Meniscus is a kind of disease with limited pain in knee joint, some patients have limp leg or knee interlocking phenomenon, quadriceps atrophy, and limited pressure pain fixed in knee joint gap as the main manifestation. Meniscus injury is mostly caused by torsion external force, when a leg load bearing, calf fixed in semi-flexion, external booth, the body and the femur violently rotated internally, the medial meniscus in the femoral condyle and tibia between, by rotational pressure, and lead to meniscus tear. Definition The medial and lateral meniscus shaped bones on the articular surface of the tibia are called menisci. II. Symptoms Most have a history of obvious trauma. In the acute stage, the knee joint has obvious pain, swelling and effusion, and the joint flexion and extension activities are impaired. After the acute stage, the swelling and effusion can subside on their own, but there is still pain in the joints, especially when going up and down the stairs, going up and down the stairs, squatting, running, jumping, etc. The pain is more obvious, and in severe cases, the patient can limp or flexion and extension dysfunction, and some of the patients have the phenomenon of “interlocking”, or in the knee flexion and extension. Some patients have the phenomenon of “interlocking”, or there is a popping sound when the knee joint is flexed or extended. 1, the site of analgesia, the site of analgesia is generally the site of the lesion, the diagnosis of meniscus injury and to determine the location of the injury are of great significance. During the examination, put the knee in the semi-flexed position, in the medial and lateral knee joint gap, along the upper edge of the tibial condyle (i.e., the edge of the meniscus), with the thumb from the front to the back of the pressure point by point, there is a fixed pressure pain in the meniscus injury. If the knee is passively flexed and extended or the calf is rotated internally and externally at the same time, the pain will be more significant, and sometimes the abnormally active meniscus can be touched. 2, Mai’s test The patient lies on his back, the examiner holds the ankle of the calf with one hand, holds the knee with the other hand to flex the hip and knee as much as possible, and then makes the calf abducted, externally rotated and adducted, internally rotated, or internally retracted, internally rotated, or internally retracted, externally rotated, and then straightens it out gradually. The presence of pain or rattling sound is positive, according to the pain and rattling sound site to determine the site of injury. 3.Powerful hyperextension or hyperflexion test: passive hyperextension or hyperflexion of the knee joint, such as anterior meniscus injury, hyperextension can cause pain; such as posterior meniscus injury, hyperflexion can cause pain. 4.Lateral compression test: With the knee in the straight position, the knee is strongly and passively adducted or abducted. If there is a meniscus injury, the pain is caused by squeezing at the joint space on the affected side. 5.Single leg squatting test The patient will gradually squat with one leg and then stand up from the squatting position. The healthy side is normal, while the affected side will squat or stand up to a certain position, because the injured meniscus will be squeezed, which may cause pain at the joint space, and the patient may not even be able to squat or stand up. 6, gravity test, patients take the lateral position, lift the lower limb for active knee flexion and extension activities, the affected side of the joint space down, due to the injury of the meniscus is squeezed and cause pain; on the contrary, the affected side of the joint space up, there is no pain. 7. Grinding test: The patient takes the prone position with the knee flexed, the examiner holds the ankle with both hands and presses the calf down while doing internal and external rotation activities, the injured meniscus will cause pain due to extrusion and grinding; on the contrary, if the calf is lifted upward and then does the internal and external rotation activities, there will be no pain. X-ray examination: taking X-ray front and side view film can not show the meniscus damage, but it can exclude other bone and joint diseases. Knee arthrography has little significance in diagnosis and can increase the patient’s pain, so it should not be used. Knee arthroscopy: arthroscopy can directly observe the site and type of meniscus injury and other structures in the joint, which can help the diagnosis of difficult cases. Third, the examination of laboratory tests 1, pressure and pain site pressure and pain site is generally the site of the lesion, the diagnosis of meniscus injury and to determine the location of the injury are of great significance. During the examination, put the knee in semi-flexion position, in the medial and lateral knee joint gap, along the upper edge of the tibial condyle (i.e., the edge of the meniscus), press with the thumb from the front to the back, point by point, there is a fixed pressure pain in the meniscus injury. If the knee is passively flexed and extended or the calf is rotated internally and externally at the same time, the pain will be more significant, and sometimes the abnormally movable meniscus can also be touched. 