In the article we will consider in what cases a rupture of the posterior horn of the medial meniscus occurs.
One of the most complex structures of bone parts human body They have both small and large joints. Features of the structure knee joint allow him to be considered susceptible to a variety of injuries such as bruises, fractures, hematomas, arthrosis. A complex injury such as a rupture of the posterior horn in the medial meniscus is also possible.
This is due to the fact that the bones of this joint(tibia, femur), ligaments, patella and menisci, working together, ensure correct flexion when sitting, walking and running. However, excessive loads on the knee, which are placed on it during various manipulations, can lead to a violation of the integrity of the posterior horn of the medial meniscus. This is a type of injury to the knee joint, which is caused by damage to the cartilage layers located between the tibia and femur.
Anatomical features of the cartilage of the knee joint
Let's take a closer look at how this structure works.
The meniscus is a cartilaginous structure of the knee, which is located between the intersecting bones and allows the bones to slide over one another, which contributes to the unhindered extension of this joint.
It includes two types of menisci. Namely:
- medial (internal);
- lateral (outer).
Obviously, the most mobile is the outer one. Therefore, its damage is much less common than internal damage.
The medial (internal) meniscus is a cartilage pad associated with the bones of the knee joint, located on the side inside. It is not very mobile, so it is susceptible to damage. A rupture of the posterior horn of the medial meniscus is also accompanied by damage to the ligamentous apparatus that connects it to the knee joint.
Visually, this structure is similar to a crescent; the horn is lined with porous tissue. The cartilage pad consists of three main parts:
- anterior horn;
- middle part;
- posterior horn.
The cartilages of the knee joint perform several important functions, without which full-fledged movement would be impossible:
- depreciation during walking, jumping, running;
- stabilization of the knee at rest.
These structures are penetrated by many nerve endings that send information to the brain about the movements of the knee joint.
Functions of the meniscus
Let's take a closer look at what functions the meniscus performs.
The lower limb joint belongs to a combined structure, where each element is called upon to solve specific problems. The knee is equipped with menisci, which divide the articular cavity in half and perform the following tasks:
- stabilizing - during any physical activity, the articular surface shifts in the desired direction;
- acts as shock absorbers to soften shocks and jolts during running, walking, and jumping.
Injury to shock-absorbing elements is observed with various joint damage, in particular, due to the loads that these joint structures take on. Each knee joint contains two menisci, which are made of cartilage tissue. Each type of shock-absorbing plate is formed by horns (front and rear) and the body. The shock-absorbing components move freely during physical activity. The bulk of the damage is associated with the posterior horn of the medial meniscus.
Causes of this pathology
The most common damage to cartilaginous plates is a tear, absolute or partial. Professional dancers and athletes, whose specialty is sometimes associated with increased stress, can be injured. Injuries are also observed in older people and occur as a result of unexpected, accidental loads on the knee area.
Damage to the body of the posterior horn occurs for the following reasons:
- excessive sports loads (jumping, jogging over rough terrain);
- active walking, prolonged squatting position;
- articular pathologies of a chronic nature, in which the development of inflammatory process in the knee area;
- congenital articular pathologies.
The listed factors lead to trauma to the posterior horn of the medial meniscus of varying degrees of complexity.
Stages of this pathology
Symptoms of trauma to cartilaginous elements depend on the severity of damage to cartilage tissue. The following stages of violation of the integrity of the posterior horn are known:
- Stage 1 ( light form) damage to the posterior horn of the medial meniscus, in which movements of the injured limb are normal, pain syndrome weak, becomes more intense when jumping or squatting. In some cases, there is slight swelling in the area of the kneecap.
- 2nd degree. The posterior horn of the medial meniscus is significantly damaged, which is accompanied by intense pain, and the limb is difficult to straighten even with outside help. It is possible to move, but the patient is limping, and at any moment the knee joint may become immobilized. The swelling gradually becomes more pronounced.
- Grade 3 damage to the posterior horn of the medial meniscus is accompanied by pain syndromes of such severity that it is impossible to tolerate. It hurts most in the kneecap area. Any physical activity with the development of such an injury is impossible. The knee increases significantly in size, and the skin changes its healthy color to bluish or purple.
When the posterior horn of the medial meniscus is damaged, the following symptoms are present:
- The pain intensifies if you press on the cup from the back side and simultaneously straighten the leg (Bazhov's maneuver).
