1. What is the meniscus?
The meniscus is a type of fibrous cartilage that is located in the gap between the femur and tibia in the knee joint. Each knee joint has two menisci: the lateral meniscus and the medial meniscus, which are approximately O-shaped or C-shaped, respectively. In some people, the meniscus has a central portion and an oval disc-shaped deformity, called a discoid meniscus. The discoid meniscus can rupture due to minor trauma. In China, the lateral discoid meniscus is more common, so contrary to what has been reported abroad, the incidence of injury to the lateral meniscus is much higher than that of the medial meniscus. The meniscus only has blood supply to the peripheral edge part, while the central part, which is the main part, has no blood supply, so it is extremely difficult for this part of the meniscus to heal after rupture.
2. What is the function of the meniscus?
The meniscus is an important structure in the knee joint and has the following functions.
(1) Its special shape of thick outside and thin inside and concave top and bottom can fully fill in the joint space between the femur and tibia, maintaining the stability of the knee joint.
(ii) It is composed of fibrocartilage, which is rich in elasticity and can withstand gravity and absorb shocks.
(iii) Disperses synovial fluid and lubricates the joint.
④cooperate with the extension and rotation activities of the knee joint.
⑤ prevent synovial membrane embedding.
3. How is the meniscus damaged?
When the knee joint is semi-flexed, the grinding force from a sudden and violent twist of the knee joint can cause the meniscus to rupture. The types of meniscus rupture include.
(i) Longitudinal tears, also known as “barrel stem tears”.
②Middle 1/3 tears, also known as body tears.
(iii) anterior horn tears.
(iv) anterior 1/3 tears
⑤ posterior 1/3 tear.
(vi) Delamination split, also known as horizontal split.
Therefore, if you have had a sudden twisting activity of the knee joint during daily activities and sports, such as playing basketball, badminton, soccer, etc., and then you experience pain and discomfort in the knee joint, especially severe pain in the joint, inability to straighten the joint completely, and “clicking” sound when moving in the joint, you should consider the possibility of meniscus injury or rupture; if it does not reduce after rest, you should consider the possibility of meniscus injury or rupture. If the pain is not reduced after rest, it is necessary to go to hospital for examination.
4.How to confirm the diagnosis of meniscus rupture?
The diagnosis of meniscus injury or rupture is a comprehensive assessment and differentiation process. First, the doctor needs to be carefully informed of any inappropriate overactivity, the location of the joint pain, any sudden inability to straighten or bend the joint during activity, and how long this has been occurring. Secondly, a physical examination of the knee joint is also important for diagnosis, including, in particular, pressure pain in the joint space, hyperextension test, hyperflexion test, and meniscal rotation test. Again, X-rays and MRI (magnetic resonance imaging) are required; X-rays cannot show the meniscus pattern and are mainly used to exclude lesions and injuries to the bones of the knee joint; MRI films with high resolution can clearly show whether there is degeneration or rupture of the meniscus, and can also detect any joint effusion and ligament damage, but there are varying degrees of limitation in the accuracy of MRI in diagnosing meniscal rupture, and there are still However, the accuracy of MRI in the diagnosis of meniscal rupture is limited to varying degrees, and some meniscal injuries or ruptures are not visible on MRI films. Finally, for some meniscal injuries or ruptures that are highly suspected but cannot be confirmed by MRI, the diagnosis can be confirmed by arthroscopy; arthroscopy is a minimally invasive technique that has been widely used in recent years, which can not only detect meniscal injuries that are difficult to detect by imaging, but also detect the presence of cruciate ligament, articular cartilage and synovial lesions; it can be used not only for diagnosis, but also for minimally invasive treatment, such as meniscus repair and synovial therapy. It can be used not only for diagnosis but also for minimally invasive treatment, such as meniscus repair and partial resection.
5.How to self-assess after meniscus injury?
Of course, for people who suspect whether they have meniscal injury or rupture, they can also check themselves by squatting and walking the duck walk (squat walk test). Changing directions from time to time, either left or right, during the squat walk duck walk can rule out a meniscus injury if these movements can be performed well. If the knee joint cannot be fully flexed because of pain and there is a rattling sound and knee pain and discomfort during the squat walk, it indicates that there is a high probability of meniscal injury or rupture, especially if the posterior horn of the meniscus is ruptured the rattling sound is obvious during the squat walk. It is important to note that no test or examination is the only basis for diagnosing meniscal injury of the knee. Clinical symptoms, pressure points, various positive result tests, and imaging examinations should be integrated to make the final diagnosis.
6.Can early meniscus injury be treated conservatively?
Early acute meniscus injury can be treated conservatively by immobilization in a long-leg cast for 4 weeks, while avoiding floor or weight-bearing activities. After the acute phase has passed, the pain can be reduced and functional exercises for the quadriceps muscle can be started to avoid muscle atrophy. Some patients can resume normal daily activities. In some people, when the meniscus is first damaged, it is not very serious and does not affect walking, or after early conservative treatment, the knee pain is significantly reduced or disappears and normal knee function is restored, but after a period of time, the pain reappears or becomes more severe, which is due to the poor blood supply to the meniscus, and it is extremely difficult to heal after injury or rupture. This is because of the poor blood supply to the meniscus, which makes it extremely difficult for the injury or rupture to heal.
7.What if conservative treatment is not good?
If the diagnosis of knee meniscus rupture is clear, the knee joint has recurrent or persistent pain, and the joint function is heavily affected, it is estimated that conservative treatment is not effective, and most of them now advocate minimally invasive surgery under arthroscopy. A meniscus with separated edges can be sutured; a ruptured meniscus flap that is easily interlocked can be partially removed, i.e., partial meniscus revision surgery; or the entire meniscus can be removed microscopically if it is broken. Arthroscopic surgery has become a routine treatment method because the incision is small, the interference with the joint is minimal, the postoperative recovery is fast, and the patient can get up and move around early.