Meniscal injuries- violation of the integrity of the cartilage lining located in the cavity knee joint. In the acute period, the patient is bothered by pain in the knee and limitation of movements, there is joint blocking, swelling, and possibly the appearance of fluid in the joint or the development of hemarthrosis. Subsequently, repeated blockades, signs of inflammation, and recurrent synovitis are sometimes observed. The diagnosis is made by a traumatologist based on examination data, anamnesis, and in some cases an MRI of the knee joint. Treatment includes eliminating the blockade, ensuring complete rest, and, if indicated, puncture of the joint. If it is impossible to remove the blockade, repeated blockades, persistence pain syndrome surgery required.

General information

Meniscal injuries are the most common injury of the knee joint. Most often, meniscal injuries are the result of a sports injury. The internal meniscus is damaged 4-7 times more often than the external one.

Causes

Typically, the cause of a meniscus tear is rotation (rotation) of a half-bent or bent shin when the leg is loaded (while skating or skiing, playing hockey or football). Damage internal meniscus occurs when the tibia rotates outward, damage to the external one occurs when the tibia rotates inward. Less commonly, damage to the meniscus occurs as a result of a fall on straight legs (long and high jumps, dismounting from a projectile) or a direct blow to the knee joint (hitting the edge of a step, hitting a moving object).

The likelihood of meniscus tear increases with degeneration due to repeated trauma, chronic intoxications, gout or rheumatism. Damage to the meniscus may be accompanied by injuries to other elements of the knee joint (ligaments, cartilage, fat body or capsules).

Pathanatomy

Menisci are cartilage pads located inside the knee joint. Two menisci: lateral (outer) and medial (inner) are located between the articular surfaces of the tibia and femur. The main functions of the meniscus are shock absorption when running and walking. In addition, the menisci act as stabilizers of the knee joint. The menisci are elastic and can change their shape during movements in the knee joint. The mobility of the menisci is not the same. The internal meniscus is connected to the medial collateral ligament and is less mobile than the external one, so its damage occurs more often.

At the edges, the menisci grow together with the joint capsule and are supplied with blood by the vessels of the capsule. The internal parts of the menisci do not have their own arteries and receive nutrition from intra-articular fluid. This nutritional feature determines good fusion of the menisci in case of marginal injuries and complete absence adhesions due to damage internal parts.

Classification

The operation is indicated if it is impossible to eliminate the blockade in the acute period, repeated blockades, pain and limitation of movements in the joint in the acute period. chronic period. Currently, when choosing a method surgical treatment preference is given to arthroscopic interventions, which reduce the level of joint trauma and reduce the likelihood of complications. If possible, they try to preserve the meniscus, since after its removal the wear of the articular surfaces accelerates, leading to rapid development

The knee joint is formed from patella And femoral tibia . The articular surface of the bone is covered with cartilage tissue with a number of strong ligaments. Sliding during flexion-extension of the knee is ensured by the presence joint fluid And synovial membrane . When moving, the stability of the joint depends on the ligaments, muscles of the joint and intra-articular cartilage - menisci . often occur when joints are damaged, and in particular the menisci.

Meniscus - This is a cartilage lining between the joints that stabilizes the knee joint and acts as a kind of shock absorber. As you walk, the menisci shrink and change shape. Menisci are divided into two types. Outdoor or lateral , resembling the letter O, more mobile than the internal one and, therefore, less likely to be injured. Internal meniscus or medial , more static and associated with the lateral internal ligament of the knee joint, shaped like the letter C. The medial meniscus is more often affected frequent injuries along with the bundle. The menisci are connected by a transverse ligament at the front of the joint.

Meniscal damage– this is the most common type of knee injury, most often found in men and athletes, less often in everyday life.

Symptoms of knee meniscus damage

Meniscal damage occurs acute And chronic Accordingly, the symptoms of meniscus damage differ depending on its type. Its main manifestations are listed below:

• the patient complains of sharp pain, first of the entire knee, then the pain is localized, depending on which meniscus is damaged, from the outside or inside knee joint;
• movement is sharply limited, the patient does not feel or feels slight pain when the leg is bent, when trying to straighten the pain intensifies;
• the joint increases in volume, an indicator that treatment should be started immediately;
• upon extension, a clicking sensation appears; infiltration of the capsule and the resulting effusion into the joint cavity can be felt with the hand. These symptoms of meniscus damage appear after 2-3 weeks of illness;
• When fixing the knee joint at an angle of 150 degrees and trying to bend the leg, the patient feels a sharp pain.
• with chronic damage, the patient feels dull ache in the knee joint, worsening when going down the stairs.

