Damage to the posterior horn of the internal meniscus. Posterior meniscus horn Incomplete rupture of the posterior meniscus horn

The meniscus is an important structural element of the knee joint. In its appearance, it resembles a crescent moon with slightly protruding edges.

The meniscus is divided into several parts:

body,

end zones,

back and front horn.

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

The medial meniscus is located in the inner region of the knee and connects to the internal lateral 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, therefore it is not so much 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: they 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 motion, which saves a person from injury.

Common meniscus injuries

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

cartilage rupture is an injury that is characterized by tearing of its thinner parts, or as a result of a severe injury, the anterior and posterior horns are torn separately or in combination with the body;
detachment of a 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 horns of the meniscus

There are a number of signs by which you can determine the rupture of the meniscus horn:

traumatic rupture... This type of injury is characterized by a sharp appearance of pain in the knee joint after an injury, as well as edema. The result of an injury to the meniscus can be the tearing off of one part of it, which will cause severe discomfort to a person while walking. With simple ruptures of the 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 the knee joint to jam (block it), since the torn off part of the cartilage interferes with the flexion and extension of the knee. With such injuries, the pain can be unbearable, in special cases the patient is not even able to step on his foot. Sometimes, severe pain can only appear as a result of performing certain actions, such as going down or climbing stairs.

degenerative rupture.

Degenerative rupture of the posterior meniscus horn

This type of meniscus injury often occurs in patients over 40 years of age. It is not characterized by acute pain or swelling because both symptoms develop gradually. The damage has spilled over into the chronic stage, in order to detect it, it is necessary to undergo diagnostics. The rupture of the posterior horn of the medial meniscus is an insidious ailment that often occurs after the habitual getting up from the sofa or chair, deep squatting.

Often, with chronic ruptures, the joint is blocked, but generally this type of injury is characterized by pain syndrome, sometimes swelling. When the posterior horn of the meniscus is torn, the adjacent cartilage of the articular surfaces is often damaged. By analogy with acute tears, degenerative ones also manifest themselves in different ways. In one case, painful sensations appear when performing certain actions, in the other - constant pain, which does not allow to step on the leg.

Causes and mechanisms of ruptures

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

strong physical activity, twisting of the lower leg (especially when playing tennis or football);
active walking or running on uneven terrain;
long sitting in a "semi-squat";
age-related changes in tissues;
jumping on one leg or spinning;
congenital weakness of the ligaments and joints;
too sharp bending or extension of the leg;
direct knee injury (severe bruise or fall).

What happens to a damaged meniscus?

Longitudinal meniscus rupture is partial or complete. The latter form is considered more dangerous, because the detached part of the posterior horn or the body of the meniscus falls into the area between the articular surfaces, which leads to blocking the movement of the entire joint. Longitudinal rupture is fraught with complete immobilization of the joint.

Oblique tears occur between the posterior meniscus horn and the middle of the cartilage body. Such an injury is considered a partial rupture (patchwork), but the edge of the cartilage can get between the joints, which will entail “wandering pain” from one part of the knee to another, and a crackling sound is heard when the knee moves. A horizontal tear occurs in the inner part of the joint (meniscus). This type of injury is characterized by swelling in the joint space and acute pain syndrome.

Often, this kind of injury combines several types of injuries 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 seek help from a traumatologist as soon as possible. To make an accurate diagnosis, the doctor must conduct a number of studies, including:

X-ray diagnostics. It can be used with obvious signs of a meniscus rupture. 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 is a more reliable method of detecting cartilage damage. MRI shows the state of the meniscus, the complexity of the injury (tear or complete rupture).

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

The consequences of injury

Rupture of the medial and lateral meniscus is a complex injury, after which it is difficult to restore the motor functions of the 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.

Every year the ligamentous apparatus becomes weaker, which affects the duration of the recovery period after the illness. Another important point is the speed of seeking help from a traumatologist. The more the patient delays the moment of 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 to the internal or external meniscus is to limit walking and load on the leg, in some cases, immobilize the injured leg. The knee must be fixed with an orthosis, an elastic bandage, apply cold, if necessary, walk with crutches.

