Injury of a meniscus of a knee

Description:

Injury of a meniscus of a knee joint wins first place among internal damages of a knee joint.
According to the mute:
75% —  Injury of an internal meniscus of a knee joint
21% — Damages and diseases of an outside meniscus
4% — Injuries of both meniscuses of a knee joint

Despite a large number of articles devoted to this injury, presently diagnostic mistakes occur at 7,2 — 27,2% of patients, and untimely and inadequate medical actions are an origin and bystry progressing of such complication as the deforming arthrosis of a knee joint.

Symptoms of Injury of a meniscus of a knee:

Traumatic injuries of meniscuses can be combined also with other injuries of structures of a knee joint: side and crucial ligaments, joint capsule. The torn-off part of a meniscus connected with a body of a meniscus can move to cavities of a joint and is restrained between the joint surfaces of femoral and tibial bones. There is a blockade of a joint which is shown sudden sharp pain and restriction of the movement in a joint. Especially often such blockade arises at a rupture of an internal meniscus on the "watering can handle" type.

The patient complains of severe pains, disturbance of movements in a knee joint. Sometimes the rupture of a meniscus is followed by bleeding in a knee joint (hemarthrosis), but there is a reactive inflammation of an internal cover of a joint more often – a synovitis. The patient holds a leg in the bent state because pain amplifies at extension, especially if there was a blockade of a joint. At palpation pain in a projection of the injured meniscus is found, the elastic roller which is rolled on an outside surface of a joint crack at extension in a joint is sometimes probed. This symptom is called a symptom of click or a rift.

For an exception of damage of bone structures carry out x-ray films. Ruptures of a meniscus in pictures are not visible as meniscuses are transparent for X-ray. Completely x-ray films with contrasting of a joint help to establish the diagnosis, but as more modern methods serve the magnetic resonance tomography or an endoscopic arthroscopy (survey of an internal surface of a joint by means of an artroskop). As first aid anesthesia is carried out, the tire is imposed and the patient is transported in a traumatologic hospital.

Reasons of Injury of a meniscus of a knee:

Sideways from a joint meniscuses are spliced with the capsule of a joint and have blood supply from capsule arteries. Internal parts are in depth of a joint and own blood supply have no, and food of their fabrics is carried out due to circulation of intra joint liquid. Therefore injuries of meniscuses near the capsule of a joint grow together well, and ruptures of an internal part, in the depth of a knee joint do not grow together absolutely. There are injuries of meniscuses at the sharp movements of a shin with turn in a knee joint, but at the fixed foot. Less often ruptures of meniscuses occur at squat, at jumps. Often the injury which led to a rupture of a meniscus can be insignificant.

Distinguish a separation of meniscuses from the place of an attachment to the capsule of a joint and a rupture of a body of a meniscus. At a rupture of a meniscus the torn-off part keeps communication with a meniscus body. Such gap is called a rupture of a meniscus as "the watering can handle". There are ruptures of meniscuses and the combined damages more often.

Treatment of Injury of a meniscus of a knee:

The joint puncture with administration of solution of novocaine is carried out. Then set the restrained meniscus special receptions in position of the patient lying on an orthopedic table. At the same time the surgeon-traumatologist makes the movements the return, to the movements which led to an injury. When the meniscus becomes on the place, the movements in a joint are recovered. After reposition of a meniscus apply a plaster bandage the injured leg, at the knee joint bent under a certain corner.

Immobilization term 3 weeks then the physical therapy and physiotherapy exercises is appointed. If at the patient repeated blockade of a joint are observed such state is called old injury of a meniscus. At the same time usually there is also an inflammation of an internal cover of a joint – a synovitis, there is constant joint pain amplifying when walking, especially during descent on a ladder. Sometimes there is "a joint mouse".

The joint mouse is a free body in a joint cavity which is formed owing to a separation of a piece of a joint cartilage, a part of a meniscus, a regional osteophyte (bone growth). Such state leads to frequent blockade of a joint and "the joint mouse" needs to be removed in the surgical way.

At traumatic injuries of meniscuses if it is not possible to eliminate blockade of a joint, blockade of a joint arise often, the patient is constantly disturbed by joint pains, there are difficulties when walking surgical treatment is required. Today an arthroscopic operative measure is considered the best exit. By means of the endoscopic equipment at first examine the internal surface of a joint, resolve an issue of operation volume. Then the injured meniscus is deleted. After operation apply a pressure bandage or a plaster splint a leg. An important condition of recovery is early occupation remedial gymnastics.