Meniscus is a structure consisting of cartilage tissue located in the knee joint. It is located where the shin and femur
join. The shape of the meniscus tissue is in the form of an upward-pointing crescent moon. There are two menisci in the knee, one internal and the other
external. It prevents these two bones from rubbing against each other during movement. Meniscus has a shock absorbing and load reducing effect. 50% of the load on the knee is transmitted to the meniscus and increases when the knee is bent. Removing 15-30% of the meniscus due to meniscus tear increases the contact pressure by 350%. The shock absorbing effect of a knee that has undergone meniscus tear surgery is reduced by 30%.
What is a meniscus tear? How does a meniscus tear occur?
Meniscus injuries are common. Injuries to the meniscus reduce the weight contact area of the knee by increasing the risk of deterioration in the joint cartilage and
calcification.
It may be a result of acute trauma or gradual wear and tear. The most common type of injury caused by acute meniscus tears is a sudden or strong turning movement while the soles of the feet are on the ground. Meniscus tear may also develop due to small, gradual traumas in the long term due to running and jumping.
With age, meniscus loses its flexibility and degenerates, and meniscus tears may occur even in a simple squatting movement in older individuals.
The patient typically describes a slow swelling due to accumulation of fluid or blood in the knee after an acute injury, followed by pain with weight-bearing and turning maneuvers, and sometimes a clicking sound in the knee. .
Patients feel stinging or tearing. Depending on which meniscus is torn, the patient
may feel pain on the inner or outer part of the knee. Locking in the knee is a symptom of a meniscus tear, defined as a bucket handle tear.
If the injury is severe, the meniscus tear may be accompanied by knee collateral ligament and cruciate ligament tears. In this case, there may be discharge in the knee, that is, the patient cannot lock the knee while walking
and sudden bending occurs.
Diagnosis of meniscus tears. How is it diagnosed?
First of all, the history of the disease is taken by the doctor. In the story; Information is obtained about the onset of the disease, the characteristics of the findings, their severity, localization, spread, relationship with time, and factors that increase or decrease the patient's complaint. This is followed by a detailed physical examination by the doctor. The distinctive findings of the physical examination are tenderness in the inner and outer parts of the knee joint. Additionally, some physical examination maneuvers specific to meniscus tears are positive. Meniscus tear is diagnosed mostly through history and physical examination. MRI is the imaging method of first choice to confirm the diagnosis of meniscus tear.
Treatment of Meniscus Tear
Treatment of meniscus tear is a rehabilitation program that includes ice, medication, reducing load-bearing activity, knee brace and
strengthening. Additional treatments depend on healing potential and the patient's goals. Simple tears have more healing potential than complex tears.
Tears in the outer part of the meniscus tend to heal more than centrally located tears
. Young individuals may be prone to arthroscopic meniscus tear repair procedures. In older
patients, if there is no mechanical problem in the treatment of meniscus tear, it is appropriate to allow a 3-6
week rest period and rehabilitation for the findings to improve. If the patient continues to have functional limitations, has persistent mechanical findings, or recurrent periods of pain and swelling, an orthopedic opinion is required to consider surgical intervention.
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