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

Meniscus injury treatment methods

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

Drug treatment

A conservative way of treating injuries of the posterior horn of the lateral and internal meniscus is used in cases where there is no separation or large rupture, which are of mild severity. 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 drug intramuscularly and fixes the joint with an elastic bandage or orthosis, if necessary;
joint puncture is performed, fluid evacuation (if required);
if there is a blockade of the joint, the doctor removes the blockade;
instrumental diagnostic methods are used to clarify the diagnosis;
the patient's taking special drugs that accelerate the healing and restoration of the meniscus;
physiotherapy and remedial gymnastics are prescribed.

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

Surgical treatment

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

Types of surgical treatment:

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

The period of complete 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, exercise therapy, and the use of chondroprotectors. For 3 months, the patient should avoid heavy physical exertion on the knee joint. In order to avoid damage to the meniscus, it is necessary to pay attention to sports training, avoid falls, bumps, and treat joint diseases in time.

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Meniscus is a dense, disc-like cartilaginous tissue that connects the two articular bones of the knee. Meniscus fulfills the role shock absorber when driving. During movement, the synovial fluid lubricates the cartilage, thereby protecting them from bumps and impacts, protecting them from possible injury. Menisci guarantee the functionality and stability of the knee joint. The function of the menisci is also to protect the bones of the joints from premature wear, meniscus reduce stress on joints. The main meniscus functions are:

- lubrication and nutrition of the hyaline cartilage of the tibia;
Shock absorber function (cushioning shock and shock);

- the formation of the integrity of the structure of the knee joint;
The function of maintaining the stability of the joint.

Rupture of the posterior horn of the meniscus

In the knee there are two menisci, outdoor and indoor. The meniscus is horizontal, consists of the front and back, called the horn, as well as the body. Rear horn rupture internal meniscus represents meniscus tear in the back of it. In this case, an operation is prescribed only if the functional state of the joint leaves much to be desired. The doctor must determine how much the injured person interferes with movement. meniscus inside the joint... In some cases, a conservative form of treatment for injuries is sufficient, namely, treatment with physiotherapy and anti-inflammatory drugs. If damaged posterior meniscus horn the patient usually complains of joint instability, anticipates its subsequent blockage. Usually, the patient begins to feel insecure when going downstairs. In any case, it is difficult to correctly diagnose this disease on your own, it is necessary to immediately consult a doctor after an injury.

Treatment of tears

Treatment of posterior meniscus tears it is carried out conservatively with the help of physiotherapy and medications, as well as a surgical method of resection and restoration of the meniscus. Recently, an innovative method in surgery is considered to be gaining popularity meniscus transplant method... The conservative method of treatment is used mainly in the treatment of small tears of the posterior horn meniscus... Very often, this kind of damage is accompanied by characteristic pain, but other symptoms, such as clicks and rolling of the joint, are not observed.

Small longitudinal tears no more than 10 mm in size sometimes do not require treatment, often healing on their own. In some cases, physiotherapy is prescribed, as well as treatment with medications. In some cases meniscus tear is treated by the method of sewing the gap from the inside out. In this case, a long needle is used, which is passed perpendicular to the site of injury from the joint cavity on the outside of the joint capsule. The sutures must be applied tightly, thereby guaranteeing the stability of the stitched fragments, but this increases the risk of damage to the nerves and blood vessels when the needle is removed from the joint cavity. This method effectively treats rupture of the posterior horn of the meniscus and a tear extending from the body of cartilage to the posterior horn.

Postoperative treatment

After the operation, the operated joint is fixed with bandages and a pad of several layers of cotton wool. The patient must spend several days in the hospital, but sometimes complete recovery occurs only after a month. The patient should perform a set of exercises, which will be prescribed by the attending physician to maintain the tone of the thigh muscles. Additionally, anti-inflammatory and analgesic drugs are prescribed to prevent postoperative complications.

Orthopedic traumatologist of the first category, specialist in foot surgery, RUDN University, 2008

Rupture of the posterior horn of the medial meniscus of the knee joint is an injury that can occur in everyone, regardless of lifestyle, gender or age. Usually, this damage occurs due to excessive stress on the patella.

