Although the bones of the knee joints are the largest in the human skeleton, the majority of injuries occur in the knee. Injury occurs due to high loads on this part of the limb. Let's talk about such an injury as damage to the posterior horn of the medial meniscus and methods to eliminate its consequences.

Appointment of the meniscus

The limb joint refers to a complex structure, where each element solves a specific problem. Each knee is equipped with menisci that bisect the articular cavity, and perform the following tasks:

• stabilizing. During any physical activity, the articular surfaces are displaced in the right direction;
• act as shock absorbers, softening shocks and shocks while running, jumping, walking.

Injury to shock-absorbing elements occurs with various articular injuries, precisely because of the load that these articular parts take on. Each knee has two menisci, which are made up of cartilage:

• lateral (outer);
• medial (internal).

Each type of shock-absorbing plate is formed by a body and horns (rear with front). Shock-absorbing elements move freely during physical activity.

The main damage occurs to the posterior horn of the internal meniscus.

Why injury happens

A common injury to the cartilage plate is a tear, complete or incomplete. Professional athletes and dancers are often injured, and whose specialty is associated with high loads. Injuries occur in the elderly, and as a result of accidental, unforeseen stress on the knee area.

Damage to the body of the posterior horn of the medial meniscus occurs for the following main reasons:

• increased, sports loads (jogging over rough terrain, jumping);
• active walking, prolonged squatting position;
• chronic, articular pathologies in which inflammation of the knee region develops;
• congenital articular pathology.

These causes lead to injuries of the meniscus of varying severity.

Classification

Symptoms of trauma to the cartilage elements depend on the severity of the damage to the cartilage tissue. There are the following stages of internal meniscal damage:

• Stage 1 (mild). Movement of the injured limb is normal. Pain is weak, and becomes more intense during squats or jumps. There may be slight swelling above the kneecap;
• 2 degree injury is accompanied by severe pain. It is difficult to straighten the limb even with outside help. You can move with a limp, but at any moment the joint can become blocked. Puffiness gradually becomes more and more, and the skin changes shade;
• damage to the posterior horn of the medial meniscus 3 degrees accompanied by pain syndromes of such intensity that it is impossible to endure. It hurts the most at the location of the kneecap. Any physical activity is impossible. The knee becomes larger in size, and the skin changes its healthy color to purple or cyanotic.

If the medial meniscus is damaged, the following symptoms exist:

1. pain intensifies if you press on the patella from the inside and at the same time straighten the limb (Bazhov's technique);
2. the skin of the knee area becomes too sensitive (Turner's symptom);
3. when the patient lies down, the palm passes under the injured knee without problems (Land's symptom).

After the diagnosis is made, the doctor decides which treatment method to apply.

Horizontal gap

Depending on the location of the injured area and the general characteristics of the damage, there are types of injury to the medial meniscus:

• walking along;
• oblique;
• passing across;
• horizontal;
• chronic form of pathology.

Features of horizontal damage to the posterior horn of the medial meniscus are as follows:

• with this type of tearing of the internal shock-absorbing plate, injury occurs, directed to the joint capsule;
• there is swelling in the area of ​​the joint gap. This development of the pathology has common signs with damage to the anterior meniscus horn of the external cartilage, therefore, special attention is needed when diagnosing.

With horizontal, partial damage, the cavity begins to accumulate excess synovial fluid. Pathology can be diagnosed by ultrasound.

Treatment of a horizontal rupture of the posterior horn of the medial meniscus, during timely seeking medical help, is prescribed as a complex, traditional therapy, because this type of injury does not block the joint. First, non-steroidal medications are prescribed to eliminate pain and swelling. Then the injured knee is fixed with a plaster cast. The traditional method of treatment can last from six months to 12 months. During the first 3 months, the joint is immobilized with a plaster splint.

After the removal of the first symptoms, a set of special gymnastic exercises is developed for each patient. Physiotherapy and massage sessions are prescribed.

If traditional methods of treatment do not give a positive result, then surgical intervention is indicated.

