Knee Meniscus Injury in Soccer

  The 2014 FIFA World Cup in Brazil is in full swing, with exciting shots and frenzied fans, highlighting the charm of soccer. As athletes fight hard on the field, there are injuries in every game. Knee meniscus injuries are common in soccer injuries. It accounted for 12 percent of injuries in the 2004-2005 season. Today we will talk about meniscal knee injuries in soccer.  The meniscus of the knee is located between the femoral condyle and the tibial plateau, one on the medial and one on the lateral side. In daily life, when the knee joint extends and flexes and rotates, the meniscus also moves accordingly. In terms of appearance, it acts as a wedge-shaped filling to accommodate the spherical surface of the femoral condyle; in terms of function, it plays an important role in conducting load, maintaining stability, and distributing synovial fluid.  Knee meniscal injuries are mostly caused by torsional external forces. For example, when kicking a soccer ball, kicking an empty ball, turning around in a hurry or tripping, when one leg is bearing the weight and the lower leg is fixed in semi-flexion and external booth, the body and the femur are violently rotated internally and the medial meniscus is subjected to rotational pressure between the femoral condyle and the tibia, resulting in meniscal tear. The greater the degree of knee flexion at the time of the sprain, the more posterior the tear site. The mechanism of injury to the lateral meniscus is the same, but the forces act in the opposite direction. If the torn meniscus slips partially between the joints, it causes mechanical impairment of joint movement and prevents joint extension and flexion, resulting in “interlocking”. In severe trauma cases, the meniscus, cruciate ligament and collateral ligament can be damaged at the same time. Meniscal injuries can occur at the anterior, posterior, middle or marginal part of the meniscus. The shape of the injury can be transverse, longitudinal, horizontal or irregular, or even broken into intra-articular free bodies. The movements of soccer players when dribbling and carrying the ball coincide with the etiology of meniscal injuries, so it is not surprising that so many people have this injury.  In the acute phase, there is significant pain, swelling and fluid accumulation in the knee joint, and the joint flexion and extension are impaired. After the acute phase, the swelling and effusion may subside on their own, but the joint is still painful when moving, especially when going up and down stairs, going up and down slopes, squatting and standing, running and jumping, etc. In severe cases, limping or flexion and extension dysfunction may occur, and some patients have interlocking phenomena or popping when flexing and extending the knee joint.  The acute phase after meniscal injury is mainly treated with ice, brace braking and pain relief. The aim is to reduce exudation and swelling, while performing isometric contraction exercises of the quadriceps muscle to prevent muscle atrophy. If the joint has obvious fluid (or blood) accumulation, the fluid should be extracted under strict aseptic operation; if the joint has “interlocking”, the “interlocking” should be released by manipulation, and then the knee joint should be fixed in the straight position for 4 weeks with a brace from the upper 1/3 of the thigh down to the ankle. The patient is allowed to go down with the brace. During immobilization and after removal of immobilization, the quadriceps muscle should be actively exercised to prevent muscle atrophy.  If non-surgical treatment is ineffective, signs and symptoms are obvious, and the diagnosis is clear, early surgery should be performed to remove or repair the damaged meniscus to prevent traumatic arthritis.  Arthroscopic application: Arthroscopy can be used for the treatment of meniscal injury. Suture repair is feasible for meniscal edge tears, and partial meniscectomy is usually performed, preserving the undamaged part of the meniscus. For early suspected meniscal injury, emergency arthroscopy is feasible. Early treatment of meniscal injury shortens the course of treatment, improves the therapeutic effect and reduces the occurrence of injurious arthritis. Arthroscopic surgery is less traumatic and quicker to recover. After the surgery, the knee extension position is bandaged with pressure, and the next day the quadriceps resting contraction exercises are started. 2 to 3 days later, straight leg raising exercises are started to prevent quadriceps atrophy, and two weeks later, walking on the ground is started, and normal function is generally restored 2 to 3 months after surgery.  Star cases: Football players such as Italian defender Barzagli, German internationals Friedrich and Mertesacker, Brazilian center back Henrique, French defender Matip, Ghanaian midfielder Essien, the skyrocketing stars Vanni, Ronaldo, Owen, and our national player Shao Jiayi …… This series of stars in their careers have A history of injuries from meniscus injuries!