When a rupture occurs, conservative therapy or surgery is required, depending on the degree of injury. Alternative medicine is also used to restore cartilage tissue. Any treatment should only be used as directed by a specialist. Independent measures will lead to an aggravation of the condition and a change in the nature of the pathology to chronic.

The meniscus is the articular tissue of the patella. It is located between two bones and allows them to slide smoothly. Thanks to this tissue, a person can flex and extend the knee. Any damage to the articular tissue can lead to blockage of the motor function of the calyx.

There are two types of meniscus:

Lateral. Another name is outdoor. This tissue is the most mobile. For this reason, injuries to the lateral meniscus are the least common.
Medial. Another name is internal. It is a cartilaginous layer, which is united with the bones of the patella by ligaments. It is located on the side of the inner side. The medial meniscus is injured much more often than the lateral. Usually, its damage is accompanied by trauma to the corresponding ligaments, in particular, the posterior horn often suffers. Therapy is prescribed by a doctor only after examining the patient and determining the nature of the damage.

Rear horn rupture

Damage of this kind is most often observed in athletes. However, this injury can also occur in people who are far from sports. Damage to such a plan can be received by any person in certain situations, for example, when trying to bend from a place in length or when falling from a height of his own growth.

People after 40 years of age fall into the risk zone, since at this age the articular tissue begins to deteriorate.

There are several forms of rupture. It is important to identify the type of injury, as well as where the injury occurred. The therapeutic measures prescribed by the doctor depend on this.

Break shapes:

Depending on the nature of the damage, the doctor may prescribe the imposition of a plaster cast, reduction of the joint, drug therapy or surgery.

Reasons for the gap

Rupture of the posterior horn usually occurs due to trauma. Damage occurs for many reasons - impact, fall, sudden movement. However, experts identify other factors due to which the gap occurs:

Weakened joints, which accompanies a person from birth and cannot be corrected and restored;
Damage due to degenerative pathologies;
Sports, in particular, lead to rupture running, especially on uneven roads, as well as jumping, especially from a standstill;
Fast walk;
The habit of squatting;
Rotation on one leg.

Symptoms of a ruptured posterior horn

The gap is accompanied by the following symptoms:

Acute pain syndrome in the injured area that does not go away even when the person does not move;
Bleeding inside the injured tissue;
Lack of knee mobility;
Swelling of soft tissues in the damaged area;

In the absence of qualified therapy, the trauma becomes protracted. In especially advanced situations, the disease becomes chronic.

Signs of damage to the rupture of the posterior horn of the medial meniscus in this case will be as follows:

Pain syndrome during physical exertion;
Distinctive sound when moving the knee;
Swelling of soft tissues in the damaged area.

When performing the study, the specialist will see tissue separation and a change in the structure - it becomes more porous.

Trauma therapy

Only timely qualified therapy will help prevent the occurrence of a chronic form of pathology. Lack of treatment leads to an irreversible change in the structure of the joint, as a result of which it is completely blocked and arthrosis develops. For this reason, when the first symptoms of rupture occur, it is not recommended to solve the problem on your own, but you should consult a specialist.

The doctor prescribes therapy only after conducting appropriate research and determining the nature of the pathology.

There are three types of treatment for this injury: conservative therapy, surgery and alternative medicine, but the latter is usually prescribed as a concomitant therapy that accelerates the process of cartilage tissue repair. Only a specialist can decide which method is most appropriate.

Conservative treatment

At an early stage of acute rupture of the posterior horn of the medial meniscus, the doctor usually prescribes drug therapy. The patient is prescribed the following drugs:

If the knee has lost mobility due to an injury, the doctor may prescribe manual therapy to straighten the joint. To solve the problem, 3-4 procedures are usually required.

At the decision of the doctor, the patient may be given a plaster cast. This will help to keep the knee in one position, which helps in the repair of cartilage tissue.

During therapy, the patient is prescribed complete rest. At first, any movement is contraindicated. It can take up to 2 months to repair an injured joint. However, therapeutic exercises are recommended to be done on the 7th day from the start of treatment.