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Synovitis due to trauma to the medial meniscus

Against the background of damage to the posterior horn of the medial meniscus, synovitis may begin. This pathology develops due to structural cartilage changes that occur in the tissues during injury. When ruptured, synovial fluid begins to be produced in large volume, and fills the joint cavity.

As synovitis (fluid buildup) develops, it becomes increasingly difficult to move. If there is a transition to the degenerative course of the pathology, then the knee is constantly in a bent position. As a result, muscle spasm develops.

Advanced forms of synovitis lead to the development of arthritis. Therefore, at the time of diagnosis, the symptoms of a torn meniscus are similar to chronic arthritis.

If synovitis is not treated in time, the cartilaginous surface will completely collapse. The joint will no longer receive nutrition, which will lead to further disability.

Therapeutic techniques

With any articular injury, treatment should be started in a timely manner, without delay. If you postpone the appeal to the clinic, then the trauma passes to a chronic course. The chronic course of the pathology leads to changes in the tissue structure of the joints, and further deformation of the damaged limb.

Treatment for damage to the posterior horn of the medial meniscus can be conservative or surgical. In the treatment of such injuries, traditional methods are often used.

Complex, traditional therapy for injuries of the internal meniscus includes the following activities:

1. an articular blockade is performed using special medications, after which the motor ability of the joint is partially restored;
2. anti-inflammatory drugs are prescribed to remove puffiness;
3. recovery period, including a set of special gymnastic exercises, physiotherapy and massage sessions;
4. then comes the reception of chondoprotectors (drugs that help restore the structure of the cartilage). Hyaluronic acid is present among the active components of chondoprotectors. The course of admission can last up to six months.

During the entire course of treatment, painkillers are present, because damage to the ligaments is accompanied by constant pain. To eliminate pain, drugs such as Ibuprofen, Diclofenac, Paracetamol are prescribed.

Surgical intervention

When the meniscus is injured, the following points serve as indications for surgical manipulations:

• severe injuries;
• when cartilage is crushed and tissues cannot be restored;
• severe injuries of the meniscus horns;
• tear of the posterior horn;
• articular cyst.

The following types of surgical procedures are performed in case of damage to the posterior horn of the shock-absorbing cartilage plate:

1. resection broken elements, or meniscus. This kind of manipulation is performed with incomplete or complete anguish;
2. recovery destroyed tissues;
3. replacement destroyed tissue by implants;
4. stitching menisci. Such surgical intervention is carried out in case of fresh damage, and immediate medical attention is sought.

Let us consider in more detail the types of surgical treatment of knee injuries.

Arthrotomy

The essence of arthrotomy is reduced to the complete resection of the damaged meniscus. Such an operation is performed in rare cases when the articular tissues, including blood vessels, are completely affected and cannot be restored.

Modern surgeons and orthopedists have recognized this technique as ineffective, and is practically not used anywhere.

Partial meniscectomy

During the surgical intervention, the torn, dangling parts of the damaged meniscus are resected, and the surviving elements are restored.

When repairing the meniscus, the damaged edges are trimmed so that there is a flat surface.

Endoprosthetics

A donor organ is transplanted to replace the damaged meniscus. This type of surgical intervention is not often performed, because the rejection of donor material is possible.

Stitching of damaged tissues

Surgical treatment of this type aims to restore the destroyed cartilage tissue. Surgical intervention of this type gives positive results if the injury has affected the thickest part of the meniscus, and there is a possibility of fusion of the damaged surface.

Stitching is performed only with fresh damage.

Arthroscopy

Surgery using arthroscopic techniques is considered the most modern and effective method of treatment. With all the advantages during the operation, trauma is practically excluded.

To perform the operation, several small incisions are made in the joint cavity, through which the instrumentation is inserted along with the camera. Through the incisions, during the intervention, a saline solution is supplied.

The technique of arthroscopy is remarkable not only for its low traumatism during the procedure, but also for the fact that you can simultaneously see the true state of the damaged limb. Arthroscopy is also used as one of the diagnostic methods in making a diagnosis after damage to the meniscus of the knee joint.

