of the anterior horn of the medial meniscus ranks first in frequency of occurrence. For this injury, longitudinal and patchwork ruptures are more characteristic.

Causes

The main reason for the rupture or separation of the anterior horn of the meniscus is a significant load on the knee joint, combined with fixation of the foot and rotational movement of the knee. At risk are young people who lead an active lifestyle, as well as older men. According to statistics, the gap occurs more often in men than in women.

Symptoms

Damage to the anterior horn of the medial meniscus is often combined with displacement of the torn part and its blocking between the inner surfaces of the joint. When the anterior horn is torn off with infringement, symptoms such as blockade of the knee joint, pain in the knee, and the inability to move independently appear. After the treatment, the block of the joint is eliminated. Also, with an injury to the anterior horn of the meniscus, the patient can often bend the knee slightly, after which the blockade occurs.

With an injury to the anterior horn of the medial meniscus, the following symptoms may also occur:

• Feeling pain inside the joint
• Increased pain when trying to bend the leg at the knee,
• Flabbiness of the thigh muscles,
• Feeling of "shoot through" with tension of the knee joint,
• Pain in the area of ​​attachment of the meniscus and ligaments.

Kinds

There are three types of breaks:

• Rupture of the directly anterior horn (complete or partial).
• Rupture of the meniscus, in which degenerative changes are observed.
• Rupture of the ligament that fixes the meniscus.

Conservative treatment

For minor injuries of the meniscus, conservative treatment is sufficient. At the first stages, the injured limb is fixed with a splint. A joint puncture may also be performed in order to get rid of the accumulated blood in the cavity and remove the blockage of the joint. The patient is advised to rest, the load on the leg should be limited. Subsequently, a course of physiotherapy was recommended, physiotherapy exercises, sessions of massage and electromyostimulation.

Surgical treatment

If there is complete break anterior horn of the internal meniscus, surgical treatment is recommended. A meniscectomy is performed, that is, an operation to remove the torn fragment. Today, open surgery is almost never performed, as is the complete removal of the meniscus. Instead, stitching or fragmentary removal by arthroscopy is performed. Due to the low invasiveness of the arthroscopic method, trauma to the knee joint and the rehabilitation period are significantly reduced. The implementation of this procedure allows you to save the functionally significant elements of the meniscus, which prevents the development of arthrosis and osteoporosis and allows the patient to quickly return to normal life.

In younger patients, it is possible to perform arthroscopic suturing of the meniscus. At the same time, a rupture of the anterior horn of the meniscus is an indication for such stitching, since the anterior horn has a good blood supply, and its recovery is faster and more complete.

Rehabilitation

Arthroscopy can significantly reduce the recovery time after a meniscus injury. After a few days it becomes possible load on the limb, the development of the knee joint and the return to the usual rhythm of life. The essence of rehabilitation is to get rid of pain and return mobility to the knee joint.

The meniscus is the lining of cartilage in the knee joint. Performs the function of a shock absorber, is located between the femur and tibia of the knee, on which the most huge pressure in the musculoskeletal system. The rupture of the posterior horn of the medial meniscus is irreversible, since it does not have its own blood supply system, it receives nutrition through the circulation of the synovial fluid.

Injury classification

Damage to the structure of the posterior horn of the medial meniscus is differentiated according to various parameters. According to the severity of the violation, there are:

• 1st degree injury to the posterior horn of the meniscus. Characterized by focal damage to the surface of the cartilage. The overall structure does not change.
• 2 degree. The changes are becoming more pronounced. There is a partial violation of the structure of the cartilage.
• 3 degree. Painful condition getting worse. Pathology affects the posterior horn of the medial meniscus. There are painful changes in the anatomical structure.

Given the main causative factor that led to the development of the pathological condition of the cartilage of the knee joint, the bodies of the lateral meniscus distinguish between traumatic and pathological damage to the posterior horn of the medial meniscus. According to the criterion of prescription of the trauma or pathological disorder The integrity of this cartilaginous structure is highlighted by fresh and chronic damage to the posterior horn of the medial meniscus. Combined damage to the body and the posterior horn of the medial meniscus is also highlighted separately.

Types of breaks

In medicine, there are several types of meniscus ruptures:

• Longitudinal vertical.
• Patchwork braid.
• Horizontal break.
• Radially transverse.
• Degenerative rupture with tissue crush.
• Oblique-horizontal.

Breaks can be complete and incomplete, isolated or combined. The most common ruptures of both menisci, isolated injuries of the posterior horn are diagnosed less frequently. The part of the inner meniscus that has come off may remain in place or move.