Diagnosis of meniscus damage

Diagnosis is based on detailed questioning of the patient and examination. Due to the transparency of the meniscus to X-rays, fluoroscopy is ineffective. Helps establish a diagnosis endoscopic arthroscopy or magnetic resonance imaging .

Treatment of knee meniscus damage

To provide first aid for injuries of the knee joint and meniscus, apply fixing splint , pain relief is performed and the patient is transported to a trauma hospital.

If necessary, blood is removed from the knee joint and conservative treatment . A plaster cast is applied for 4 weeks, after removal - rehabilitation therapy.

If conservative treatment is ineffective, MRI is recommended ( magnetic resonance imaging ). If necessary, arthroscopy of the knee joint is performed. This is a low-traumatic method of surgical intervention, which has become an integral part in modern diagnostics and treatment of many forms of intra-articular pathologies, this method of treatment is currently considered the “gold standard”.

This diagnosis of meniscal injuries is also simultaneous therapy. Arthroscopy- this is an examination of the joint cavity using a special optical device, during which, if possible, stitching is carried out damaged meniscus. If suturing is impossible, as well as when the damage is localized in the extravascular part, complete or partial removal of the meniscus is performed. Meniscus removal or meniscectomy, most often, in 80% of cases, is possible during arthroscopy; in other cases, the surgeon is forced to resort to arthrotomy, i.e. open surgery.

In the absence of the ability to perform arthroscopy, it is performed puncture of the knee joint, at which the solution is introduced. Then, using special techniques, the pinched meniscus is reduced, while the patient must be in a lying position on an orthopedic table. The trauma surgeon must perform movements that are opposite to those movements that led to the injury. As soon as the meniscus is in place, all movements in the joint are immediately restored. Once the meniscus is repaired, treatment does not end. To fix the leg, a plaster cast is applied, and the injured leg is bent at a certain angle at the knee joint.

The period of immobilization, after treatment of the meniscus injury and application of plaster, is 3 weeks. After removal plaster cast appoint and physical therapy . In cases where the patient experiences repeated blockages of the joint, this condition is called chronic meniscus damage. With chronic damage to the meniscus, inflammation of the inner lining of the joint usually occurs, called, permanent It's a dull pain in the joint, which intensifies when walking, and especially when going down stairs. Possible development concomitant disease damaging the knee joint, such as cutting articular surfaces or. This condition almost always leads to frequent blockade of the joint. There is a need to remove " articular muscle » surgically. After the operation, a tight bandage or plaster cast is applied to the leg. An important condition recovery is the early exercise of therapeutic exercises.

The doctors

Medicines

Prevention of meniscus damage

As a preventative measure for meniscus damage, Everyday life It is recommended to be careful when running, walking, going up and down stairs. Women are advised to wear more stable shoes. Athletes are recommended to use special fixing bandages when playing sports ( knee pads ), if it is not possible to use them, you can bandage the knee joints for insurance elastic bandage . Prevention of meniscus damage makes it possible to avoid injury in 9 out of 10 cases.

Complications of meniscal injuries

If complications occur, it may develop deforming arthrosis, premature wear of intra-articular cartilage or blockade of the knee joint. Sudden pain when moving. Treatment may require surgery.

Diet, nutrition for meniscus damage

List of sources

• Traumatology and orthopedics / Guide for doctors. In 3 volumes. v.2/ Ed. SOUTH. Shaposhnikova. - M.: Medicine, 1997. -592 p.
• Comprehensive rehabilitation of athletes after injuries of the musculoskeletal system, Bashkirov V.F. – Moscow: Physical culture and sport, 2004, - 240 p.
• Sports injuries. Clinical practice prevention and treatment / under general. ed. Renström P.A.F.H. - Kyiv, “Olympic Literature”, 2003.