In a month and a half, the articular tissue grows together. However, the full recovery period lasts much longer. Rehabilitation can take six months. All this time, any excessive physical activity is contraindicated to the patient.

There are other conservative methods for treating a rupture of the posterior horn of the medial meniscus, but they are prescribed after the main therapeutic course:

Physiotherapy;
Therapeutic massage;

Traditional methods of therapy

Treatment of a ruptured posterior horn of the medial meniscus of the knee joint can be carried out with the help of alternative medicine. However, it is advisable to use such products only in conjunction with traditional medications to increase the effectiveness of therapy.

Experts advise the use of compresses and rubbing that promote the restoration of cartilage tissue, the convergence of edema and have anti-inflammatory and analgesic agents.

Fresh burdock leaves - 1 pc .;
Elastic bandage - 1 pc.

Burdock leaves are applied to the affected joint and fixed with an elastic bandage. The compress is kept for 4 hours. The procedure is performed daily until recovery. A dried plant can be used as an alternative to fresh burdock leaves.

It is recommended to soak the leaves in hot water for a few minutes before use. After that, the plant is laid out on a piece of gauze. The compress is fixed on the damaged area for 8 hours. The procedure is also carried out daily until the condition improves.

Required components:

Bee honey - 1 part;
Alcohol - 1 part.

The products are mixed until a homogeneous consistency and kept over the steam of boiling water to warm the preparation. The mass is placed on the problem area, wrapped on top with natural wool material and the compress is fixed with an elastic bandage. The product is kept for 2 hours.

To prepare the product you will need:

Chopped wormwood - 1 large spoon;
Water - 1 glass.

The plant is poured with boiling water and left to infuse for 60 minutes. After that, the agent is filtered and a piece of gauze is impregnated. The compress is fixed on the problem knee and kept for half an hour. The manipulation is repeated daily until recovery.

Surgical intervention

Sometimes, when the posterior horn of the medial meniscus ruptures, an operation is prescribed. This is true if the injury is accompanied by the separation of the joint capsule.

Most often, the patient is assigned arthroscopic surgery. With this kind of surgery, healthy tissue is minimally traumatized. The operation is closed. The surgeon makes two punctures and inserts a device into the knee joint to determine the nature of the injury.

Depending on the degree of damage, the joint capsule is fully or partially amputated. If there is a severe rupture, then the patient may be prescribed suturing. After surgery, the doctor prescribes appropriate anti-inflammatory and restorative drugs.

When the operation is completed, the patient is left in the hospital for 4 days. Such a short period of a patient's stay in a clinical setting is due to the fact that surgical intervention practically does not damage healthy tissues and quickly solves the existing problem.

Only a doctor can understand whether an operation is required or not, as well as determine what kind of surgery is required. The decision is made depending on the type of injury, the severity of the injury, age and other subjective characteristics of the patient.

After surgery, a recovery period follows. It usually takes 4-6 weeks. At this time, the patient is transferred to an outpatient setting and appropriate medications are prescribed. After a week, you can start exercise therapy. Exercises are prescribed by a doctor.

Any injury to the musculoskeletal system needs treatment. The first thing to do when damage is found is to see a doctor.

The meniscus is a lining of cartilage tissue in the knee joint. It acts as a shock absorber, located between the femur and the tibia of the knee, which carries the greatest load in the musculoskeletal system. The rupture of the posterior horn of the medial meniscus is irreversible, since it does not have its own blood supply system, it receives nutrition due to the circulation of synovial fluid.

Trauma classification

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

1 degree of trauma to the posterior horn of the meniscus. Focal damage to the surface of the cartilage is characteristic. The holistic structure does not undergo changes.
2nd degree. The changes become much more pronounced. There is a partial violation of the structure of the cartilage.
3 degree. The painful condition worsens. Pathology affects the posterior horn of the medial meniscus. Painful changes in the anatomical structure occur.

Considering the main causative factor that led to the development of the pathological state of the cartilage of the knee joint, the body of the lateral meniscus distinguishes between traumatic and pathological damage to the posterior horn of the medial meniscus. According to the criterion of the prescription of the trauma or pathological violation of the integrity of this cartilaginous structure, a fresh and old damage to the posterior horn of the medial meniscus stands out. Also, the combined damage to the body and the posterior horn of the medial meniscus is highlighted.