- Skin in the knee area they become overly sensitive (Turner's symptom).
- When the patient is lying down, the palm passes under the damaged knee joint (Land's syndrome).
After making a diagnosis of damage to the posterior horn of the medial meniscus of the knee joint, the specialist decides which therapeutic technique to use.
Features of horizontal tear of the posterior horn
Features include the following:
- with this type of tear, injury occurs that is directed to the joint capsule;
- swelling develops in the area of the joint gap - a similar development pathological process It has general symptoms with damage anterior horn external cartilage;
- with partial horizontal damage, excess fluid accumulates in the cavity.
Meniscus tear
In what cases does this happen?
Injuries to the knee joints are quite common. Moreover, such injuries can occur not only active people, but also those who, for example, squat for a long time, try to spin on one leg, and make various long and high jumps. Tissue destruction can occur gradually over time, with people over 40 years of age at risk. Damaged knee menisci in at a young age gradually begin to acquire an inveterate character in older people.
Damage can be very diverse depending on where the gap is observed and what shape it has.
Forms of meniscus tears
Ruptures of cartilage tissue can vary in shape and nature. IN modern traumatology The following categories of gaps are distinguished:
- longitudinal;
- degenerative;
- oblique;
- transverse;
- rupture of the posterior horn;
- horizontal type;
- tear of the anterior horn.
Rupture of the posterior horn of the medial meniscus of the knee joint
This type of tear is one of the most common categories of knee injuries and the most dangerous injury. Similar damage also has some varieties:
- horizontal, which is also called a longitudinal tear, in which layers of tissue are separated from each other with subsequent blocking of knee movements;
- radial, which is a type of damage to the knee joints, in which oblique transverse ruptures of the cartilage tissue develop, while the lesions have the shape of rags (the latter, falling between the bones of the joint, provoke a cracking sound in the knee joint);
- combined, carrying damage to the (medial) internal portion of the meniscus of two types - radial and horizontal.
Symptoms of injury
How it manifests itself this pathology, is discussed in detail below.
Symptoms of the resulting injury depend on the form of the pathology. If this damage is acute form, then the symptoms of injury may be as follows:
- acute pain syndrome, which manifests itself even in calm state;
- hemorrhage into tissues;
- blocking knee activity;
- swelling and redness.
Chronic forms ( old breakup), which are characterized the following symptoms:
We will learn how to treat a tear of the posterior horn of the medial meniscus.
Therapy for cartilage damage
In order to acute stage the pathology has not become chronic, treatment must be started immediately. If you are late in carrying out therapeutic procedures, the tissues begin to become significantly damaged and turn into rags. Tissue destruction leads to the development of degeneration of cartilaginous structures, which, in turn, provokes the occurrence of knee arthrosis and complete immobility of this joint.
Therapy depends on the degree of injury for damage to the posterior horn of the medial meniscus.
Stages of conservative treatment of this pathology
Traditional methods used in acute, non-advanced stages of early stages the course of the pathological process. Therapy with conservative methods consists of several stages, which include:
- elimination of inflammation, pain and swelling with the help of anti-inflammatory non-steroidal drugs;
- in cases of “jamming” of the knee, reposition is used, namely reduction through traction or manual therapy;
- therapeutic exercises, gymnastics;
- therapeutic massage;
- physiotherapeutic measures;
- use of chondroprotectors;
- treatment hyaluronic acid;
- assisted therapy folk recipes;
- pain relief with analgesics;
- application of plaster casts.
What else is the treatment for a tear of the posterior horn of the medial meniscus?
Stages of surgical treatment of the disease
Surgical techniques are used exclusively in the most difficult cases when, for example, tissues are so damaged that they cannot be restored, if traditional methods The therapy did not help the patient.
Surgical methods for restoring torn cartilages of the posterior horn consist of the following manipulations:
- Arthrotomy is the partial removal of damaged cartilage with extensive tissue damage.
- Meniscotomy is the complete removal of cartilage tissue.
- Transplantation is the movement of a donor meniscus to a patient.
- Endoprosthetics is the introduction of artificial cartilage into the knee joint.
- Stitching of damaged cartilages (performed for minor injuries).
- Arthroscopy is a puncture of the knee joint in two places in order to carry out the following manipulations with cartilage tissue (for example, endoprosthetics or suturing).