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How dangerous is the rupture of the posterior horn of the medial meniscus of the knee joint, the treatment of damage to the horns of the meniscus - these issues are of interest to patients. Movement is one of the most beautiful gifts that human nature has endowed. Walking, running - all types of movement in space are made thanks to a complex system, and largely depend on such a small cartilage pad, which is otherwise called the meniscus. It is located between the knee joints and serves to be a kind of shock absorber when any movement of a person occurs.

meniscus injury

The medial meniscus changes shape when moving, because the gait of people is so smooth, plastic. The knee joints have 2 menisci:

The meniscus itself is divided into 3 parts:

• the body of the meniscus itself;
• the posterior horn of the meniscus, that is, its inner part;
• anterior horn of the meniscus.

The inner part differs in that it does not have its own blood supply system, however, because. nutrition should still be, it is carried out due to the constant circulation of the articular synovial fluid.

Such unusual properties lead to the fact that if an injury to the posterior horn of the meniscus occurs, then, unfortunately, it is most often incurable, because the tissues cannot be restored. Moreover, a rupture of the posterior horn of the medial meniscus is difficult to determine. And if such a diagnosis is suspected, urgent research is needed.

Most often, the correct diagnosis can be found using magnetic resonance imaging. But even with the help of developed tests, which are based on the extension of the joints, scrolling movements, as well as the sensation of pain, it is possible to determine the disease. There are a lot of them: Rocher, Landa, Baikov, Shteiman, Bragard.

If the posterior horn of the medial meniscus is damaged, a sharp pain appears, and severe swelling begins in the knee area.

When a horizontal rupture of the posterior horn of the medial meniscus has occurred, it is impossible to go down the stairs due to severe pain. If there is a partial tear of the meniscus, it is almost impossible to move: the torn part dangles freely inside the joint, giving pain at the slightest movement.

If not such painful clicking sounds are felt, then the gaps have occurred, but they are small in size. When the tears occupy a large area, the torn part of the meniscus begins to move to the center of the damaged joint, resulting in blocking of the knee movement. There is a twisting of the joint. When the posterior horn of the internal meniscus has ruptured, it is practically impossible to bend the knee, and the sore leg will not be able to withstand the load from the body.

Symptoms of a knee meniscus injury

If there is a rupture of the meniscus of the knee joint, then the following symptoms will appear:

• pain, which over time will concentrate in the joint space;
• there is weakness of the muscles in the anterior surface of the thigh;
• accumulation of fluid in the joint cavity begins.

As a rule, a degenerative rupture of the posterior horn of the meniscus in the knee occurs in people of pre-retirement age due to age-related changes in cartilage tissue or in athletes whose load falls mainly on the legs. Even a sudden awkward movement can lead to a break. Very often, ruptures of the degenerative form acquire a protracted chronic character. A symptom of a degenerative rupture is the presence of a dull aching pain in the knee area.

Treatment of damage to the medial meniscus

In order for the treatment to be beneficial, it is necessary to correctly determine the severity of the disease and the type of injury.

But first of all, when damage has occurred, it is necessary to relieve pain. In this case, an anesthetic injection and tablets that reduce inflammation help, and cold compresses will help.

You need to be prepared for the fact that doctors will take a puncture of the joint. Then it is necessary to clean the articular cavity from the blood and fluid accumulated there. Sometimes you even have to apply the blockade of the joints.

These procedures for the body are stressful, and after them the joints need rest. In order not to disturb the joints and fix the position, the surgeon applies a plaster or splint. During the rehabilitation period, physiotherapy, fixing the kneecaps will help to recover, it will be necessary to do physiotherapy exercises and walking with various means of support.

Minor damage to the posterior horn of the lateral meniscus or an incomplete tear of the anterior horn can be treated conservatively. That is, you will need anti-inflammatory drugs, as well as painkillers, manual and physiotherapy procedures.

How is damage treated? As a rule, surgery is usually unavoidable. Especially if it is an old medial meniscus of the knee joint. The surgeon is faced with the task of suturing the damaged meniscus, but if the damage is too serious, it will have to be removed. A popular treatment is arthroscopic surgery, thanks to which whole tissues are preserved, only the resection of damaged parts and the correction of defects are performed. As a result, there are very few complications after surgery.

