Posterior horn

Treatment of a tear in the posterior horn of the lateral (outer) meniscus

The lateral meniscus is a structure in the knee joint that has a shape close to a ring. Compared to the medial meniscus, the lateral meniscus is slightly wider. The meniscus can be 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 is attached 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 activity associated with heavy physical labor. According to statistics, this injury is more common than anterior injury. cruciate ligament. However, approximately one third of all cases of ligament rupture are associated with a meniscus tear. In terms of frequency, damage of the “watering can handle” type is in first place. Isolated damage to the posterior horn of the meniscus accounts for about a third of all meniscus injuries.

Causes

Injury to the posterior horn of the lateral meniscus varies from patient to patient. The causes of injury largely depend on the age of the person. Thus, in young people under 35 years of age, the cause of injury is most often mechanical impact. In elderly patients, the cause of rupture of the posterior horn is most often a degenerative change in the meniscal tissue.

In women, rupture of the posterior horn of the external meniscus occurs less frequently than in men, and the rupture itself is usually organic character. In children and adolescents, rupture of the posterior horn also occurs, usually due to awkward movement.

Injury resulting from mechanical impact can have two possible reasons: direct blow or rotation. Direct impact in in this case associated with a strong blow to the knee. The victim's foot is usually fixed at the moment of impact. Damage to the posterior horn is also possible with awkward, sharp bending of the leg at the knee joint. Age-related changes in the meniscus significantly increase the risk of injury.

The rotational mechanism of injury implies that a meniscus rupture occurs in the event of a sharp twisting (rotation) of the ankle with the foot fixed. The condyles of the tibia and femur with such rotation shift in opposite directions. The meniscus also moves when attached to tibia. If there is excessive displacement, there is a high risk of rupture.

Symptoms

Damage to the posterior horn of the lateral meniscus manifests itself with symptoms such as pain, impaired joint mobility, and even complete blocking of the joint. 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 only manifest itself nonspecific symptoms, which are also typical for other injuries: damage to the ligaments or patella.

A complete tear of the horn of the meniscus, 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 restrained by the structures of the joint. A typical rupture of the posterior horn is a limitation in the ability to bend the leg at the knee.

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

Conservative treatment

For small tears, non-surgical treatment is preferred. Puncture gives good results when blocking a joint - removing blood helps to “free” the joint and eliminate the blockage. Further treatment consists of undergoing a number of physiotherapeutic procedures: therapeutic exercises, electromyostimulation and massage.

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

Surgical treatment

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

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 knee joint, reducing pain and restoring full range of motion in the joint. It is worth noting that full recovery possible even if the meniscus is removed.

The meniscus is important structural element knee joint. In appearance, it resembles a crescent with slightly forward-leaning edges.

The meniscus is divided into several parts:

body,

end zones,

posterior and anterior horn.

The knee joint has a complex structure; it contains two menisci – the lateral (outer) and the medial. They are attached to the tibia using their elongated ends. The outer meniscus is considered more mobile than the medial one and is located in the outer part of the knee. The first rupture occurs quite rarely.

The medial meniscus is located in the inner region of the knee and connects to the medial collateral ligament. The paracapsular part of the meniscus (or red zone) contains many small capillaries through which it is supplied with blood. The intermediate part of the cartilage has fewer capillaries, and therefore is not as strongly supplied with blood. The inner part of the cartilage (meniscus) does not receive blood at all, since it does not have blood vessels.

Menisci perform many different functions: serve as shock absorbers during movement, reduce and evenly distribute the load on the joints, participate in stabilizing the position of the knee joint, thereby limiting the range of movements, which protects a person from injury.

Common meniscus injuries

Most patients present to the hospital with a combined meniscus tear, which includes a tear or tear of the posterior, anterior horn, or body of the meniscus.

cartilage rupture is an injury that is characterized by tearing of its thinner parts, or as a result severe injury the anterior and posterior horns rupture, either alone or in combination with the body;
separation of part of the meniscus or its appearance in the capsule of the knee joint occurs as a result of damage or abrasion. This case occurs frequently in traumatology.