After the therapy (regardless of what methods it was carried out - surgical or conservative), the patient will have a long course of rehabilitation. It necessarily includes absolute peace throughout the entire course. Any physical activity after completion of treatment is contraindicated. The patient should take care that his limbs do not become overcooled, and sudden movements should not be avoided.
Tears of the posterior horn of the medial meniscus of the knee joint are a fairly common injury that occurs more often than other injuries. These injuries can vary in size and shape. A rupture of the posterior horn of the meniscus occurs much more often than its middle part or anterior horn. This is due to the fact that the meniscus in this area is the least mobile, and, therefore, the pressure on it during movements is greater.
Treatment of this injury to cartilage tissue must begin immediately, otherwise its chronic nature can lead to complete destruction of the joint tissue and its absolute immobility.
In order to avoid injury to the posterior horn, you should not make sudden movements in the form of turns, avoid falls, and jumps from heights. This is especially true for people over 40 years of age. After treatment of the posterior horn of the medial meniscus, physical activity is usually contraindicated.
Injury to the medial meniscus of the knee, the treatment of which will depend on the severity, is a common injury. The cartilage layer that is located inside the knee is called the meniscus, there are 2 types - medial (internal) and lateral (external). They perform shock-absorbing and stabilizing functions.
The knee joint is one of the most complex and bears the greatest load. Therefore, meniscus damage is a very common occurrence. According to statistics, more than 70% of damage occurs precisely there. Athletes involved in sports are at risk athletics, skiers and speed skaters. However, a similar injury can be obtained at home by performing simple exercises.
The most common and dangerous looking damage to the medial meniscus of the knee joint is considered a tear. There are 3 forms of it:
- Rupture of cartilage tissue itself.
- Rupture of the fixing ligaments.
- Rupture of a pathologically altered meniscus.
During damage to the medial meniscus, not only discomfort, but also severe pain, especially when extending the knee. This symptom also appears when the body of the medial meniscus is torn. In addition, the patient may notice unexpected shooting sensations in the injured knee.
Dorsal horn ruptures are a complex injury that involves locking, buckling, and slipping of the knee. By type, such breaks can be radial, horizontal or combined.
With a horizontal rupture of the posterior horn of the medial meniscus, the mobility of the knee joint is blocked due to the separation of its tissues. Radial rupture is characterized by the formation of oblique and transverse tears of cartilage tissue. Combined gap posterior horn combines signs of radial and horizontal injury.
A rupture of the posterior horn of the medial meniscus of the knee joint is accompanied by certain symptoms, which depend on the form of the injury and have the following characteristics:
- acute pain;
- interstitial hemorrhage;
- redness and swelling;
- blocking of the knee joint.
If an acute injury progresses to chronic form pain syndrome manifests itself only with significant physical activity, and during any movement a cracking sound is heard in the joint. Additional symptom There is an accumulation of synovial fluid in the cavity of the damaged joint. In this case, the cartilage tissue of the joint exfoliates and resembles a porous sponge. Injuries to the anterior horn of the medial meniscus or its posterior part occur much less frequently. This is due to its least mobility.
Experts identify the following as reasons leading to rupture of the cartilage tissue of the posterior horn:
- acute injury;
- congenital weakness of ligaments and joints;
- active walking;
- frequent and prolonged squatting;
- excessively active sports;
- degenerative changes in the posterior horn of the medial meniscus.
Degenerative changes in the medial meniscus often occur in older people. Moreover, if left untreated acute injuries, then they turn into a degenerative form. Signs of such changes are different - these are the formation of cysts filled with fluid, and the development of meniscopathy, as well as cartilage separation and ligament rupture.
Diagnosis and treatment
To diagnose knee joint injuries, the following are used: instrumental methods, How:
- Ultrasound can reveal signs of damage to the medial meniscus, determine the presence of torn fragments, and see whether there is blood in the cavity of the knee joint.
- X-ray with contrast allows you to identify all possible defects from the inside.
- MRI reliably reveals all injuries associated with rupture cartilaginous layer knee joint.
After diagnosis, optimal treatment methods for the posterior horn of the medial meniscus are selected. Treatment for a medial meniscus injury depends on where the tear occurs and its severity. Based on this criterion, there are 2 types of treatment: conservative and surgical. It is advisable to use conservative or therapeutic methods of treatment in cases where there are minor injuries and ruptures. If such treatment measures are carried out in time, they turn out to be quite effective.