The whole procedure goes like this: an arthroscope with instruments is inserted into the joint through 2 holes in order to first determine the damage, its extent. With ruptures of the posterior horn of the meniscus affecting the body, it happens that the torn fragment is displaced, rotating along its axis. He is immediately returned to his place.

Then make an incomplete biting out of the meniscus. This must be done at the base of the posterior horn, leaving a thin "bridge" to prevent displacement. The next stage is cutting off the torn fragment from the body or the anterior horn. Parts of the meniscus then need to be given the original anatomical shape.

It will be necessary to spend time in the hospital under the supervision of a doctor and undergo rehabilitation recovery.

The meniscus is the lining of cartilage in the knee joint. It acts as a shock absorber, located between the femur and tibia of the knee, which bears 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 through the circulation of the synovial fluid.

Injury 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, there are:

• 1st degree injury to the posterior horn of the meniscus. Characterized by focal damage to the surface of the cartilage. The overall structure does not change.
• 2 degree. The changes are becoming more pronounced. There is a partial violation of the structure of the cartilage.
• 3 degree. The disease state worsens. Pathology affects the posterior horn of the medial meniscus. There are painful changes in the anatomical structure.

Given the main causative factor that led to the development of the pathological condition of the cartilage of the knee joint, the bodies of the lateral meniscus distinguish between traumatic and pathological damage to the posterior horn of the medial meniscus. According to the criterion of prescription of an injury or a pathological violation of the integrity of this cartilaginous structure, fresh and chronic damage to the posterior horn of the medial meniscus is distinguished. Combined damage to the body and the posterior horn of the medial meniscus is also highlighted separately.

Types of breaks

In medicine, there are several types of meniscus ruptures:

• Longitudinal vertical.
• Patchwork braid.
• Horizontal break.
• Radially transverse.
• Degenerative rupture with tissue crush.
• Oblique-horizontal.

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

Causes of damage

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

Especially many injured seek help in winter, during ice.

Injuries contribute to:

• Alcohol intoxication.
• Fights.
• Haste.
• Failure to take precautions.

In most cases, the tear occurs during fixed extension of the joint. Hockey players, football players, gymnasts, and figure skaters are at particular risk. Frequent ruptures often lead to meniscopathy - a pathology in which the integrity of the internal meniscus of the knee joint is violated. Subsequently, with each sharp turn, the gap is repeated.

Degenerative damage is observed in elderly patients with the repetition of microtraumas caused by strong physical exertion during labor activity 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 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

The characteristic signs of a torn posterior horn are:

• Sharp pain.
• Puffiness.
• Joint block.
• Hemarthrosis.

Pain

The pain is acutely manifested in the first moments of injury, 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 this with difficulty. When lying down, during a night's sleep, the pain intensifies imperceptibly. But by morning, the knee hurts so much, as if a nail had been stuck into it. Flexion and extension of the limb increases pain.

puffiness

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

Joint block

Jamming of the joint is considered the main sign of rupture of the posterior horn of the medial meniscus. There comes a blockade of the joint after clamping the separated part of the cartilage by the bones, while there is a violation of the motor function of the limb. This symptom can also be observed with sprains, which makes it difficult to diagnose the pathology.

Hemarthrosis (accumulation of blood inside a joint)

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

• Acute 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, diagnosing a meniscal tear in the acute period is very difficult. In the subacute period, a meniscus tear can be diagnosed based on the manifestation of local pain, compression symptoms, and extension symptoms. If a meniscus rupture has not been diagnosed, the swelling, pain, and effusion in the joint will disappear during treatment, but with the slightest injury, careless movement, the symptoms will manifest themselves again, which will mean the transition of the pathology to a chronic form.

It is not uncommon for patients to be diagnosed with a knee bruise, parameniscal cyst, or sprain.

x-ray

Radiography is prescribed to rule out damage to the bones of fractures and cracks. X-rays are not able to diagnose soft tissue damage. To do this, you need to use magnetic resonance imaging.