Signs of rupture of the posterior and anterior horn of the meniscus

There are a number of signs by which you can determine a meniscal horn tear:

traumatic rupture. This type of injury is characterized by a sharp onset of pain in the knee joint after the injury, as well as swelling. The result of a meniscus injury can be a tear of one of its parts, which will cause severe discomfort person while walking. For simple breaks medial meniscus there are clicks in the knee during movement, the patient loses the ability to walk fully, and daily activity is limited.

Large tears cause jamming of the knee joint (blockage), since the torn part of the cartilage prevents the knee from bending and straightening. With such injuries, the pain can be unbearable, in special cases the patient is unable to even step on his foot. Sometimes severe pain can only occur as a result of performing certain activities, for example, going up or down stairs.

degenerative gap.

Degenerative tear of the posterior horn of the meniscus

This type of meniscus injury often occurs in patients over 40 years of age. It is not characterized by acute pain and swelling, since both of these symptoms develop gradually. The damage progressed to chronic stage To detect it, you need to undergo diagnostics. A rupture of the posterior horn of the medial meniscus is an insidious ailment that often occurs after getting up from a sofa or chair, or deep squatting, as everyone is accustomed to.

Often, with chronic ruptures, the joint is blocked, but this type of injury is mainly characterized by pain and sometimes swelling. When the posterior horn of the meniscus ruptures, the cartilage of the articular surfaces located nearby is often damaged. By analogy with acute ruptures, degenerative ones also manifest themselves in different ways. In one case painful sensations appear when performing certain actions, in others there is constant pain that prevents you from stepping on your leg.

Causes and mechanisms of ruptures

Medicine knows a number of reasons that lead to meniscus injury:

strong physical exertion, twisting of the shin (especially while playing tennis or football);
active walking or running on uneven terrain;
sitting for a long time in a “half squat”;
age-related tissue changes;
jumping on one leg or spinning;
congenital weakness of ligaments and joints;
bending or straightening the leg too sharply;
direct knee injury ( severe bruise or fall).

What happens to a damaged meniscus?

Longitudinal gap The meniscus can be partial or complete. The latter form is considered more dangerous because the separated part of the posterior horn or body of the meniscus enters the area between the articular surfaces, which leads to blocking the movement of the entire joint. A longitudinal rupture is fraught with complete immobilization of the joint.

Oblique tears occur between the posterior horn of the meniscus and the middle of the cartilage body. This injury is considered partial rupture(flap), however, the edge of the cartilage can get between the joints, which will lead to “wandering pain” from one part of the knee to another; a cracking sound is heard when moving the knee. A horizontal tear occurs in the inside of the joint (meniscus). This type of injury is characterized by swelling in the joint space and acute pain.

Often this type of injury combines several types of damage at the same time (combined rupture).

Diagnosis of meniscus damage

Acute pain syndrome and other symptoms described above clearly indicate that it is necessary to as soon as possible seek help from a traumatologist. Doctor for staging accurate diagnosis should conduct a number of studies, including:

X-ray diagnostics. Can be used when obvious signs meniscus tear. The method is considered ineffective, therefore it is used to determine the presence or absence of fractures;
Ultrasound diagnostics. It is considered ineffective because the correctness and accuracy of the diagnostic results obtained largely depends on the experience and qualifications of the doctor;

MRI – more reliable method detection of cartilage damage. An MRI shows the condition of the meniscus and the complexity of the injury (tear or complete rupture).

The reliability of the data obtained is important for further choice of treatment method (surgery, medication).

Consequences of injury

A tear of the medial and lateral meniscus is a complex injury, from which it is difficult to recover motor functions knee joint. However, the success of this event depends on several factors, including the location of the rupture and the duration of the injury. The likelihood of a speedy recovery decreases in a certain group of patients, which includes people over 50 years of age.

From year to year ligamentous apparatus becomes weaker, which affects the duration of the recovery period after illness. Another important point– speed of seeking help from a traumatologist. The longer the patient delays the meeting with the doctor, the longer the period of treatment and rehabilitation will last.

What to do if the meniscus is damaged?

Emergency care for injuries of the internal or external meniscus consists of limiting walking and load on the leg, and in some cases, immobilizing the injured leg. The knee must be fixed with an orthosis, elastic bandage, apply cold, walk with crutches if necessary.