First of all, it is necessary to provide assistance in case of injury, which includes restoring the injured person, applying a cold compress to the injury site, pain relief with an injection, and applying plaster cast. Conservative treatment takes a long period time and involves the use of painkillers and anti-inflammatory drugs medicines, as well as physiotherapy and manual therapy procedures.
If the damage and tear are severe, the medial meniscus must be treated through surgery. If possible, surgeons try to preserve the damaged meniscus by using various manipulations. There are the following types of operations for the treatment of a tear of the medial meniscus of the knee joint:
The most suitable method is selected by the surgeon.
Rehabilitation period
An important stage in the treatment of such injuries is the restoration of normal functioning of the joint. The rehabilitation process should be supervised by an orthopedist or rehabilitation specialist. During the recovery process, the victim is shown a set of the following procedures:
- physiotherapy;
- physiotherapeutic procedures;
- massage;
- hardware methods for joint development.
Rehabilitation activities can be carried out both at home and in a hospital. However, being in a hospital would be preferable. The duration of the rehabilitation course is determined by the degree of damage and the type of treatment performed. Typically complete recovery occurs after 3 months.
During the rehabilitation process, it is important to relieve the swelling that forms inside the joint as a result of surgical intervention. Swelling may persist long time and interfere with the complete restoration of the joint. To eliminate it, the use of lymphatic drainage massage will be effective.
A tear of the posterior horn of the medial meniscus, despite its severity, has a favorable prognosis if the main condition is met - timely treatment.
The prognosis becomes less favorable if horizontal gap medial meniscus is accompanied by concomitant severe injuries.
27Oct
2014
What is a meniscus?
The meniscus is a cartilage pad that sits between joints and acts as a shock absorber.
During motor activity The menisci can change their shape, making the gait smooth and not dangerous.
The knee joint contains the outer (lateral) and inner (medial) menisci.
The medial meniscus is less mobile, so it is susceptible to various injuries, among which ruptures should be noted.
Each meniscus can be divided into three parts: anterior horn, posterior horn, and body.
The posterior horn of the meniscus, which is the internal part, is characterized 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 tissue is not designed for regeneration. Trauma is difficult to diagnose, which is why mandatory procedure is magnetic resonance imaging.
Why do meniscal injuries occur?
Meniscus injuries can be caused by various diseases and other reasons. Knowing all the reasons that increase risks, you can guarantee the maintenance of ideal health.
- Mechanical injuries can be caused by external mechanical influence. The danger is caused by 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 knee ligaments, tear of the posterior horn of the medial meniscus, tear of the body lateral meniscus, fracture of the joint capsule. In this situation, treatment must be started in a timely manner and must be thoughtful, since only in this case can unwanted complications be avoided and all functions restored.
- Genetic causes suggest a predisposition to various diseases joints. Diseases may be hereditary or 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 in the knee joint is impaired. Degenerative damage may appear early. Damage to cartilaginous ligaments and menisci can occur at a young age.
- Pathologies of the joints caused by previous or chronic diseases, is usually classified as a biological type of damage. As a result, the risk of injury increases due to exposure pathogenic microbes. Ruptures of the horn or body of the meniscus, abrasion, and separation of fragments may be accompanied by inflammatory processes.
It should be noted that the above list represents only the main reasons.
Types of meniscus injuries.
As noted, many people experience combined meniscal injuries that include a tear or avulsion of the posterior or anterior horn.
- Tears or the appearance of a part of the meniscus in the capsule of the knee joint, torn off due to abrasion or damage, are one of the most common cases in traumatology. These types of damage usually include 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.
Symptoms of a meniscus tear.
- Traumatic ruptures.
After this injury, a person may feel pain and notice swelling of the knee.
When pain When descending stairs, you may suspect a tear in the posterior part of the meniscus.
When a meniscus ruptures, one part can come off, after which it will hang loose and interfere with the full functioning of the knee joint. Small tears can cause difficulty moving and painful clicking sounds in the knee joint. A large tear leads to a 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 meniscus of the medial meniscus in most cases is limited to impaired motor activity of the knee joint and knee flexion.
In case of injury, sometimes the pain is particularly intense, as a result of which a person cannot step on his leg. In other cases, the tear may cause pain only when performing certain movements, such as going up or down stairs.
- Acute rupture.
IN in this case a person may suffer from swelling of the knee, which develops in a minimum time and is particularly severe.
- Degenerative ruptures.
Many people after forty years suffer from degenerative meniscal tears that are chronic.