Causes of damage

A sharp movement of the lower leg, a strong outward rotation are the main causes of damage to the posterior horn of the medial meniscus. Pathology is provoked by the following factors: microtraumas, falls, stretch marks, traffic accidents, bruises, blows. Gout and rheumatism can provoke the disease. In most cases, the posterior horn of the meniscus suffers due to indirect and combined trauma.

Especially many injured seek help in winter, during ice.

Injuries contribute to:

• Alcohol intoxication.
• Fights.
• Haste.
• Failure to take precautions.

In most cases, the tear occurs during fixed extension of the joint. Hockey players, football players, gymnasts, and figure skaters are at particular risk. Frequent ruptures often lead to meniscopathy - a pathology in which the integrity of the internal meniscus of the knee joint is violated. Subsequently, with each sharp turn, the gap is repeated.

Degenerative damage is observed in elderly patients with the repetition of microtraumas caused by strong physical activity during labor activity or irregular training. Rheumatism can also provoke a rupture of the posterior horn of the medial meniscus, since the disease disrupts the blood circulation of tissues during edema. Fibers, losing strength, cannot withstand the load. Rupture of the posterior horn of the medial meniscus can provoke tonsillitis, scarlet fever.

Symptoms

The characteristic signs of a torn posterior horn are:

• Sharp pain.
• Puffiness.
• Joint block.
• Hemarthrosis.

Pain

The pain is acutely manifested in the first moments of injury, lasts for several minutes. Often, the appearance of pain is preceded by a characteristic click in the knee joint. Gradually, the pain subsides, a person can step on a limb, although he does this with difficulty. When lying down, during a night's sleep, the pain intensifies imperceptibly. But by morning, the knee hurts so much, as if a nail had been stuck into it. Flexion and extension of the limb increases pain.

puffiness

The manifestation of puffiness is not observed immediately, it can be seen a few hours after the rupture.

Joint block

Jamming of the joint is considered the main sign of rupture of the posterior horn of the medial meniscus. A blockade of the joint occurs after the clamping of the separated part of the cartilage by the bones, with a violation motor function limbs. This symptom can also be observed with sprains, which complicates the diagnosis of pathology.

Hemarthrosis (accumulation of blood inside a joint)

Intra-articular accumulation of blood is detected when the "red zone" of the cartilage layer, which performs a shock-absorbing function, is damaged. According to the time of development of pathology, there are:

• Acute break. Hardware diagnostics shows sharp edges, the presence of hemarthrosis.
• Chronic rupture. It is characterized by swelling caused by the accumulation of fluids.

Diagnostics

If there is no blockage, diagnosing a meniscal tear in the acute period is very difficult. In the subacute period, a meniscus tear can be diagnosed based on the manifestation of local pain, compression symptoms, and extension symptoms. If a meniscus rupture has not been diagnosed, the swelling, pain, and effusion in the joint will disappear during treatment, but with the slightest injury, careless movement, the symptoms will manifest themselves again, which will mean the transition of the pathology to a chronic form.

It is not uncommon for patients to be diagnosed with a knee bruise, parameniscal cyst, or sprain.

x-ray

Radiography is prescribed to rule out damage to the bones of fractures and cracks. X-rays are not able to diagnose soft tissue damage. To do this, you need to use magnetic resonance imaging.

MRI

The research method does not harm the body, like radiography. MRI makes it possible to view layered images internal structure knee. This allows not only to see the gap, but also to obtain information about the extent of its damage.

ultrasound

Allows visualization of knee tissue. With the help of ultrasound, the presence of a degenerative process, an increased volume of intracavitary fluid is determined.

Treatment of damage to the posterior horn of the meniscus

After injury, it is necessary to immediately immobilize the limb. It is dangerous to treat a victim of a blockage on your own. The complex treatment prescribed by the doctor includes conservative therapy, surgery, rehabilitation.

Therapy without surgery

At partial damage of the posterior horn of the medial meniscus of 1-2 degrees, conservative therapy is carried out, including drug treatment and physiotherapy procedures. Of the physiotherapy procedures successfully applied:

• Ozokerite.
• Electrophoresis.
• Mud cure.
• Magnetotherapy.
• Electrophoresis.
• Hirudotherapy.
• Electromyostimulation.
• Aerotherapy.
• UHF therapy.
• Massotherapy.

Important! During the treatment of rupture of the posterior horn of the medial meniscus, it is necessary to ensure the rest of the knee joint.