To relieve the victim of unbearable pain, you need to give him an anesthetic in the form of a tablet or injection. It is necessary to seek help from a traumatologist as soon as possible in order to reduce the patient’s suffering.

Treatment methods for meniscus damage

There are two ways to restore the functions of the external and medial meniscus - operative and conservative. The choice of one treatment method or another depends on the complexity of the injury and the accuracy of the diagnosis.

Drug treatment

Conservative way of treatment of injuries of the posterior horn of the lateral and internal meniscus used in cases where there is no separation or large gap that has mild degree gravity. To avoid complications, the traumatologist resorts to the following measures:

upon the patient’s arrival at the hospital immediately after the injury, the doctor applies a cold compress to the injured area, injects an anesthetic intramuscularly and fixes the joint with an elastic bandage or orthosis if necessary;
joint puncture and fluid evacuation are performed (if required);
if there is a joint block, the doctor removes the block;
apply instrumental methods diagnostics to clarify the diagnosis;
the patient takes special medications that accelerate the healing and restoration of the meniscus;
Physiotherapy and therapeutic exercises are prescribed.

The recovery period can last up to 8-12 weeks, but the speed of healing directly depends on the age of the victim, the nature of the damage and the correctness of the prescribed treatment.

Surgical method of treatment

Surgical intervention is indicated in cases where the cartilage tissue is completely destroyed, with severe tears or tears of part of the meniscus.

Kinds surgical treatment:

removal of the meniscus if it is not possible to restore it (can be complete or partial);
suturing the injury site (arthroscopy, meniscal suture);
removal of the damaged portion of the meniscus and reconstruction of the remaining part (partial meniscectomy + suture);
meniscus transplant (an implant or donor cartilage is implanted into the patient);

Period full recovery and restoration of the meniscus depends on the nature of the damage and the type of surgical intervention. After surgical treatment, the patient undergoes a rehabilitation course, which includes physiotherapy, massage, physical therapy, taking chondroprotectors. For 3 months the patient should avoid severe physical activity on the knee joint. To avoid damage to the meniscus, attention must be paid to sports training, avoid falls, impacts, and also treat joint diseases in a timely manner.

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Pathology of the musculoskeletal system includes a rupture of the posterior horn of the medial meniscus. This injury is a consequence of indirect trauma to the lower limb. The human knee joint is very complex. Each of them contains 2 menisci. They are formed by cartilage tissue. They consist of a body, posterior and anterior horns. Menisci are essential for shock absorption, limiting range of motion, and matching bone surfaces.

Types of breaks

A type of tear of the posterior horn of the medial meniscus is called closed injury joint This pathology is most often found in adults. This type of injury is rare in children. Women suffer from this disease 2 times more often than men. The gap is often combined with.

This is the most common joint injury. Complex rupture is diagnosed mainly in people from 18 to 40 years old. This is due to an active lifestyle. Sometimes combined damage to both menisci is observed.

The relevance of this problem is due to the fact that such an injury often requires surgical intervention and a long recovery period.

After surgical treatment patients move on crutches. There are complete and incomplete rupture fabrics. The following options are known:

longitudinal;
vertical;
patchwork bias;
radial-transverse;
horizontal;
degenerative with tissue crushing;
isolated;
combined.

Isolated Gap posterior diagnosed in 30% of all cases of this injury.

Causes of damage

The development of this pathology is based on strong extension of the lower leg or its sharp outward rotation. The longitudinal gap is due to several reasons. Main etiological factors are:

falling onto a hard surface;
bruises;
traffic accidents;
blows;
degenerative processes against the background of gout and rheumatism;
sprains;
microtraumas.

A rupture of the posterior horn of the meniscus is most often caused by indirect and combined trauma. This usually happens in winter when there is ice. Lack of precautions, haste, condition alcohol intoxication and fighting all contribute to injury. Often, rupture occurs when the joint is in fixed extension. Athletes face a similar problem. The risk group includes football players, figure skaters, gymnasts and hockey players.

Permanent damage causes meniscopathy. Subsequently, when making sharp turns, a rupture occurs. Stands out separately degenerative damage. It occurs mainly in elderly people with repeated microtraumas. The cause may be intense stress during training or careless work activity. Degenerative horizontal gap posterior horn of the medial meniscus often occurs against the background of rheumatism.