Increased pain and swelling of the knee cannot always be detected, since their development occurs gradually.
It is important to note that it is not always possible to find indications of the injury that occurred in the patient’s health history. In some cases, a meniscus tear may occur after performing normal action, for example, getting up from a chair. At this time, blockage of the knee joint may occur. It should be borne in mind that in many cases chronic ruptures lead only to pain.
With this injury, the meniscus may be damaged, and its adjacent cartilage may cover the tibia or femur.
The signs of chronic meniscus tears are different: pain with a certain movement or a pronounced pain syndrome that does not allow you to step on your leg.
Regardless of the type of injury, you should consult a doctor in a timely manner.
How should a torn posterior horn of the meniscus be treated?
Once an accurate diagnosis has been made, it is necessary to begin treatment in a hospital setting.
For minor breaks it is necessary conservative treatment. The patient takes anti-inflammatory and painkillers and undergoes manual therapy and physical therapy.
Serious damage requires surgery. In this case, the torn meniscus must be sutured. If restoration is not possible, the meniscus should be removed and a menisectomy performed.
IN Lately Arthroscopy, which is a invasive technique. 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 the supervision of a physician. IN mandatory Rehabilitation treatment should be prescribed to promote full recovery. Rehabilitation includes therapeutic exercises, taking antibiotics and drugs to prevent inflammatory processes.
Features of surgical intervention.
If surgery is necessary, the possibility of suturing the meniscus is determined. This method is usually preferred when the “red zone” is damaged.
What types of operations are usually used for injury to the horn of the medial meniscus?
- Arthrotomy is a complex operation that involves removing damaged cartilage. They are trying to abandon this method, but arthrotomy is mandatory if the damage to the knee joint is extensive.
- Meniscatomy is an operation that involves complete removal of cartilage. The technique used to be common, but now it is considered harmful and ineffective.
- Partial meniscectomy is a surgical procedure during which the damaged part of the cartilage is removed and the remaining part is restored. Surgeons must trim the edge of the cartilage, trying to bring it into an even state.
- Endoprosthetics and transplantation. Many people have heard about these types of operations. The patient must have a donor or artificial meniscus transplanted, and the affected meniscus is removed.
- Arthroscopy is recognized as the most modern look operations. This method is characterized by low trauma. The technique involves two small punctures. An arthroscope, which is a video camera, must be inserted through one puncture. Saline solution enters the joint. Another puncture is necessary to perform various manipulations with the joint.
- Cartilage suturing. This method can be performed using an arthroscope. The operation can be effective only in the thick zone, where there is a high chance of cartilage fusion. Surgery should be performed almost immediately after the rupture.
The best method of surgery should be selected by an experienced surgeon.
Rehabilitation period.
Treatment of the meniscus necessarily involves restoring the functions of the knee joint. It is important to remember that rehabilitation should be carried out under the strict supervision of a rehabilitation specialist or orthopedist. The doctor must determine a set of measures aimed at improving the condition of the knee joint. Rehabilitation measures should contribute quick recovery. Recovery stage Treatments can be carried out at home, but it is necessary to visit a clinic. Ideally, rehabilitation should be carried out in a hospital. It should be noted that the range of measures includes physical therapy, massage, and modern hardware methods. To stimulate the muscles and develop the joint, the load must differ in dosage.
In most cases for full recovery It takes several months for the knee joint to function properly. You can lead a normal lifestyle one month after surgery. Functions will be restored gradually as serious problem due to the presence of intra-articular edema. To eliminate swelling, lymphatic drainage massage is necessary.
Staging accurate diagnosis and timely treatment allow us to count on a favorable prognosis. Consulting with an experienced physician will ensure that any knee joint problems are addressed, thereby eliminating any mobility issues. Compliance with all recommendations experienced doctor will restore ideal health.
Menisci in the human body can be found not only in the knees. They are also a cartilaginous lining in the clavicular and jaw joints. But it is the knee joint that constantly experiences increased stress. This is how degenerative changes in the posterior horn of the medial meniscus develop over time. Also, not only the internal, but also the external (lateral) cartilage may suffer.
Degenerative-dystrophic changes in the structure of the knee joints
Degenerative changes in the posterior horn of the medial meniscus
Normal knee joints of the left and right leg protected from loads by menisci. Two cartilages fix and cushion the bones lower limbs, preventing most damage from normal walking. The meniscal ligaments secure the protective layer to the anterior and posterior protrusions (horns).