Surgical methods

An effective method of treating pathology is surgical intervention. During surgical therapy, doctors are aimed at the preservation of the organ and its functions. When the posterior horn of the meniscus is torn, the following types operations:

• Cartilage stitching. The operation is performed using an arthroscope - a miniature video camera. It is injected at the site of the knee puncture. The operation is performed with fresh ruptures of the meniscus.
• Partial meniscectomy. During the operation, the area of ​​damage to the cartilage layer is removed, and the rest is restored. The meniscus is cut to a smooth state.
• Transfer. A donor or artificial meniscus is transplanted.
• Arthroscopy. 2 small punctures are made in the knee. An arthroscope is inserted through the puncture, along with which saline enters. The second hole makes it possible to perform the necessary manipulations with the knee joint.
• Arthrotomy. Complicated meniscus removal procedure. The operation is performed if the patient has an extensive lesion of the knee joint.

A modern method of therapy that differs low rate trauma

Rehabilitation

If the operations were carried out with a small amount of interventions, a short period of time will be required for rehabilitation. Early rehabilitation in postoperative period includes elimination inflammatory process in the joint, normalization of blood circulation, strengthening of the thigh muscles, limiting the range of motion. Therapeutic exercises are allowed to be performed only with the permission of the doctor in different positions of the body: sitting, lying, standing on a healthy leg.

Late rehabilitation aims to:

• Elimination of contracture.
• Correction of gait
• Functional restoration of the joint
• Strengthening the muscle tissue that stabilizes the knee joint.

The most important

Rupture of the posterior horn of the medial meniscus is a dangerous pathology. To reduce the risk of injury, precautions should be taken seriously: do not rush when moving up the stairs, exercise muscles with physical activity, regularly take prophylactic chondroprotectors, vitamin complexes, during training use knee pads. You need to constantly monitor your weight. In case of injury, a doctor should be called immediately.

rear horn

Treatment of rupture of the posterior horn of the lateral (outer) meniscus

The lateral meniscus is a structure in the knee joint that has a shape close to annular. Compared to the medial, the lateral meniscus is somewhat wider. The meniscus can be conditionally divided into three parts: the body of the meniscus (middle part), the anterior horn and the posterior horn. The anterior horn is attached to the internal intercondylar eminence. The posterior horn of the lateral meniscus attaches directly to the lateral intercondylar eminence.

Statistics

Rupture of the posterior horn of the lateral meniscus is an injury that is quite common among athletes, people leading an active lifestyle, as well as those whose professional activities are associated with heavy physical labor. According to statistics, this injury in frequency exceeds the injury of the anterior cruciate ligament. However, about a third of all torn ligaments are associated with a meniscus tear. In terms of frequency, damage of the “watering can handle” type is in the first place. Isolated damage to the posterior horn of the meniscus accounts for about a third of all meniscal injuries.

Causes

Injury to the posterior horn of the lateral meniscus wears 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 elderly patients, the cause of rupture of the posterior horn is most often degenerative change meniscus tissues.

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.

An injury resulting from a mechanical impact can have two possible reasons: direct strike or rotation. The direct impact in this case is associated with with a strong blow on 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 changes menisci 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.

Symptoms

Damage to the posterior horn of the lateral meniscus manifests itself with symptoms such as pain, impaired joint mobility, and even its complete blockage. The complexity of the injury in diagnostic terms is due to the fact that often a rupture of the posterior horn of the meniscus can manifest itself only with non-specific symptoms that are also characteristic of other injuries: damage to the ligaments or patella.

A complete detachment of the meniscus horn, in contrast to minor tears, often manifests itself as a blockade of the joint. The blockade is due to the fact that the torn fragment of the meniscus is displaced and infringed by the structures of the joint. A typical rupture of the posterior horn is the limitation of the ability to bend the leg at the knee.

In acute, severe rupture, accompanied by damage to the anterior cruciate ligament (ACL), the symptoms are pronounced: edema appears, usually on the anterior surface of the joint, strong pain, the patient cannot step on the foot.

Conservative treatment

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.

Surgical treatment

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

Rehabilitation

The rehabilitation period after meniscus surgery lasts up to 3-4 months. A set of measures during this period is aimed at reducing swelling of the knee joint, reducing pain and restoring the full range of motion in the joint. It is worth noting that complete recovery is possible even if the meniscus is removed.

Although the bones of the knee joints are the largest in human skeleton, but it is the knee that accounts for the majority of injuries. Injury occurs due to high loads on this part of the limb. Let's talk about such an injury as damage to the posterior horn of the medial meniscus and methods to eliminate its consequences.