Education: Graduated from Vitebsk State medical University specialty "Surgery". At the university he headed the Student Council scientific society. Advanced training in 2010 - in the specialty "Oncology" and in 2011 - in the specialty "Mammology, visual forms of oncology".

Experience: Work in a general medical network for 3 years as a surgeon (Vitebsk Emergency Hospital medical care, Liozny Central District Hospital) and part-time as a district oncologist and traumatologist. Worked as a pharmaceutical representative for a year at the Rubicon company.

Presented 3 rationalization proposals on the topic “Optimization of antibiotic therapy depending on the species composition of microflora”, 2 works took prizes in the republican competition-review of student scientific works (categories 1 and 3).

The menisci of the knee joint are located between the tibial and femur cartilage discs. They are crescent-shaped “spacers” and provide stability to the joint, play the role of a shock absorber and increase the contact area of ​​the articular surfaces. When talking about meniscal damage, experts usually mean its rupture. In this article we will introduce you to the main causes, symptoms, types, methods of diagnosing and treating injuries to the meniscus of the knee joint.

Despite the large margin of safety of the menisci, such injuries are one of the most common problems of the knee joint and are usually observed in physically active people(youth, athletes, working individuals).

According to statistics, 60-70 people out of 100 thousand encounter such injuries every year, and 3-4 times more often such injuries occur in men. People under 30 years of age usually experience traumatic ruptures of the menisci, and after 40, a violation of their integrity due to the appearance of chronic degenerative changes.

A little anatomy

This is how the knee joint works.

There are two menisci in each knee joint:

• lateral (or external) - its shape resembles the letter C;
• medial (or internal) - has the shape of a regular semicircle.

Each of them is divided into three parts:

• anterior horn;
• body;
• posterior horn.

Menisci are formed from fibrous cartilage tissue and are attached to the tibia (front and back). In addition, the inner meniscus along the outer edge is attached by the coronary ligament to the joint capsule. This triple fastening makes it more stationary (compared to the external one). Because of this, it is the inner meniscus that is more susceptible to injury.

A normal meniscus consists primarily of special collagen fibers. Most of them are located circularly (alongwise), and the smaller part is located radially (from the edge to the center). Such fibers are connected to each other by a small amount of perforating (i.e., random) fibers.

The meniscus consists of:

• collagen – 60-70%;
• extracellular matrix proteins – 8-13%;
• elastin – 0.6%.

In the meniscus there is a red zone - an area with blood vessels.

Functions of the menisci

Previously, scientists believed that menisci were nonfunctional muscle remnants. It is now known that they perform a number of functions:

• contribute to uniform distribution of load on the surface of the joint;
• stabilize the joint;
• absorb shocks when moving;
• reduce contact tension;
• send signals to the brain about the position of the joint;
• limit the range of motion of the cartilage and reduce the likelihood of dislocations.

Causes and types of ruptures

Depending on the causes of meniscus damage, there are:

• traumatic ruptures - appear as a result of traumatic impact (awkward turn or jump, deep squatting, squatting, rotational-flexion or rotational movements during sports, etc.);
• degenerative ruptures - appear due to chronic diseases joint, which lead to degenerative changes in its structures.

Depending on the location of the damage, meniscal rupture can occur:

• in the anterior horn;
• body;
• posterior horn.

Depending on the shape, a meniscus tear can be:

• horizontal - occurs due to cystic degeneration;
• oblique, radial, longitudinal - occurs at the border of the middle and posterior third of the meniscus;
• combined - occurs in the posterior horn.

After an MRI, specialists can judge the extent of meniscus damage:

• 0 – meniscus without changes;
• I – a focal signal is recorded in the thickness of the meniscus;
• II – a linear signal is recorded in the thickness of the meniscus;
• III – intense signal reaches the surface of the meniscus.

Symptoms

Traumatic ruptures

At the time of injury, a person feels sharp pain in the affected area, the joint swells and hemarthrosis may develop.

At the time of injury (during a jump, deep squat, etc.), the patient develops sharp pain in the knee joint and soft fabrics knees swell. If damage occurs in the red zone of the meniscus, then blood flows into the joint cavity and leads to development, manifested by the appearance of bulging and swelling above the kneecap.

