What is a meniscus?
Menisci are small oval pieces of cartilage located between the bones that make up the knee joint. Their main function is to reduce the friction of the cartilage surfaces of the bones against each other and to distribute the loads on the joint in a balanced manner. There are two meniscus cartilages in the knee, inner and outer.
How does a meniscus tear occur?
Meniscus is flexible and soft at a young age and is resistant to knee strain. With advancing age, meniscus cartilage begins to wear out like other joint elements. It becomes harder and begins to lose its shock absorbing properties. Especially in young people, meniscus can tear when there is abnormal load on the knee joint during sports activities. These types of tears may occur as a result of a direct blow to the knee, rotation of the knee, or falls. In older ages, much milder knee traumas may result in meniscus tears.
What kind of complaints occur in meniscus tears?
Meniscus tears are basically caused by the way the tear occurs. It is classified in two ways. In cases that we call acute rupture, there is a challenging trauma to the knee and the knee suddenly swells. This swelling is caused by knee joint fluid or blood mixed with joint fluid. The knee is usually locked and moving the knee is very painful. These types of acute meniscus injuries generally occur in young people during sports activities and are less common. There are also chronic meniscus injuries. In this type of injury, complaints begin gradually. Although there may be fluid accumulation in the knee, this is not as much as in acute tears. The pain is lighter. It should be kept in mind that there may be no pain in some chronic meniscus tears. It is generally seen in middle and older ages. Locking in the knee is rare. In fact, these types of meniscus injuries are almost always accompanied by calcification. Bone deformities that occur due to calcification cause strain on the meniscus cartilages and the meniscus can tear easily.
Is surgical treatment necessary for meniscus tears?
It is a common belief in society that almost every meniscus is damaged. The tear requires surgical treatment. In fact, this is not true; on the contrary, surgical treatment is generally not required for meniscus tears. Menisk� In the acute phase of abdominal tears, ice, rest and bandage are applied several times a day for 15 minutes. Painkillers are used to relax the patient during this period. If the knee is very swollen, the fluid can be drained with the help of a needle and the patient can be relieved. With these treatments, knee complaints generally decrease significantly within a week. The decision for surgery should be made after the acute period has passed. Especially in young people and high-level amateur or professional athletes, the knees will continue to be stressed, and the knee may become blocked and swollen again due to the torn meniscus. Therefore, such cases are generally treated with surgical arthroscopy. The tear in the meniscus can be stitched or removed depending on the situation.
However, if the patient is middle or older or is young but does not do activities that will strain the knee, surgical treatment is rarely required. Especially after the ages of 45-50, meniscus tears are generally accompanied by calcification. Scientific research shows that menisci are often torn in patients with arthritis. In these cases, removing the meniscus will not reduce the patient's pain. Because the real issue is not the tear in the meniscus but the calcification. In such cases, pain can generally be successfully controlled with methods such as physical therapy, ice application, medication, bandages and injections, which we call conservative treatment. Sometimes the lateral ligaments are subjected to stretching, especially in the medial collateral ligament, which mimics medial meniscus pain. In these cases, knee pain can be completely relieved with a simple injection instead of surgery.
Is "Platelet Rich Plasma" (PRP) injection effective in meniscus lesions?
Although there is not much data on the use of PRP injection in meniscus lesions, there are a few applications. It has been determined that PRP can be effective. It is a very useful method, especially in preventing the damage that the damaged meniscus or arthroscopic removal of the meniscus will cause to the knee cartilages over time.
What are the drawbacks of surgically removing the meniscus?
The most important fact that should not be forgotten is that menisci are in the knee for a reason. It has been proven that removing all or part of the meniscus from the knee accelerates the destruction of cartilage in the knee and causes premature calcification. So meniscus Surgery has a price, and that price is early calcification.
In order not to pay this price, the diagnosis of meniscus lesions must be made correctly and the choice of treatment must be made after a multifaceted evaluation.
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