MRI

The research method does not harm the body, like radiography. MRI makes it possible to consider layered 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

Allows 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 damage to the posterior horn of the meniscus

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

Therapy without surgery

With partial damage to the posterior horn of the medial meniscus of 1-2 degrees, conservative therapy is carried out, including drug treatment and physiotherapy. Of the physiotherapy procedures successfully applied:

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

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

Surgical methods

An effective method of treating pathology is surgical intervention. During surgical therapy, doctors are aimed at the preservation of the organ and its functions. When the posterior horn of the meniscus is torn, the following types of operations are used:

• Cartilage stitching. The operation is performed using an arthroscope - a miniature video camera. It is injected at the site of the knee puncture. The operation is performed with fresh ruptures of the meniscus.
• Partial meniscectomy. During the operation, the area of ​​damage to the cartilage layer is removed, and the rest is restored. The meniscus is cut to a smooth 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 enters. 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 an extensive lesion of the knee joint.

A modern method of therapy, characterized by a low rate of trauma

Rehabilitation

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

Late rehabilitation aims to:

• Elimination of contracture.
• Correction of 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, precautions should be taken seriously: do not rush when moving up the stairs, exercise muscles with physical activity, regularly take prophylactic chondroprotectors, vitamin complexes, and use knee pads during training. You need to constantly monitor your weight. In case of injury, a doctor should be called immediately.

rear horn

Treatment of rupture of the posterior horn of the lateral (outer) meniscus

The lateral meniscus is a structure in the knee joint that has a shape close to annular. Compared to the medial, the lateral meniscus is somewhat wider. The meniscus can be conditionally 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 attaches 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 activities are associated with heavy physical labor. According to statistics, this injury in frequency exceeds the injury of the anterior cruciate ligament. However, about a third of all torn ligaments are associated with a meniscus tear. In terms of frequency, damage of the “watering can handle” type is in the first place. Isolated damage to the posterior horn of the meniscus accounts for about a third of all meniscal injuries.

The reasons

Injury to the posterior horn of the lateral meniscus has a different character in different patients. The causes of injury largely depend on the age of the person. So, in young people under 35, the cause of injury most often becomes a mechanical effect. In older patients, the cause of rupture of the posterior horn is most often a degenerative change in the tissues of the meniscus.

In women, rupture of the posterior horn of the external meniscus occurs less frequently than in men, and the rupture itself is, as a rule, of an organic nature. In children and adolescents, a tear in the posterior horn also occurs - usually due to awkward movement.

Mechanical injury can have two possible causes: direct impact or rotation. Direct impact in this case is associated with a strong blow to the knee. The foot of the victim at the moment of impact is usually fixed. 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 tear occurs in the event of a sharp twisting (rotation) of the ankle with a fixed foot. The condyles of the lower leg and thigh with such rotation are displaced in opposite directions. The meniscus is also displaced when attached to the tibia. With excessive displacement, the risk of rupture is high.

Symptoms

Damage to the posterior horn of the lateral meniscus manifests itself with symptoms such as pain, impaired joint mobility, and even its complete blockage. 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 manifest itself only with non-specific symptoms that are also characteristic of other injuries: damage to the ligaments or patella.

A complete detachment of the meniscus horn, 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 infringed by the structures of the joint. A typical rupture of the posterior horn is the limitation of the ability to bend the leg at the knee.

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

Conservative treatment

For small tears, non-surgical treatment is preferred. Good results in the blockade of the joint are given by puncture - the removal of blood helps to "free" the joint and eliminate the blockade. Further treatment consists in undergoing a number of physiotherapeutic procedures: therapeutic exercises, electromyostimulation and massage.

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

Surgical treatment

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

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

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

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

What is an injury to the anterior or posterior horn of the internal meniscus? To do this, you must at least in general terms know what the meniscus itself is. In general terms, this is a special cartilaginous structure consisting of fibers. It is needed for cushioning in the joints of the knees. There are similar cartilaginous structures in other places of the human body - they are provided with all its parts, which are responsible for flexion and extension of the upper and lower extremities. But damage to the posterior or anterior horn of the lateral meniscus is considered the most dangerous and most common injury, which, if not treated in time, can lead to various complications and make a person disabled.