Break types

In medicine, there are several types of meniscus ruptures:

Longitudinal vertical.
Patchwork oblique.
Horizontal break.
Radial-transverse.
Degenerative rupture with tissue crush.
Oblique horizontal.

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

Causes of damage

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

Especially many injured people seek help in winter, during icy conditions.

Contribute to injury:

Alcoholic intoxication.
Fights.
Haste.
Failure to comply with safety precautions.

In most cases, rupture occurs during fixed extension of the joint. Hockey players, football players, gymnasts, figure skaters are in particular danger. Frequent ruptures often lead to meniscopathy, a pathology in which the integrity of the inner meniscus of the knee joint is disrupted. Subsequently, with each sharp turn, the gap is repeated.

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

Symptoms

Typical signs of a ruptured posterior horn are:

Sharp pain.
Swelling.
Joint block.
Hemarthrosis.

Painful sensations

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

Puffiness

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

Joint block

Joint wedging is considered the main symptom of rupture of the posterior horn of the medial meniscus. Blockade of the joint occurs after the clamping of the separated part of the cartilage with bones, while the motor function of the limb is impaired. This symptom can also be observed when the ligaments are stretched, which complicates the diagnosis of pathology.

Hemarthrosis (accumulation of blood inside a joint)

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

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

Diagnostics

If there is no blockage, it is very difficult to diagnose a meniscus rupture in the acute period. In the subacute period, a diagnosis of a meniscus rupture can be established based on the manifestation of local pain syndrome, compression symptoms, and extension symptoms. If a meniscus rupture was not diagnosed, during treatment, edema, pain, effusion in the joint will pass, but with the slightest injury, careless movement, the symptoms will manifest themselves again, which will mean the transition of pathology to a chronic form.

Often, patients are diagnosed with a bruised knee joint, a parameniscus cyst, or a sprain.

X-ray

X-rays are given to exclude bone damage from fractures and fissures. X-rays fail to diagnose soft tissue damage. To do this, you must use magnetic resonance imaging.

MRI

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

Ultrasound

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

Treatment of injuries of the posterior horn of the meniscus

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

Therapy without surgery

In case of partial damage to the posterior horn of the medial meniscus of 1-2 degrees, conservative therapy is carried out, including drug treatment and physiotherapy procedures. Of the physiotherapeutic procedures, the following are successfully used:

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

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

Surgical methods

Surgical intervention is an effective method of treating pathology. During surgical therapy, doctors focus on the preservation of the organ and its functions. When the back horn of the meniscus ruptures, the following types of operations are used:

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

A modern method of therapy with a low trauma rate

Rehabilitation

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

Late rehabilitation pursues the following goals:

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

The most important

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

A characteristic feature of the knee joints is their frequent susceptibility to various injuries: damage to the posterior horn of the meniscus, impaired bone integrity, bruises, hematomas and arthrosis.

Anatomical structure

The origin of various injuries in this particular place of the leg is explained by its complex anatomical structure. The structure of the knee joint includes the bone structures of the femur and tibia, as well as the patella, a conglomerate of the muscular and ligamentous apparatus, and two protective cartilages (menisci):

lateral, in other words, external;
medial or internal.

These structural elements visually resemble a crescent with the ends protruding slightly forward, in medical terminology called horns. Due to their elongated ends, the cartilage formations are attached with high density to the tibia.

The meniscus is a cartilaginous body that resides in the interlocking bony structures of the knee. It provides unimpeded flexion-extension manipulation of the leg. It is structured from the body as well as the anterior and posterior horns.

The lateral meniscus is more mobile than the internal one, and therefore it is more often subjected to force loads. It happens that it does not withstand their onslaught and breaks in the area of the lateral meniscus horn.

On the inside of the knee, a medial meniscus is attached, which connects to the lateral ligament. Its paracapsular part contains many small vessels that supply blood to this area and form the red zone. Here, the structure is denser, and closer to the middle of the meniscus, it becomes thinner, since it is devoid of a vascular network and is called the white zone.