Appointment of the meniscus

The limb joint refers to a complex structure, where each element solves a specific problem. Each knee is equipped with menisci that bisect the articular cavity, and perform the following tasks:

• stabilizing. During any physical activity, the articular surfaces are displaced in the right direction;
• act as shock absorbers, softening shocks and shocks while running, jumping, walking.

Injury to shock-absorbing elements occurs with various articular injuries, precisely because of the load that these articular parts take on. Each knee has two menisci, which are made up of cartilage:

• lateral (outer);
• medial (internal).

Each type of shock-absorbing plate is formed by a body and horns (rear with front). Shock-absorbing elements move freely during physical activity.

The main damage occurs to the posterior horn of the internal meniscus.

Why injury happens

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 (mild). 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;
• 2 degree 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 3 degrees accompanied pain syndromes of such intensity that it is unbearable. 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 is aggravated by pressure on the kneecap inside and simultaneous extension of 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 medical technique apply.

Horizontal gap

Depending on the location of the injured area and the general characteristics of the damage, there are types of injury to the medial meniscus:

• walking along;
• oblique;
• passing across;
• horizontal;
• chronic form of pathology.

Peculiarities horizontal damage the posterior horn of the medial meniscus is:

• with this type of tearing of the internal shock-absorbing plate, injury occurs, directed to the joint capsule;
• there is swelling in the area of ​​the joint gap. This pathological development common signs with damage to the anterior meniscus horn of the external cartilage, therefore, special attention is needed when diagnosing.

With horizontal, partial damage, the cavity begins to accumulate excess synovial fluid. Pathology can be diagnosed by ultrasound.

Treatment horizontal gap the posterior horn of the medial meniscus, during timely seeking medical help, is prescribed as a complex, traditional therapy, because with this type of injury, the joint does not block. First, non-steroidal medications are prescribed to eliminate pain and swelling. Then the injured knee is fixed plaster cast. The traditional method of treatment can last from six months to 12 months. During the first 3 months, the joint is immobilized with a plaster splint.

After the removal of the first symptoms, a set of special measures is developed for each patient. gymnastic exercises. Physiotherapy and massage sessions are prescribed.

If a traditional techniques treatment does not give a positive result, then surgery is indicated.

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Synovitis due to trauma to the medial meniscus

Against the background of damage to the posterior horn of the medial meniscus, synovitis may begin. This pathology develops due to structural cartilage changes that occur in the tissues during injury. When ruptured, synovial fluid begins to be produced in large volume, and fills the joint cavity.

As synovitis (fluid buildup) develops, it becomes increasingly difficult to move. If there is a transition to the degenerative course of the pathology, then the knee is constantly in a bent position. As a result, muscle spasm develops.

Advanced forms of synovitis lead to the development of arthritis. Therefore, at the time of diagnosis, the symptoms of a torn meniscus are similar to chronic arthritis.

If synovitis is not treated in time, the cartilaginous surface will completely collapse. The joint will no longer receive nutrition, which will lead to further disability.

Therapeutic techniques

With any articular injury, treatment should be started in a timely manner, without delay. If you postpone the appeal to the clinic, then the trauma passes to a chronic course. The chronic course of the pathology leads to changes in the tissue structure of the joints, and further deformation of the damaged limb.

Treatment for damage to the posterior horn of the medial meniscus can be conservative or surgical. In the treatment of such injuries, traditional methods are often used.

Complex, traditional therapy in case of injury to the internal meniscus, includes the following measures:

1. articular blockade is performed using special medical preparations, after which the motor ability of the joint is partially restored;
2. anti-inflammatory drugs are prescribed to remove puffiness;
3. recovery period, including a set of special gymnastic exercises, physiotherapy and massage sessions;
4. then comes the reception of chondoprotectors (drugs that help restore the structure of the cartilage). Among active components chondoprotectors present Hyaluronic acid. The course of admission can last up to six months.

Throughout the course of treatment, painkillers are present, because damage to the ligaments is accompanied by constant painful sensations. To eliminate pain, drugs such as Ibuprofen, Diclofenac, Paracetamol are prescribed.

Surgical intervention

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 broken elements, or meniscus. This kind of manipulation is performed with incomplete or complete anguish;
2. recovery destroyed tissues;
3. replacement destroyed tissue by implants;
4. stitching menisci. Such surgery is performed in case of a fresh injury, and immediate appeal for medical help.

Let's take a closer look at the varieties surgical treatment knee injury.

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

During the surgical intervention, the torn, dangling parts of the damaged meniscus are resected, and the surviving elements are restored.

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 kind 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.

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