The intensity of pain when a meniscus is damaged can vary. Sometimes, due to its severity, the victim cannot even step on his foot. And in other cases, it is felt only when performing certain movements (for example, when going down the stairs it is felt, but not when going up).

After an injury to the internal meniscus, when trying to strain the leg, the victim feels a sharp shooting pain, and flexing the limb leads to pain along the tibial ligament. After an injury, the kneecap cannot be moved, and muscle weakness is detected in the area of ​​the front surface of the thigh.

If the outer meniscus is damaged, the pain intensifies when trying to turn the lower leg inward. It is felt when the fibula is tense collateral ligament and shoots along it and into the outer part of the joint. In the area of ​​the front of the thigh, the patient exhibits muscle weakness.

After a meniscus rupture, the torn part moves and impedes movement in the knee joint. With minor injuries, sensations of difficulty in movement and painful clicks may appear, and with large ones, a blockade of the joint may occur, which is caused by the movement of a large moving fragment to the center of the joint (i.e., it seems to jam the joint). Typically, the gap posterior horn leads to limited flexion of the leg at the knee, and damage to the body and anterior horn makes it difficult to straighten the limb.

Sometimes a meniscus tear (usually the external one) can be combined with. In such cases, swelling of the knee occurs faster and is more significant than with an unrelated injury.

Degenerative tears

Typically, such injuries occur in people over 40 years of age. Their appearance is not always associated with a traumatic factor, and a rupture can occur after performing habitual actions (for example, after rising from a chair, bed, armchair) or with minor physical impact (for example, a normal squat).

The patient experiences swelling and pain in the knee area, which does not occur acutely. Usually, this is where the manifestations of a degenerative meniscus end, but in some cases they may be accompanied by a blockade of the joint. Often, with such injuries to the meniscus, there is a violation of the integrity of the adjacent cartilage that covers the tibia or femur.

As with traumatic injuries, the severity of pain during degenerative ruptures may vary. In some cases, because of it, the patient cannot step on his leg, and in others, pain occurs only when performing a specific movement (for example, squatting).

Possible complications

Sometimes, in the absence of unbearable pain, meniscus damage is confused with ordinary damage. The victim may long time do not seek help from a specialist, and painful sensations may disappear completely over time. Despite this relief, the meniscus remains damaged and ceases to perform its functions.

Subsequently, destruction of the articular surfaces occurs, leading to the development severe complication– (deforming arthrosis). This dangerous disease in the future it may become an indication for knee replacement.

If a knee injury is the reason for compulsory treatment See your doctor for the following symptoms:

• even mild pain in the knee when walking up stairs;
• the appearance of a crunching or clicking sound when bending the leg;
• episodes of knee locking;
• swelling;
• sensations of interference when moving in the knee joint;
• inability to squat deeply.

If at least one of the above symptoms appears, you should contact an orthopedist or traumatologist.

First aid

Ice should be applied to the injured knee.

For any knee injury, the victim should be provided with first aid:

1. Immediately avoid any stress on the knee joint and subsequently use crutches to move around.
2. To reduce pain, swelling and stop bleeding, apply a cold compress to the area of ​​injury or wrap your leg in cotton cloth and apply ice to it (be sure to remove it every 15-20 minutes for 2 minutes to prevent frostbite).
3. Allow the victim to take a painkiller in the form of tablets (Analgin, Ketanol, Nimesulide, Ibuprofen, etc.) or perform an intramuscular injection.
4. Give your leg an elevated position.
5. Do not delay visiting a doctor and help the victim get to medical institution or trauma center.

Diagnostics

After interviewing and examining the patient, the doctor conducts a series of tests that allow the presence of meniscus damage to be determined with an accuracy of 95%:

• Steinman rotation tests;
• identification of the extension symptom using the Roche and Baikov tests;
• mediolateral test to identify the symptom of compression.

The following can accurately determine the presence of a meniscus tear: additional methods examinations:

• MRI of the knee joint (accuracy up to 95%);
• Ultrasound (sometimes used);
• radiography (less informative).

The information value of radiography in the study of cartilage tissue is small, but it is always prescribed if a meniscus tear is suspected to exclude the presence of other injuries (ligament ruptures, fractures, etc.).

Sometimes diagnostic arthroscopy is performed to confirm the diagnosis.