Brief anatomical description of the meniscus

The knee joint of a healthy organism incorporates the following cartilage tabs:

• external (lateral);
• internal (medial).

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

The very structure of this body consists of several elements:

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

The main part of the cartilaginous tissue is girdled and permeated with a network of capillary vessels, which form the so-called red zone. This whole area has an increased density and is located on the edge of the knee joint. In the middle part is the thinnest part of the meniscus. There are no vessels in it and it is called the white zone. In the initial diagnosis of an injury, it is important to determine exactly which area of ​​the meniscus has been damaged and torn. Previously, it was customary to completely remove the meniscus if damage to the posterior horn of the inner layer was diagnosed, which allegedly contributed to the relief of the patient from 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 surgical intervention. 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 is rare, since its structure has an increased density and better resists various loads.

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

Causes of cartilage rupture

Damage to the posterior horn of the medial meniscus is most often caused by an acute injury, since when a force is applied to the knee joint, it does not always lead to a rupture of the cartilage tissue, which is responsible for the cushioning of this area. Doctors identify a number of factors that contribute to getting a cartilage rupture:

• excessively active jumping or running over rough terrain;
• twisting the human body on one leg, when her foot does not come off the surface;
• frequent and prolonged squatting or active walking;
• the development of degeneration of the knee joint in certain diseases and limb injury in this condition;
• the presence of congenital pathology, in which there is a weak development of ligaments and joints.

There are different degrees of damage to the meniscus. Their classification is different in different clinics, but the main thing is that they are all determined according to generally recognized signs, which will be discussed below.

Symptoms of damage to the posterior horn of the internal meniscus

Signs of such an injury to the medial meniscus are as follows:

• sharp, sharp pain occurs when an injury occurs. It can be felt within 3-5 minutes. Before that, a clicking sound is heard. After the pain has disappeared, the person will be able to move around. But this will cause new bouts 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 unbending the knee joint, the pain intensifies, and after a short rest it subsides;
• blockade of the knee (“jamming”) occurs when the cartilage tissue of the inner meniscus is torn. It can manifest itself at the moment when a torn piece of the meniscus is clamped between the tibia and femur. This results in the inability to move. These symptoms also bother a person if the ligaments of the knee joint are damaged, so the exact cause of the pain syndrome can only be found out when making a diagnosis in the clinic;
• when blood enters the joint, traumatic hemarthrosis may occur. This occurs when a meniscus rupture occurs in the red zone, when blood vessels are damaged;
• after several hours from the moment of injury, swelling of the knee joint may occur.

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Chronic damage to the posterior horn of the medial meniscus of the 2nd degree from an acute injury should be clearly distinguished. This is possible today with the use of hardware diagnostics, which allows you to carefully examine the state of cartilage and fluid in the knee joint. A grade 3 meniscus tear leads to a pool of blood in the inner parts of the knee. At the same time, the edges of the cliff are even, and in case of a chronic disease, the fibers are scattered, there is edema, which occurs from damage to the nearby cartilage, and the penetration into this place and the accumulation of synovial fluid there.

Treatment of an injury to the posterior horn of the internal meniscus

The rupture of the tissues of the knee joint should be treated immediately after the injury, because over time, the disease from the acute stage can turn into a chronic disease. 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 bone surfaces. This situation is observed in half of the cases of rupture of the posterior horn of the internal meniscus in patients who, for various reasons, started the disease and sought medical help late.

The rupture can be treated by the following methods:

• conservative way;
• surgical intervention.

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

Treatment with conservative methods consists of several, fairly effective stages (if the injury is not started):

• manual therapy and traction with the help of various equipment, which are aimed at repositioning, that is, repositioning the knee joint during the development of blockade;
• 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 appointments;
• 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 for several years, but is important for the restoration of the meniscus structure;
• since the injury of the posterior horn of the meniscus is accompanied by a strong pain syndrome, the doctors continue the treatment using painkillers. For this purpose, analgesics are usually used, for example, Ibuprofen, Paracetamol, Indomethacin, Diclofenac and other drugs. They can only be used as prescribed by the attending physician in a dosage that is determined by the course of therapy.