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Abstract: In this article, a 40-year-old male patient suffered a knee torsion while playing soccer, causing a meniscal injury and knee symptoms, and the meniscal injury was confirmed by MRI. In order to restore the function of the meniscus, conservative treatment such as limiting the weight-bearing activities of the knee joint and using braces for immobilization was performed.
Basic information】Male, 40 years old
Disease Type】Meniscus injury
Hospital】Harbin First Hospital
Date of Consultation】August 2021
Treatment plan】Conservative treatment (brace fixation)
Treatment Period】7 days of hospitalization and regular follow up
Results】The meniscus healed, pain was relieved, and the knee resumed activity.
I. Initial consultation
The patient was 40 years old, because he was playing soccer with his knee in a semi-flexed position, his body weight was squeezed on the affected knee joint, and at the same time, in order to complete the shooting action, he needed to rotate his body, so the knee joint rotated sharply and squeezed the meniscus, resulting in meniscus injury. The patient agreed, so he was admitted with meniscal injury.
II. Treatment process
After meniscal injury, direct surgical treatment will lose the opportunity to repair the meniscal injury on its own, and the surgery itself will cause a certain degree of collateral damage to the knee joint. Since the patient had a fresh meniscus injury and no significant meniscal displacement had occurred, conservative treatment was recommended for 1 week to promote meniscal repair, and if conservative treatment did not meet the need, arthroscopic surgery to suture the meniscus or perform meniscal revision surgery was further considered. The specific method is to use braces for immobilization to keep the knee joint stable, while avoiding weight-bearing on the affected limb to ensure that no local pressure is generated on the meniscus, which is conducive to its gradual healing. At the same time, straight leg raising exercises were performed daily to prevent muscle atrophy in the lower limbs and to promote blood circulation in the knee joint to speed up the smooth healing of the meniscus. 6-8 weeks later, depending on the healing of the meniscus, the knee joint bending activities were gradually started to restore the range of motion of the knee joint.
III. Treatment effect
After conservative treatment, the meniscus eventually healed completely and the patient was discharged after 7 days of hospitalization. At the time of discharge, the patient’s clinical symptoms such as knee pain, swelling, and limitation of movement had completely disappeared, and the range of knee flexion and extension had been fully restored. After several reviews, it was confirmed that the patient was able to walk with normal weight bearing in the knee joint, and no lower limb claudication or joint interlocking symptoms had occurred, and there was no significant atrophy of the leg muscles. The patient was followed up 1 month later and indicated that after long-term strict rehabilitation exercises, the stability of the knee joint had been significantly improved and normal movement could be gradually resumed.
IV. Precautions
I was pleased with the patient’s positive cooperation and good recovery. I also advised the patient to closely observe the knee pain, swelling, and limitation of movement after discharge from the hospital. If the pain and swelling worsen with knee fever, the patient should be reviewed at the orthopedic clinic to confirm whether infection has occurred. If there are symptoms of interlocking joints, the meniscus injury site is not healing smoothly, or even the meniscus injury site is dislocated, which requires further minimally invasive arthroscopic surgery to avoid damage to the articular cartilage and serious dysfunction of the knee joint.
V. Personal insight
Sudden twisting of the knee joint during sports can easily damage the meniscus. Therefore, this patient needs to pay strict attention to protecting the knee joint after this complete repair of the meniscus to avoid a recurrence of knee sports injury that could lead to meniscal damage. The knee joint tolerance and knee joint stability should be fully considered before exercise, and knee pads should be worn for protection if necessary to improve knee joint stability, while avoiding sudden twisting movements of the knee joint to prevent frequent meniscus injuries, protect the knee cartilage and knee joint function, and ensure the service life of the knee joint.