Menisci in the knee joint - degenerative-dystrophic changes

Meniscus of the knee joint (MCS) is a cartilaginous lining, the role of which is to depreciate and stabilize the joint with simultaneous increased congruence (the shape of articular surfaces of the articulating bones fully correspond to each other) articular surface.

When the leg moves, the ISS compresses, changing its shape. Meniscus exists in two types - the external (called the lateral meniscus), the inner (in the language of medics - the medial). The former is less prone to injury, as it is more mobile.

Causes

The most common types of knee injury (CS) are genetic pathologies (congenital injuries in the locomotor system) and degenerative changes (occur usually in the elderly due to the erasure and wear of functional elements of the COP), manifested only with time.

Age factors contributing to degenerative dystrophic changes in menisci include anomalies associated with aging of the human body, and other causes.

Causes of the disease:

• a man worked for a long time in chemical production;
• the patient worked in conditions involving large loads (directly on the joint itself);
• the patient was previously diagnosed with infectious diseases or an inflammatory process was developed;
• other diseases of the musculoskeletal system of chronic form were observed;
• poor quality of life.

The cause of the rupture (the most common injury) may be an indirect (combined) injury, causing a subsequent rotation of the tibia outward (touches the medial meniscus) and inward (if it is a question of lateral ISS).

Degenerative changes include tissue breaking, massive crushing and a multiple-plane rupture. They can develop because of previous rheumatism, gout or micro-injury, and as a result chronic intoxication (typical for people who work a lot in standing or constantly moving position). If there was a rupture of the medial meniscus, most likely the joint was blocked, fixing at a 150-170 degree angle.

Types of degenerative changes

There are several types of degenerative changes:

• the meniscus came off the place of attachment;
• dystrophic changes in the horn and body of the medial meniscus;
• excessive mobility due to damage to the intermenal ligaments;
• cyst, formed as a convexity filled with fluid, inside the cavity of the cartilage;
• meniscopathy.

The posterior horn of the meniscus does not have its own blood supply system, since the food gives circulation to the joint fluid. Dystrophic changes in the posterior horn of the medial meniscus are irreversible, since the tissue is not capable of regeneration. It is quite difficult to diagnose such a case. To make an accurate diagnosis, the doctor must appoint a magnetic resonance imaging.

Degrees of severity of damage to the ISS

Dystrophic change of the meniscus of the 1st degree is characterized by minor (partial) injuries (horns of the meniscus including), painful sensations in the region of the knee joint and its swelling. Such signs cease to be noticeable 3 weeks after the onset.

To the changes of the medial meniscus 1 degree belong to injuries resulting from jumps, displacements along the inclined plane, squats performed with excessive load on the knee.

In severe (grade 2), the pain is acute, the swelling becomes more noticeable. In the joint cavity, blood appears, and the horn is completely detached from the ISS, with some of its parts falling into the joint, causing a blockade of movements. In this case, surgery is necessary.

Treatment

There are two types of treatment:

1. conservative;
2. surgical.

Everything depends on the severity of the damage and from the area that has been deformed. The conservative way, also called therapeutic, is based on a series of therapeutic manipulations, and most often leads to the expected (positive) effect.

It is necessary to help the victim immediately after getting injured. To do this, ensure that the patient is in complete rest, apply a cool compress on the inside of the knee and make an anesthetic injection. Then it is necessary to impose a plaster bandage and perform a fluid puncture. This can be done only by a specialist, self-treatment is completely excluded.

With degenerative changes in the inner and outer meniscus treatment lasts from six months to a year. First, repositioning (correction) of the knee joint (if blockage is present) is performed. To remove it, apply manual methods.

If the cartilage has been damaged, the appointment is mandatoryhyaluronic acidandchondroprotectors(preparations containing glucose and chondroitin). Eliminate painful symptoms and inflammatory process will help non-steroidal anti-inflammatory drugs (to which belongibuprofen, alsodiclofenacandindomethacin).

To eliminate puffiness, accelerate the healing of a dystrophic change in the meniscus 1 -2 degree, use external ointments (most often it is a voltaren and a dolgite, sometimes an amzan is prescribed). At the same time, a course of physiotherapy is conducted, accompanied by a special set of therapeutic exercises.

The need for surgical intervention appears only with a change in the medial meniscus 2 (severe) degree, when the cartilage is crushed, severely ruptured or displaced by the ISS, completely torn both the front and back horn of the ISS. It may be necessary to remove the entire meniscus or only the separated horn, restoration, suturing the rupture site, fixing the detached horns, transplanting the meniscus.

After the operation, rehabilitation is carried out, which includes exercises for the development of CS, therapeutic massages and physiotherapy methods. The patient should be completely protected from physical activity.

Treatment of the ISS without surgical intervention is possible, if there were no serious gaps. In another case, such a measure is necessary.

Preventive measures of degenerative-dystrophic changes in the meniscus

Statistics state that a person who takes preventive measures avoids injury to the COP in 95% of cases. To do this, you should exercise in a stable and comfortable shoes that can minimize the risk of falls, use special lining, fixing the knee, (knee pads), safely distribute the load on the knee joint. A flexible bandage can be used as a fixative.

Before training or prolonged physical activity, you should warm up well, do it gradually and smoothly. Also it is worth keeping an eye on your weight and not overeating (avoid obesity), in the morning doing exercises, eating properly (the diet should be rich in proteins and trace elements).