Over time, due to degenerative phenomena and injuries, the menisci are damaged. The medial one most often suffers, as it is thinner. Over time, the picture of the disease gradually worsens until the pathology begins to seriously affect the patient’s health and ability to move. There are 5 types of degeneration processes:
- Meniscopathy. This is a degenerative phenomenon that is most often a consequence of another problem, such as arthritis, gout or osteoporosis. The cartilage gradually becomes thinner and ceases to perform its functions.
- Cystosis. Small tumors form in the cartilage cavity, which interfere with the normal movement of the joint and deform the surrounding tissue.
- Degenerative tear of the posterior horn of the medial meniscus. Likewise, the anterior or body cartilage may rupture.
- Meniscal ligament rupture. At the same time, the cartilage retains its integrity, but becomes too mobile, which can lead to subsequent injuries and dislocations.
- Meniscus tear. In this case, the cartilage pad simply moves out of 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 bruise as a consequence of degenerative changes in cartilage
Degenerative changes in the structure of cartilage tissue occur not only due to bruises and fractures, when damaged bones begin to wear away cartilage. Much more often, the cause of such pathological phenomena is a person’s lifestyle or natural processes related to structural features of the body:
- Hyperload. The main segment of the population suffering from degenerative changes in the meniscus are athletes and dancers. Also at risk are people engaged in heavy physical labor. It is worth mentioning separately the problem excess weight. Every day, excess pounds place additional stress on the knees, gradually damaging the menisci.
- Improper formation of the musculoskeletal system. Degeneration – by-effect dysplasia, flat feet and disorders during the development of the ligamentous apparatus. The body tries to compensate for all these problems by placing additional stress on the knees, which leads not only to meniscal dystrophy, but also to other chronic pathologies.
- Diseases. Syphilis, tuberculosis, rheumatism and a number of other pathologies of various types affect the health of the knees. In addition, treatment of these diseases can also provoke a worsening of the joint condition. So glucocorticoids worsen the condition of the meniscal ligaments.
Damage to articular cartilage appears sharply only with severe injuries. Otherwise, it is a long process that can be reversed with timely treatment.
Signs of degeneration
The first symptoms of initial meniscus lesions are unlikely to force a person to seek treatment. medical care. Typically, signs of degenerative changes in the posterior horn of the medial meniscus appear when walking and running. It is enough to put a serious load on the joint to feel pain. At the same time, a person can still play sports and do morning exercises without much discomfort in damaged knees. This is how the first stage of the disease begins.
But there are other symptoms according to the gradation proposed by American sports doctor Stephen Stoller:
- Zero degree. Completely healthy meniscus.
- First degree. All damage remains inside joint capsule. Externally, you can only notice a slight swelling on the outer front of the knee. Pain occurs only with heavy exertion.
- Second degree. Degenerative changes in the medial meniscus, grade 2. 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 increases, as does the pain. When moving, characteristic clicks appear. Joints begin to stiffen with prolonged immobility.
- Third degree. The stretching of the cartilage reaches its maximum possible value and tears the meniscus. The person feels severe pain and easily notices swelling above the knee. If a complete tissue rupture occurs, the loose areas can move and block the joint.
Degenerative lesions of the posterior horn internal meniscus Grade 2 and even 3 can still be treated with conservative methods if everything is done correctly. And the first key to healing is timely diagnosis.
Knee examination
The doctor can determine degenerative damage to the posterior horn and the body of the medial meniscus simply by characteristic tumor, joint blockade and clicking. But for a more accurate diagnosis and identification of the degree of damage to the joint, it will be necessary additional examination which is carried out using hardware and laboratory methods:
- Ultrasound. Ultrasound helps to detect cavities of the joint capsule filled with blood and exudate. Thanks to this data, the doctor can prescribe a further puncture.
- MRI. Most exact method, demonstrating a complete picture of the disease.
- Puncture. If the tumor is pronounced, the doctor may take a fluid sample to make sure there is no infection in the knee joints.
Can also be carried out additional research using an arthroscope. Through a small puncture in the tissue, 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 a complete tear of the meniscus, the doctor will insist on a conservative method of treatment. Surgical intervention Best saved for a 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 that fix the knee or completely immobilize it may be prescribed. In addition, complex therapy will be prescribed:
- Drug treatment. Medications are used primarily as aids. 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 natural regenerative abilities. A bacterial infection will also require a course of antibiotics.