Treatment

Treatment tactics for meniscus injuries are determined by the severity of the injury. Small tears or degenerative changes can be repaired conservative methods, and in case of significant ruptures and blockages of the knee joint, the patient needs surgical intervention.

Conservative therapy

The patient is advised to provide maximum rest to the injured limb. To ensure the immobility of the joint, a bandage of elastic bandage, and when in bed, an elevated position of the leg is recommended. In the first days after injury, cold should be applied to the injured area. When moving, the patient must use crutches.

For elimination pain and inflammation, antibacterial and antibacterial drugs are prescribed. After cupping acute period the patient is recommended a rehabilitation program that provides the most full recovery functions of the knee joint.

Surgery

Previously, in case of severe injury to the meniscus, surgery was performed to completely remove it. Such interventions were considered harmless, since the role of these cartilage pads was underestimated. However, after such radical surgical operations, 75% of patients developed arthritis, and after 15 years - arthrosis. Since 1980, such interventions have been found to be completely ineffective. By this time, it had become technically possible to carry out such a minimally invasive and effective operation like arthroscopy.

This surgical intervention is performed through two small punctures (up to 0.7 cm) using an arthroscope, consisting of an optical device connected to a video camera that displays an image on a monitor. The device itself is inserted into one of the punctures, and the instruments for performing the operation are inserted through the other.

Arthroscopy is performed in an aquatic environment. Such surgical technique allows you to achieve good therapeutic and cosmetic results and significantly reduces the patient’s rehabilitation time after an injury. Using an arthroscope, the surgeon can reach the most distant parts of the joint. To eliminate damage to the meniscus, a specialist installs special fasteners (anchors) on it or applies sutures. Sometimes, if the meniscus is significantly displaced during surgery, it is partially removed (that is, its torn section is cut off).

If during arthroscopy the doctor detects chondromalacia (cartilage damage), then the patient may be recommended to administer special drugs intra-articularly after surgery. For this, the following can be used: Duralan, Ostenil, Fermaton, etc.

The success of arthroscopic interventions for meniscal tears largely depends on the severity of the injury, the location of the injury, the age of the patient and the presence of degenerative changes in the tissues. A greater likelihood of good results is observed in young patients, and a lower likelihood in patients over 40 years of age or in the presence of severe meniscal damage, horizontal dissection or displacement.

Typically, such surgery lasts about 2 hours. Already on the first day after arthroscopy, the patient can walk on crutches, stepping on the operated leg, and after 2-3 days he walks with a cane. Its full recovery lasts about 2 weeks. Professional athletes can return to training and their usual loads after 3 weeks.

In some cases, with significant damage to the meniscus and complete loss of its functionality, the patient may be recommended such surgery, like meniscal transplantation. Frozen (donor and cadaveric) or irradiated menisci are used as a graft. According to statistics, better results from such interventions are observed when using frozen donor menisci. There are also grafts made from artificial materials.

Damage to the meniscus of the knee joint, symptoms and treatment is a problem for people who are not used to sitting in one place and those who are actively involved in sports. The meniscus plays a very important role in the knee joint system, and its injury can seriously affect a person’s motor abilities. Any damage to the internal meniscus of the knee joint requires emergency measures And effective treatment. Poorly healed injuries can cause the development of various joint pathologies and early human disability.

Anatomical and physiological features

The knee meniscus is a triangular cartilage-like pad that separates the femur and tibia. The main tasks of such gaskets are to absorb sharp shocks, redistribute emerging loads, reduce contact stress in the area of ​​bone articulation and stabilize the joint. When bending a joint, more than 80% of the load is absorbed by the meniscus, and when extending the leg, up to 70% of the load.

In any knee joint there are 2 types of elements: the internal (medial) and external (lateral) meniscus. Internal meniscus C-shape connects the tibia to the outer capsular border of the joint. The tibial ligament is fixed in its middle. Such a mount medial meniscus reduces its mobility, which is the reason for its more frequent damage (destruction). The external meniscus covers almost the entire upper lateral area of ​​the tibia joint. Due to the fact that the lateral meniscus is not limited by the articular capsule in mobility, its injuries are recorded 8-9 times less often than injuries to the internal element.