After a knee injury, it is important to accurately determine the place of the meniscus rupture - in the white or red zone. Their treatment and recovery are different.

Functional features

Previously, doctors without any problems removed the meniscus by surgery, considering it justified, without thinking about the consequences. Often, complete removal of the meniscus led to serious medical conditions such as arthrosis.

Subsequently, evidence was presented of the functional importance of leaving the meniscus in place, both for bone, cartilaginous, articular structures, and for the general mobility of the entire human skeleton.

The functional purposes of the menisci are different:

They can be thought of as shock absorbers when driving.
They evenly distribute the load on the joints.
Limit the leg span at the knee by stabilizing the position of the knee joint.

Break shapes

The characteristic of meniscus injury depends entirely on the type of injury, location and shape.

In modern traumatology, there are several types of ruptures:

Longitudinal.
Degenerative.
Oblique.
Transverse.
Rupture of the anterior horn.
Horizontal.
Tears of the posterior horn.

The longitudinal fracture is found to be partial or complete. Full is the most dangerous due to the complete jamming of the joint and immobilization of the lower limb.
An oblique rupture occurs at the junction of the posterior horn and the middle of the body part. It is considered "patchwork", it can be accompanied by a wandering pain sensation passing over the knee area from side to side, and is also accompanied by a certain crunch during movement.
A horizontal rupture of the posterior horn of the medial meniscus is diagnosed by the appearance of soft tissue edema, intense pain in the area of the joint fissures, it occurs inside the meniscus.

The most common and unpleasant knee injury, based on medical statistics, is considered to be the rupture of the posterior horn of the medial meniscus of the knee joint.

It happens:

Horizontal or longitudinal, in which the tissue layers are separated from each other with further blocking of the knee's motor ability. The horizontal rupture of the posterior horn of the internal meniscus manifests itself in the inner side and extends to the capsule.
Radial, which manifests itself on oblique transverse tears of the cartilage. The edges of the damaged tissue look like rags on examination.
Combined, which includes a double lesion of the meniscus - horizontal and radial

The combined gap is characterized by:

ruptures of cartilaginous formations with tears of the thinnest particles of the meniscus;
tears in the back or front of the horn along with its body;
detachment of some particles of the meniscus;
the occurrence of ruptures in the capsule part.

Signs of breaks

Usually occurs due to an unnatural position of the knee or pinching of the cartilaginous cavity after injury to the knee region.

The main symptoms include:

Intense pain syndrome, the strongest peak of which occurs at the very moment of injury and lasts for some time, after which it can fade away - a person can step on his foot with some restrictions. It happens that the pain is ahead of a soft click. After a while, the pain turns into another form - as if a nail was stuck in the knee, it intensifies during the flexion-extension process.
Puffiness that appears after a certain time after injury.
Joint blockage, jamming. This symptom is considered the main one at the time of rupture of the medial meniscus; it manifests itself after mechanical clamping of the cartilaginous part with the bones of the knee.
Hemarthrosis, manifested in the accumulation of blood inside the joint when the red area of the meniscus is injured.

Modern therapy, in conjunction with hardware diagnostics, has learned to determine which gap has occurred - acute or chronic. After all, it is impossible by human forces to discern the true cause, for example, of a fresh injury characterized by hemarthrosis and smooth edges of the gap. It is strikingly different from a neglected knee injury, where with the help of modern equipment it is possible to distinguish the causes of puffiness, which consist in the accumulation of a liquid substance in the joint cavity.

Causes and mechanisms

There are many reasons for the violation of the integrity of the meniscus, and all of them most often occur as a result of non-compliance with safety rules or banal negligence in our daily life.

Break shapes

Injury occurs due to:

excessive stress - physical or sports;
twisting the ankle region during such games, in which the main load is on the lower limbs;
overly active movement;
prolonged squatting;
deformations of bone structures that occur with age;
jumping on one or two limbs;
unsuccessful rotational movements;
congenital joint and ligamentous weakness;
sharp flexion-extension manipulations of the limb;
severe bruises;
falls from a hill.