It is facilitated by previously suffered tonsillitis and scarlet fever. Damage to the meniscus due to rheumatism is caused by impaired blood supply to tissues due to edema and other pathological changes. The fibers become less elastic and durable. They are not able to withstand heavy loads.

Less commonly, the cause of rupture is gout. Tissue traumatization occurs due to crystals uric acid. Collagen fibers become thinner and less durable.

How does a gap manifest itself?

If there is damage to the posterior horn of the medial meniscus, the following symptoms are possible:

pain in the knee area;
restriction of movements;
cracking sound when walking.

IN acute period reactive inflammation develops. The intensity of the pain syndrome is determined. If it is incomplete, then the symptoms are mild. Clinical signs lasts 2–4 weeks. Patchwork gap medium degree severity is characterized acute pain and limitation of limb extension at the knee.

The sick person can walk. If proper treatment is not carried out, then this pathology becomes chronic. Strong pain in combination with tissue swelling is characteristic of a severe rupture. In such people, small blood vessels in the knee area. Developing. Blood accumulates in the cavity of the knee joint.

It is difficult to support your leg. IN severe cases local temperature rises. The skin takes on a bluish tint. The knee joint becomes spherical. After 2–3 weeks from the moment of injury, a subacute period develops. It is characterized by localized pain, effusion and blockages. Typical specific symptoms Roche, Baykova and Shteiman-Bragarda. In the degenerative form of this meniscus pathology, complaints may appear only during work.

Patient examination plan

Treat line break necessary after clarification of the diagnosis. The following studies will be needed:

general clinical tests;
CT or MRI;
radiography;
arthroscopy.

Differential diagnosis is carried out in the following cases:

arthritis of various etiologies;
gonarthrosis;
softening cartilage tissue;

If the posterior horn of the meniscus is damaged, treatment begins after assessing the condition of the joint tissues. Magnetic resonance imaging is very informative. Its advantage is the absence radiation exposure. Arthroscopy is performed according to indications. This endoscopic method research. Examination of the knee can be carried out with both therapeutic and diagnostic purpose. Arthroscopy can be used to visually assess the condition of the knee joint. Before the procedure, you must undergo a series of tests. The study can be carried out on an outpatient basis.

Treatment tactics

Partial damage to the meniscus requires conservative therapy. The main aspects of treatment are:

plaster application;
use of painkillers;
puncture of the knee joint;
maintaining peace;
applying cold compresses;
massage;
physiotherapy.

If the cause is degenerative-dystrophic processes, then chondroprotectors are prescribed. These are medications that strengthen the cartilage tissue of the joints. They contain chondroitin sulfate and glucosamine. Chondroprotectors include Arthra, Teraflex, Dona and. To eliminate pain, NSAIDs are prescribed (Ibuprofen, Movalis, Diclofenac Retard). These medications are taken orally and applied to the skin in the joint area.

External agents are used after the plaster is removed. Patients must maintain motor rest. To accelerate the healing of the medial meniscus, physiotherapy (electrophoresis, UHF therapy, exposure to magnetic fields) is performed. A puncture is often required. A needle is inserted into the joint. If there is a small amount of blood, the puncture is not performed.

Analgesics and anti-inflammatory drugs may be administered during the procedure. medications. In severe cases it is required radical treatment. Indications for the operation are:

separation of the horns and body of the medial meniscus;
lack of effect from conservative therapy;
displacement rupture;
tissue crushing.

Reconstructive surgical interventions are most often performed. A complete meniscectomy is performed less frequently. This is due to the fact that removal of the medial meniscus in the future can lead to the development of deforming gonarthrosis. Special designs are used for tissue restoration. In the case of peripheral and vertical tears, the meniscus may be sutured.

Such intervention is justified only if there are no degenerative changes cartilage tissue. A complete meniscectomy can only be performed if there is a large tear and severe damage to the meniscus. Currently, arthroscopic operations are widely used. Their advantage is less trauma. After the operation, painkillers, physiotherapy and exercises are prescribed. Patients need to rest for up to a year.

Forecast and preventive measures

The prognosis for a rupture of the posterior horn of the internal meniscus of the knee is most often favorable. It worsens with severe hemarthrosis, combined lesions and untimely treatment. After therapy, pain disappears and range of motion is restored. In some cases, gait instability and discomfort while walking are observed.