Both types of menisci have the following main components in their structure: the body, as well as the anterior and posterior horn. The composition of the menisci is almost 75% formed by collagen fibers with multidirectional orientation. The interweaving and orientation of the fibers ensures very high strength of the structure. The outer end of the meniscus is composed of a thickened layer of collagen and is firmly attached to the joint capsule, while the inner end is slightly pointed and oriented into the joint cavity. Increased elasticity of the meniscus is ensured by a small amount of a specific protein (elastin). This structure makes the menisci almost 1.5 times more elastic than cartilage, which determines the functions of reliable shock-absorbing elements.

If we consider the blood flow system, the menisci have a specific character. The following zones are distinguished in them: the red area, which is in contact with the capsule and has its own circulatory network; an intermediate zone, powered by the red zone, and a white zone, in which there is no blood vessels, and nutrition occurs as a result of the diffusion of nutritional components from synovial fluid. In the meniscus attachment system, the following main ligaments are distinguished that strengthen the structure: the transverse ligament, which connects the menisci to each other, the frontal and dorsal femoral ligaments.

The essence of the problem

Despite the significant loads placed on the menisci, in in good condition they are capable of performing their functions. Another thing is the appearance of excessive loads exceeding the strength of the fibers. Such forces usually occur when the tibia rotates abnormally at the knee, when landing after a jump from a great height, or when squatting with a large load. In general, knee meniscus injury, especially medial meniscus injury, is a fairly common occurrence, most often affecting men. The most common type is a sports injury.

Damage to the meniscus takes the form of a rupture along its body or a complete tear at the site of attachment to the capsule or bone ending. Damage to the posterior horn of the medial meniscus is considered one of the most common, but ruptures of the anterior horn and body can be observed, both in the medial and lateral element. Damage to the meniscus can be completely isolated, but is often combined with damage to other articular elements. As a rule, the lateral and cruciate ligament, joint capsule. Almost half of the pathologies are combined with a fracture of the tibia condyles. Body rupture can occur with complete separation and movement of the severed part, or in the form partial rupture, when the connection between elements is not completely broken.

Etiological features of the pathology

In the etiology of meniscal injuries, there are 2 main mechanisms: traumatic and degenerative. The traumatic mechanism causes damage to an absolutely healthy joint at any age of a person when excessive load occurs. The most common injuries: damage to the internal meniscus - a sharp rotation of the tibia with a significant amplitude in the outer direction, and damage to the lateral meniscus - when it rotates inward.

Traumatic destruction of the medial meniscus often occurs in the longitudinal direction with destruction in its central area. A “watering can handle” lesion is considered typical, when the middle of the body is destroyed, but both horns are not destroyed. At the same time, lesions of the anterior and posterior horns are quite often observed. Transverse ruptures occur much less frequently. Rupture of the lateral fibers in an adult is not a typical lesion due to the high mobility of this meniscus. This injury is more common in adolescence when the tissues are not yet strong enough.

The degenerative mechanism of joint destruction is associated with chronic processes that reduce the strength of colloidal fibers. It develops in people over 48-55 years of age. When the structure of the menisci weakens, their destruction can occur under loads that are not normally critical. The provoking reasons that trigger the degenerative mechanism are the following factors:

• rheumatism;
• polyarthritis;
• gout;
• age factor;
• hypothermia;
• metabolic disease.

Symptomatic manifestation of pathology

If an injury such as a meniscus injury occurs, symptoms depend on the extent of the injury and the involvement of other joint elements. Most characteristic feature- pain syndrome. It can be localized at the point of rupture, and is often felt throughout the entire joint space. If the damage is not too great and the parts have not separated, then pain in the form of clicks is felt and discomfort appears.

In case of complete destruction, the torn fragment migrates into the joint and blocks its mobility. An intense painful symptom occurs.

In the case when destruction occurs in the red zone, a hematoma develops as a result internal bleeding. The process is accompanied by swelling slightly above the kneecap. If a piece of the anterior horn comes off, the function of the joint to extend the leg is impaired, and if the posterior horn is destroyed, the function of flexing the joint is impaired. Gradually, effusion – exudate – can accumulate in the joint as a result of the inflammation process.

