The meniscus is located on the tibial articular surface and has a medial and lateral meniscus shape. The medial meniscus is “C” shaped with the anterior horn attached to the anterior cruciate ligament attachment point and the posterior horn attached between the tibial intercondylar ridge and the posterior cruciate ligament attachment point, and the middle of its outer edge is closely connected to the medial collateral ligament. The lateral meniscus is “O” shaped with the anterior horn attached to the anterior cruciate ligament attachment point and the posterior horn attached to the posterior horn of the medial meniscus, and its outer edge is not attached to the lateral collateral ligament, and its mobility is greater than that of the medial meniscus.
Causes of knee meniscus injury
This disease is a traumatic disease, mostly caused by torsional external forces, when a leg is weight-bearing, the lower leg is fixed in semi-flexion, when the external booth, the body and the femur are violently rotated internally, the medial meniscus is between the femoral condyle and the tibia, and is subjected to rotational pressure, resulting in meniscal tear, such as the greater the degree of knee flexion at the time of the sprain, the more posterior the tear site, the lateral meniscus injury mechanism is the same, but the direction of the force is opposite, the ruptured meniscus such as The mechanism of the lateral meniscus injury is the same, but the force is in the opposite direction.
Diagnosis:
The diagnosis of this disease can be summarized in the following points.
1. History of injury: Most patients have a definite history of trauma.
2. Pain: Meniscal injuries are combined with synovial injuries, resulting in more pain, especially on the injured side.
3.Joint swelling: caused by the accumulation of blood and fluid.
4.Rattling sound: there can be a crisp sound on the injured side when the joint moves.
5.Joint strangulation: that is, the joint is suddenly stuck when moving, which is caused by the broken meniscus stuck between the femoral condyle and tibial plateau.
6. Quadriceps atrophy: This is usually seen in chronic cases.
Treatment of meniscal injury of the knee joint
1. In the acute stage, if there is a significant fluid (or blood) accumulation in the joint, the fluid should be extracted under strict aseptic operation and then wrapped with an elastic bandage from the upper 1/3 of the thigh down to the ankle and fixed with a brace to keep the knee joint in the straight position for 4 weeks. The patient was allowed to walk with the brace. During the immobilization period and after removal of the immobilization, the quadriceps muscle should be actively exercised to prevent muscle atrophy.
2.Repair of meniscus blood supply area injury
Injuries to the blood supply area of the meniscus, especially longitudinal lacerations, can be healed by suturing surgery, which has a good prognosis, as confirmed by many experimental and clinical studies.
3.Repair of meniscus injury without blood supply area
Injuries to the meniscus without blood supply are relatively difficult and have become a challenge in knee surgery. Smaller and regular injuries to the meniscus without blood supply, such as barrel stem-like tears, are often partially resected with fair results, but this compromises the biomechanical and biophysical function of the meniscus to a greater or lesser extent.
4.Severe meniscus injury
When the meniscus is severely damaged, only total resection surgery can be performed. At this time, frozen meniscus and meniscus prosthesis transplantation are feasible, but there are many difficulties in meniscus prosthesis transplantation, such as the biomechanical function of the prosthesis cannot meet the requirements, the prosthesis is difficult to fix, and joint degeneration is still obvious after transplantation.
5.Surgical treatment
Surgical treatment mostly refers to the use of arthroscopy to remove the free meniscus fragments, or to remove the damaged meniscus. Among them, removal of meniscus is the last resort. Patients will lose or weaken the basic physiological functions such as jumping and weight-bearing after meniscus removal.