Cluster large quantity If left untreated, blood in the knee joint can cause arthrosis.

In old age, treatment can be difficult due to the impossibility of surgery. Rupture of the horns of the medial meniscus can be prevented. To do this, you need to adhere to the following recommendations:

avoid sudden movements of the legs;
observe safety precautions while working at work and at home;
stop drinking alcohol;
do not get into fights;
wear knee pads when playing sports;
give up traumatic activities;
be careful during icy conditions;
in winter weather, wear shoes with threads;
give up extreme sports;
promptly treat arthritis and arthrosis;
diversify your diet;
move more;
take vitamins and mineral supplements;
treat rheumatism in a timely manner and.

A meniscus tear is a very common pathology in adults and adolescents. In case of a fall or injury and pain, you should go to the emergency room.

A tear of the posterior horn of the lateral meniscus or its anterior counterpart occurs as a result of trauma. This happens in people in the following risk groups:

professional athletes (especially football players);
people who lead a very active lifestyle and engage in various types extreme sports;
elderly men and women suffering from different types arthrosis and similar diseases.

What is damage to the anterior or posterior horn of the internal meniscus? To do this you need at least general outline know what the meniscus itself is. In general terms, it is a special cartilaginous structure consisting of fibers. It is needed for shock absorption in the knee joints. Similar cartilaginous structures exist in other places of the human body - all parts of the human body are equipped with them, which are responsible for flexion and extension of the upper and lower limbs. But damage to the posterior or anterior horn of the lateral meniscus is considered the most dangerous and most frequent injury, which, if not treated promptly, can lead to various complications and make a person disabled.

Brief anatomical description of the meniscus

Knee-joint healthy body contains the following cartilaginous inlays:

external (lateral);
internal (medial).

Both of these structures are shaped like a crescent moon. The density of the first meniscus is higher than that of the posterior cartilaginous structure. Therefore, the lateral part is less susceptible to injury. The internal (medial) meniscus is rigid and most often injury occurs when it is damaged.

The structure of this organ itself consists of several elements:

cartilaginous body of the meniscus;
anterior horn;
its rear counterpart.

The main part of the cartilage tissue is surrounded and penetrated by a network of capillary vessels, which form the so-called red zone. This entire area has increased density and is located on the edge of the knee joint. The middle part contains the thinnest part of the meniscus. There are no vessels in it and it is called the white zone. At primary diagnosis injury, it is important to determine exactly which area of the meniscus was injured and ruptured. Previously, it was customary to completely remove the meniscus if damage to the posterior horn of the inner layer was diagnosed, which allegedly helped relieve the patient of complications and problems.

But at the current level of development of medicine, when it is precisely established that the internal and external meniscus perform very important functions for the bones and cartilage of the knee joint, doctors try to treat the injury without resorting to surgery. Since the meniscus plays the role of a shock absorber and protects the joint, its removal can lead to the development of arthrosis and other complications, the treatment of which will require additional time and money. Damage to the anterior horn of the meniscus rarely occurs, since its structure has increased density and better resists various loads.

For such injuries it is usually prescribed conservative treatment or surgery if damage to the anterior horn of the lateral meniscus has caused blood to pool in the knee joint.

Causes of rupture of cartilage tissue

Damage to the posterior horn of the medial meniscus is most often caused by an acute injury, since forceful impact on the knee joint does not always lead to rupture of the cartilage tissue, which is responsible for shock absorption of this area. Doctors identify a number of factors that contribute to cartilage rupture:

excessively active jumping or running over rough terrain;
twisting of a person’s body on one leg when the foot does not leave the surface;
frequent and prolonged squatting or active walking;
development of degeneration of the knee joint in certain diseases and limb injury in this condition;
Availability congenital pathology, in which there is poor development of ligaments and joints.

There are different degrees of meniscal damage. Their classification is different in different clinics, but the main thing is that they are all determined by generally accepted criteria, which will be discussed below.