- Hardware treatment. UHF, electrophoresis, shock wave therapy, acupuncture, iontophoresis, magnetic therapy and eozokerite improve knee health. The specific list of procedures will depend on the individual's medical history and hospital capabilities.
- Puncture. The procedure is prescribed for severe tumors that provoke pain and reduce joint mobility. Excess fluid is pumped out through the puncture. If necessary, drainage can be installed.
If conservative treatment methods do not help, then you need to wait for remission and undergo surgery. The use of an arthroscope is usually sufficient. The only difference from the diagnostic procedure is that micro-instruments will be inserted through 2 punctures and an incision. With their help, the doctor will sew up damaged tissue. Then the stitches are applied to the soft tissues, and after a week you can already walk, although only with a cane.
For more extensive damage, endoprosthetics may be required. In this case, instead of the destroyed cartilage, artificial substitutes will be installed. They are durable and usually do not require replacement for a couple of decades. In this way, it is possible to correct not only degenerative changes in the meniscus, but also a number of other associated chronic pathologies knee joint.
What is the danger of a rupture of the posterior horn of the medial meniscus of the knee joint, treatment of damage to the horns of the meniscus - these questions 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 carried out thanks to a 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 as a kind of shock absorber when any human movement occurs.
Meniscus injury
The medial meniscus changes shape when moving, which is why people’s gait is so smooth and flexible. The knee joints have 2 menisci:
Doctors divide the meniscus itself 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 internal part differs in that it does not have its own blood supply system, however, because nutrition should still be there, it is carried out thanks to the constant circulation of 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 tissue cannot recover. Moreover, a tear in 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 determined using magnetic resonance imaging. But with the help of developed tests, which are based on joint extension, scrolling movements, as well as the sensation of pain, the disease can be determined. There are a lot of them: Roche, Landa, Baikov, Shteiman, Bragard.
If damage to the posterior horn of the medial meniscus occurs, sharp pain, and severe swelling begins in the knee area.
When a horizontal tear of the posterior horn of the medial meniscus occurs, it is impossible to go down the stairs due to severe pain. If a partial tear of the meniscus occurs, it is almost impossible to move: the torn part dangles freely inside the joint, giving off pain at the slightest movement.
If you feel less painful clicking sounds, it means that tears have occurred, but they are small in size. When the tears occupy a large area, the torn part of the meniscus begins to move towards the center of the damaged joint, as a result the movement of the knee is blocked. The joint becomes wedged. When the posterior horn of the internal meniscus is torn, it is almost impossible to bend the knee, and the affected leg will not be able to withstand the load from the body.
Symptoms of a knee meniscus injury
If a meniscus tear occurs in the knee joint, the following symptoms will appear:
- pain that will eventually concentrate in the joint space;
- weakness of the muscles in the front of the thigh is felt;
- fluid begins to accumulate in the joint cavity.
As a rule, 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 whose load falls mainly on the legs. Even a sudden awkward movement can lead to a rupture. Very often, ruptures of the degenerative form become protracted and chronic. A symptom of a degenerative rupture is the presence of a dull aching pain in the knee area.
Treatment of medial meniscus injury
For 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 the pain. In this case, a pain-relieving injection and pills that will reduce inflammation will help, and cold compresses will also help.
You need to be prepared for doctors to puncture the joint. Then it is necessary to clean the joint cavity from the blood and fluid accumulated there. Sometimes it is even necessary to use a joint blockade. 
These procedures are stressful for the body, and after them the joints need rest. To avoid disturbing the joints and fix the position, the surgeon applies a plaster cast or splint. During rehabilitation period Physiotherapy, fixing knee pads will help you recover, you will need to do physical therapy and walking with by various means 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 medications, as well as painkillers, manual and physical therapy procedures.
How is damage treated? As a rule, surgical intervention 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, which preserves intact tissue, only resection of damaged parts and correction of defects. As a result, complications very rarely occur after surgery.
The whole procedure goes like this: an arthroscope with instruments is inserted into the joint through 2 holes to first determine the damage and its extent. When the posterior horn of the meniscus ruptures affecting the body, it happens that the torn fragment moves, rotating along its axis. He is immediately returned to his place.
Then the meniscus is partially bitten out. This needs to 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 anterior horn. Part of the meniscus then needs to be given its original anatomical shape.
It will be necessary to spend time in a hospital under the supervision of a doctor and undergo rehabilitation.