Injuries in which a rupture of the posterior horn of the meniscus occurs have their own symptoms and directly depend on its form.

If it is acute, in other words, fresh, then the symptoms include:

acute pain that does not leave the affected knee even at rest;
internal hemorrhage;
joint block;
smooth break structure;
redness and swelling of the knee.

If we consider a chronic, in other words, an old form, then it can be characterized:

pain from excessive exertion;
crackle in the process of motor movements;
accumulation of fluid in the joint;
porous structure of the meniscus tissue.

Diagnostics

You cannot joke with acute pain, as well as with all the above symptoms. Seeing a doctor with a rupture of the posterior horn of the medial meniscus or with other types of ruptures of the cartilaginous tissues of the knee is mandatory. It should be carried out in a short period of time.

In a medical facility, the victim will be examined and sent to:

Radiography, which is used for visible signs of rupture. It is considered not particularly effective and is used to exclude concomitant bone fractures.
Ultrasound diagnostics, the effect of which directly depends on the qualifications of the traumatologist.
MRI and CT, which is considered the most reliable way to determine the gap.

Based on the results of the above examination techniques, a selection of treatment tactics is performed.

Therapeutic tactics

Treatment of a rupture of the posterior horn of the medial meniscus of the knee joint should be performed as soon as possible after injury, in order to prevent the transition of the acute course of the disease into a chronic one in time. Otherwise, the even edge of the tear will begin to shaggy, which will lead to violations of the cartilaginous structure, and after that - to the development of arthrosis and complete loss of motor functions of the knee.

It is possible to treat a primary violation of the integrity of the meniscus, if it is not of a chronic nature, using a conservative method, which includes several stages:

Reposition. This stage is distinguished by the use of hardware traction or manual therapy to reposition the damaged joint.
The stage of elimination of edema, during which the victim takes anti-inflammatory drugs.
The stage of rehabilitation, which includes all procedures of a restorative nature:
massage;
physiotherapy.
Recovery stage. It lasts up to six months. For complete recovery, the use of chondroprotectors and hyaluronic acid is shown.

Often, the treatment of the knee joint is accompanied by the imposition of a plaster cast, the need for this is decided by the attending physician, after all, after all the necessary procedures, it needs long-term immobility, in which the application of plaster helps.

Operation

The method of treatment with the help of surgical intervention solves the main problem - the preservation of the functionality of the knee joint. and its functions and is used when other treatments are excluded.

First of all, the damaged meniscus is examined for stitching, then the specialist chooses one of several forms of surgical treatment:

Arthromia. A very complicated method. It is used in exceptional cases with extensive damage to the knee joint.
Cartilage stitching. The method is performed using an arthroscope inserted through a mini-hole in the knee in case of a fresh injury. The most favorable outcome is observed when stitching in the red zone.
Partial meniscectomy is an operation to remove the injured part of the cartilage, restore its whole part.
Transfer. As a result of this operation, a foreign meniscus is inserted into the victim.
Arthroscopy. Traumatization with this most common and modern method of treatment is the smallest. As a result of the arthroscope and saline introduced into two mini-holes in the knee, all the necessary restorative manipulations are performed.

Rehabilitation

The importance of the recovery period, compliance with all the doctor's prescriptions, its correct implementation can hardly be overestimated, since the return of all functions, painlessness of movements and complete recovery of the joint without chronic consequences directly depend on its effectiveness.

Small loads that strengthen the structure of the knee give correctly prescribed hardware recovery methods - simulators, and physiotherapy procedures and exercise therapy are shown to strengthen the internal structures. Remove edema with lymphatic drainage massage.

Treatment is allowed to be carried out at home, but still a greater effect is observed with inpatient treatment.

Several months of such therapy ends with the return of the victim to his usual life.

The consequences of injury

Tears of the internal and external menisci are considered the most difficult injuries, after which it is difficult to return the usual motor functions to the knee.

But there is no need to despair - the success of treatment largely depends on the victim himself.

It is very important not to self-medicate, because the result will largely depend on:

timely diagnosis;
correctly prescribed therapy;
rapid localization of injury;
the age of the gap;
with the success of the recovery procedures.