Symptoms of damage to the posterior horn of the internal meniscus

The signs of such a medial meniscus injury are as follows:

acute sharp pain upon injury. It can be felt for 3-5 minutes. Before this, a clicking sound is heard. After the pain has disappeared, the person will be able to move around. But this will cause new attacks of pain. After 10-12 hours, the patient will feel a sharp burning sensation in the knee, as if a sharp object had penetrated there. When bending and straightening the knee joint, the pain intensifies, and after a short rest it subsides;
knee blockage (“jamming”) occurs when the cartilage tissue of the internal meniscus ruptures. It can appear at the moment when a torn piece of the meniscus is pinched between the tibia and femur. This leads to the inability to move. These symptoms also bother a person when the ligaments of the knee joint are damaged, so the exact cause of the pain syndrome can only be found out when a diagnosis is made in the clinic;
When blood penetrates into the joint, traumatic hemarthrosis can occur. This occurs when a meniscal tear occurs in the red zone, when blood vessels are damaged;
after several hours from the moment of injury, swelling of the knee joint may appear.

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It is necessary to clearly distinguish between chronic damage to the posterior horn of the medial meniscus of the 2nd degree from acute injury. This is possible today using hardware diagnostics, which allows you to carefully examine the condition of the cartilage tissue and fluid in the knee joint. A third degree meniscus tear leads to blood accumulation in the internal parts knee In this case, the edges of the cliff are smooth, and when chronic disease the fibers are scattered, there is swelling, which occurs from damage to the nearby cartilage, and penetration into this place and accumulation of synovial fluid there.

Treatment of injury to the posterior horn of the internal meniscus

Rupture of the tissues of the knee joint must be treated immediately after the injury, since over time the disease from acute stage can go to chronic illness. If treatment is not started on time, meniscopathy may develop. This will lead to changes in the structure of the knee joint and degradation of cartilage tissue on the surfaces of the bones. This situation is observed in half of the cases of rupture of the posterior horn of the internal meniscus in patients who various reasons neglected the disease and sought medical help late.

Treatment of a rupture can be carried out using the following methods:

conservative method;
surgical intervention.

After making an accurate diagnosis, doctors eliminate the primary rupture of the horn of the meniscus with the help of a therapeutic course. In most cases, conservative treatment gives good results, although in about a third of cases of such injuries, surgical intervention is necessary.

Treatment conservative methods consists of several, quite effective stages (if the injury is not advanced):

manual therapy and traction with the help of various equipment, which are aimed at repositioning, that is, realigning the knee joint when a blockade develops;
the use of anti-inflammatory drugs that doctors prescribe to the patient to eliminate swelling of the knee;
a rehabilitation course in which treatment is carried out using therapeutic, restorative gymnastics, physiotherapy methods and massage;
prescribing a course to the patient in which treatment is carried out with chondroprotectors and hyaluronic acid. This lengthy process can last from 3 to 6 months over several years, but it is important for the restoration of the meniscal structure;
since injury to the posterior horn of the meniscus is accompanied by severe pain syndrome, then doctors continue treatment using painkillers medicines. For this purpose, analgesics are usually used, for example, Ibuprofen, Paracetamol, Indomethacin, Diclofenac and other drugs. They can be used only as prescribed by the attending physician in a dosage determined by the course of therapy.

The extent of meniscus damage is determined using MRI (magnetic resonance imaging). The study allows you to diagnose the localization of the disease and prescribe competent treatment. American orthopedist and doctor medical sciences David Stoller identified and characterized 3 degrees pathological process. Changes in meniscal integrity are classified based on physiological criteria determined during MRI. The procedure is effective but expensive. However, only tomograph data provide a complete picture of the condition of the menisci of the knee joints.

Principles for determining the extent of the disease

MRI is a non-invasive imaging test bone structures on the computer screen. The tomograph reveals the slightest violations integrity of cartilage. Pathological changes The menisci are displayed on the monitor and examined by a specialist. This method based on layer-by-layer scanning of tissues. Construction of a high-quality and reliable image is possible thanks to magnetic field. A nuclear resonance effect occurs. The protons of the atoms that make up the meniscus are involved. The released energy is recorded by a special sensor. The image is created using digital processing.

The stages of the pathological process in the meniscus of the knee joint are determined by an orthopedist based on MRI data.

IN modern medicine There are 4 basic principles that allow diagnosing advanced disease:

study of the severity of damage;
study of signal intensity;
detection of the localization of the violation;
identifying the prevalence of pathological changes.