The presence of a meniscus tear is determined by performing certain tests to determine the following symptoms:

1. Baykova: when straightening a leg bent at a right angle, with the help of a doctor, intense pain should appear;
2. Shteiman: rotation of the lower leg by the doctor while bending the leg at a right angle. To determine the location of the injury, the rotation is performed in different sides. If pain occurs during inward rotation of the leg, the medial element is affected; if it occurs in the opposite direction of rotation, the outer meniscus is affected.
3. Chaklina: detection of a click in the articular area during flexion and extension movements (click symptom) and sartorius symptom - thinning of the vastus femoris muscle.
4. Polyakova: pain occurs when lifting a healthy limb from a lying position, while lifting the body with support on the shoulder blades and heel of the affected limb.
5. Landau: pain occurs when taking the “sitting cross-legged” position.
6. Perelman - 2 types are identified: “staircase” - increased pain when walking down stairs or any hill; “Galosh” - pain manifests itself when turning the lower leg.
7. McMurray: pain and crunching are detected during rotational movement of the knee in a supine position with bent limbs.

Symptoms of damage to the meniscus of the knee joint, most often, manifest themselves quite clearly (pain, swelling, impaired mobility), but to definitively determine the type of pathology, it is necessary to differentiate these signs from joint diseases.

Diagnostics

The primary diagnosis is made based on the results of examination and testing. The next step to clarify the pathology is radiography and ultrasound of the knee joint. However, it should be borne in mind that x-rays do not provide a clear picture of meniscus damage, but help to establish the involvement of bone tissue in the process. Accurate diagnosis based on results computed tomography and MRI.

• 0 degree – meniscus in normal condition;
• 1st degree – initiation of a lesion within the meniscus without reaching its surface;
• 2nd degree – a linear type signal is detected inside the meniscus without reaching the surface;
• 3rd degree – the lesion reaches the surface of the meniscus or complete rupture of the body.

Principles of therapeutic measures

The treatment regimen for a damaged meniscus is determined by the type and extent of the damage. For small lesions it can be used conservative therapy, but the most common method is surgery. Only a doctor can decide which method to use after receiving the results of ultrasound and MRI.

Conservative therapy aims to eliminate the blockade of the joint. For this purpose, fluid is removed from the joint cavity by puncture and Procaine is administered. Important stage treatment - repositioning the meniscus in its place. If the procedure is carried out correctly, the blockade of the joint is removed. Further treatment includes the following procedures: UHF exposure, physiotherapy By individual program, massotherapy, prescribing chondroprotectors for cartilage restoration (Glucosamine, Chondroitin, Rumalon). If necessary, medications are used to relieve pain and relieve inflammation.

Surgery is performed in the following circumstances:

• flattening of the meniscal body;
• damage to blood vessels with bleeding;
• rupture (severance) of the horn;
• complete break;
• destruction of the meniscus with displacement;
• relapse of joint immobilization after conservative therapy.

Which doctor treats knee meniscus?

Which doctor treats knee meniscus?

An orthopedist deals with diseases of the musculoskeletal system and any disorders in its functioning. They undergo appropriate training, which allows them to quickly detect the disease and prescribe adequate treatment. If your clinic does not have such a specialist, a surgeon will replace him.

The traumatologist provides first aid, helps relieve pain and swelling, and assesses the degree of injury. That is, it will relieve pain, swelling, and, if necessary, realign the joint or meniscus. The traumatologist will also give recommendations on how to behave if it is not possible to see a doctor immediately.

Rheumatologist deals systemic diseases bones, joints and connective tissues. People turn to him if pathologies of the meniscus are accompanied by other disorders: pain in the shoulder or hip joints, inflammatory processes etc. If damage to the meniscus is caused by one of them, then you need to contact him. As a rule, a surgeon or traumatologist gives a referral to him.

An orthopedic surgeon performs operations on the knee joint. An experienced doctor with such qualifications has the skills to carry out open operations and arthroscopic. He accompanies the patient during the period of preparation for surgical intervention and during rehabilitation. Further observation is carried out by a local surgeon or orthopedist.

A chiropractor treats minor injuries and meniscal injuries, muscular system knees without the help of drugs. He uses massage and gymnastics technology that help restore blood flow and strengthen the muscles and joints of the body.