Meniscus injury and treatment

02-05-2018

Cartilage injury or cartilage detachment is a commonly occurring “diagnosis” associated with knee injuries. However, it is important to know that the cartilage injury can mean the meniscus injury, as well as the damage of the cartilago hyalina covering the joint surface, which may also be indicated by the harm of the meniscus. The following article describes the injury and treatment methods of the meniscus.

What the meniscus is, and where does it take place?

The meniscus is two, crescent shape fibrocartilage formation in the knee joint, between the shinbone and the thighbone. Both knee joints have 2 menisci cartilage, one on the outer (lateral) and one on the inner (medial) part of the joint.

Meniscus plays an important role in the functioning of the knee joint:

improve insertion and backfill: reduce the modal differences between the femur and the tibia
increasing surface: disperse the pressure on the joint surfaces
power absorption and transformation: absorb the mechanical shock
stabilization: support the stability of the knee

How can meniscus be injured?

Actually, meniscus injury means tear, which can lead to cartilage removal in more severe cases. In some cases, the injury is accompanied with cartilage detachment, which should be eliminated as soon as possible, to avoid the destruction of the cartilage on the condyles. The injuries of the medial meniscus are more common to the lateral ones. As the medial meniscus is more fixed to the joint capsule, it can be pinched easier between the condyles, which cause at last the tear of the meniscus cartilage.

A meniscal tear can be caused by acute or chronic stress. A sudden, indirect force or in some kind of rotation on the knee joint often leads to an acute tear

This type is more regular at a younger age, mostly between athletes, and usually accompanied by a ligament tear. Degenerative tear occurs due to a persistent overload of the knee joint as a result of repeated microtraumas. Regular weight-borne loads weaken the cartilage. Its occurrence is more common among older people.

Depending on the forces acting the most common types of a meniscus tear are shown in this illustration:

normal meniscus
radial tear
longitudinal tear
horizontal tear
bucket handle tear
parrot beak tea

What are the symptoms of a meniscus injury?

The following symptoms might refer to a meniscus injury:

swell around the knee
sudden, intense pain, typically in the articular gap
pain in the articular gap for twisting and rotating movements
in case of a bucket handle tear, the knee cannot be fully straightened and bent
the knee is gently bent, as the thorn part is wedged between the condyles and blocking its movement
popping sensation by moving the knee

How are meniscus injuries diagnosed?

The traumatologist / orthopedic specialist examines the painful joints and also compares them with their healthy sides. Tensely checks the pressure sensitivity, localizes the exact place of the pain, and examines the patella function. Then, by exercise test examines the active and passive range of motion of the knee, checking the stability of the knee joint.

In case of a suspected meniscus injury, he tests direct pressure sensitivity and then performs rotational tests.

A meniscus injury can be diagnosed by these physical tests, but in case of uncertain symptoms, MRI scan is recommended.

What kind of treatments are available for a meniscus tear?

A meniscus tear is treated surgically, by refixing (meniscus repair) or removing (meniscectomy) the torn part. At our hospital, meniscus surgeries are performed by an arthroscopic procedure. This precise, minimally invasive technique allows faster recovery, as it is performed with minimal tissue damage, without big incisions.

The aim of the surgery is to preserve as much cartilage, as possible, because meniscectomy (total removal) enhances instability of the knee and accelerates the abrasion of the cartilage on the condyles.