The main criterion for classification according to Stoller is the severity of the destruction of the cartilage tissue that makes up the meniscus of the knee joint. Currently, for diagnosis and prescription effective therapy orthopedists all over the world use the technique American doctor medical sciences. Stoller's classification makes it possible to perform surgical intervention in a timely manner and maintain full mobility of the diseased knee.

Initial stage of the pathological process

Happens most often. The violation is caused physiologically. This is where the development of the pathological process begins. If stage 1 of the disease is diagnosed, there is no need to panic. The MRI result shows that the increased signal intensity is point-like and does not reach the cartilage. The pathological focus is localized inside the meniscus. The density of diseased and healthy tissues is different; this is clearly visible on the monitor during an MRI.

At the initial stage it manifests itself weakly. Most people don't even realize that they have knee problems. The meniscus and its individual parts are only partially damaged.

At the initial stage of development of the pathology, the following symptoms appear:

mild pain in the knee during physical activity;
slight swelling;
crunching of the joint while squatting or bending the leg;
periodic instability and unsteadiness of gait.

The human body adapts to the emerging disturbances. After 3 weeks, compensatory functions are activated, the symptoms cease to be noticeable. In this case, it is extremely difficult to identify the pathology, since the patient has no apparent reason to see a doctor. The initial degree of damage is discovered during a routine examination or MRI of the knee joint for a completely different purpose.

What is 2nd degree damage?

MRI results make it possible to distinguish the initial stage from more serious violations. If the increased intensity signals are linear and do not extend beyond the cartilage, a grade 2 meniscal injury is diagnosed. General anatomical structure bone tissue is not violated. The cartilage does not come off and retains its natural shape.

A feature of grade 2 according to Stoller is a pronounced clinical picture. Pathological condition It is diagnosed immediately after the first symptoms appear and a person contacts an orthopedist. Happens most often. It is not as mobile as the external one and needs chondroprotectors. 2nd degree of pathology is characterized by:

constant pain in the joint;
increased discomfort during prolonged standing;
crunching and clicking in the knee joint when moving the leg;
swelling and redness of the knee;
soreness of soft tissues;
loss of balance;
impaired coordination of movements.

If a person suffers from the 2nd degree of meniscus damage according to Stoller, conservative treatment is prescribed. This stage of the pathological process is prone to progression, so it is important to follow all the recommendations of the orthopedist. The development of the degenerative-dystrophic process sometimes leads to meniscal rupture.

The manifestations that characterize the 2nd degree of pathology cannot be ignored. Early diagnosis plays a key role in maintaining full mobility of the knee joint. A patient diagnosed with stage 2 of the disorder can still be helped with minimal intervention in the body.

What is 3rd degree damage?

The most severe stage of the pathological process requires special attention on the part of the doctor and the patient. The timeliness of applying for qualified personnel plays an important role. medical care and literacy of the orthopedist. Grade 3 is characterized by a complete tear of the meniscus of the knee joint. Signals of increased intensity are horizontal and reach the surface of the cartilage. The anatomical structure is disrupted, this is clearly visible on the computer screen during an MRI. Doctors identify subdegree 3a. It is characterized not only by separation, but also by displacement of cartilage.

Stage 3 pathology rarely develops due to age-related changes or congenital disorders. Much more often, a torn meniscus is a consequence of injuries. Squats with heavy weights, high jumps, accidents at home or at work can cause damage to the integrity of cartilage tissue. Clinical picture manifests itself sharply and acutely. Stage 3 of the pathology is characterized by the following symptoms:

hemarthrosis (bleeding into the joint cavity);
sharp or rapidly increasing pain;
limited movements;
forced position of the lower leg at an angle of 30°;
accumulation of reactive effusion;
redness of the knee.

With the 3rd degree of meniscus damage, the pathology from acute form often becomes chronic. At any moment, the disease can worsen again. The relapse manifests itself clearly. The joint may suddenly jam, leaving the person unable to straighten the leg. In this case, only surgery will help.

You should contact an orthopedist at the first sign of possible violation. The doctor will refer the patient for an MRI to determine the severity of the disease. The results of the study will help make a diagnosis and prescribe the correct therapy.