2, Mai’s test (rotary squeeze test) The patient lies on the back, the examiner holds the calf ankle with one hand, holds the knee with the other hand to flex the hip and knee as much as possible, and then makes the calf abducted, externally rotated and abducted, internally rotated, or internally retracted, internally rotated, or internally retracted, externally rotated, and then straightens it out gradually. The presence of pain or rattling sound is positive, according to the pain and rattling sound site to determine the site of injury. 3.Powerful hyperextension or hyperflexion test: passive hyperextension or hyperflexion of the knee joint, such as anterior meniscus injury, hyperextension can cause pain; such as posterior meniscus injury, hyperflexion can cause pain. 4.Lateral compression test: With the knee in the straight position, the knee is strongly and passively adducted or abducted. If there is a meniscus injury, the pain is caused by squeezing at the joint space on the affected side. 5.Single leg squatting test The patient will gradually squat with one leg and then stand up from the squatting position. The healthy side is normal, while the affected side will squat or stand up to a certain position, because the injured meniscus will be squeezed, which may cause pain at the joint space, and the patient may not even be able to squat or stand up. 6, gravity test, patients take the lateral position, lift the lower limbs for active knee flexion and extension activities, the affected side of the joint space down, due to the injury of the meniscus is squeezed and cause pain; on the contrary, the affected side of the joint space up, there is no pain. 7, grinding test The patient takes the prone position, the knee is flexed, the examiner holds the ankle with both hands and presses the calf down while doing internal and external rotation activities, the injured meniscus will cause pain due to extrusion and grinding; on the contrary, if the calf is lifted upward and then does the internal and external rotation activities, there will be no pain. 8.X-ray examination X-ray front and side view film, although it can not show the meniscus damage, but can exclude other bone and joint diseases. Knee arthrography has little significance in diagnosis and can increase the patient’s pain, so it is not suitable for use. 9, knee arthroscopy through the arthroscope can directly observe the meniscus injury site, type and other structures in the joint, which can help the diagnosis of difficult cases. IV. Diagnosis Most patients have a clear history of knee sprain. After the injury, there is severe pain in the knee joint, walking can be accompanied by popping sound, can not be automatically straightened, and the joint is swollen. Pressure pain at the knee joint space is an important basis for meniscus injury. In traditional Chinese medicine is a tendon injury, which is mainly due to exertion, trauma, infection and other reasons to the body’s immune system low, visceral function deficiency, wind, cold, dampness, evil invasion of the body to take advantage of the weakness of the stagnant joints, meridians and so on. Meniscus injury belongs to the category of aseptic inflammation, ordinary plasters can only play a role in activating blood circulation and eliminate blood stasis, can not eliminate the aseptic inflammation, the treatment of meniscus injury is not effective. And the meniscus . Plate analgesic. Pain. Paste for meniscus injury special special drugs, specifically for meniscus injury and research and development of the disease mechanism, more targeted, more accurate and reliable efficacy. Treatment precautions: most patients believe that bone and joint diseases should be more exercise, which will help the disease recovery, but meniscus injuries due to the specificity of the disease, so it is not suitable for sports and exercise; do not be too tired, can not be cold. V. Therapeutic measures 1. Acute stage If there is obvious fluid (or blood) in the joint, the fluid should be extracted under strict aseptic operation; if there is “interlocking” in the joint, the joint should be lifted by maneuvering, and then it should be fixed with a tube-type plaster from the upper third of the thigh down to the ankle. The knee should be kept in the straight position for 4 weeks. The cast should be properly molded and the patient can walk on the ground with the cast. During the period of immobilization and after removal of immobilization, the quadriceps muscle should be actively exercised to prevent muscle atrophy. 2.Chronic stage If the non-operative treatment is ineffective, the symptoms and signs are obvious, and the diagnosis is clear, the damaged meniscus should be removed as early as possible in order to prevent the occurrence of traumatic arthritis. After surgery, the knee should be extended with pressure bandage, the next day, the quadriceps muscle should be static contraction exercise, 2~3 days later, the straight leg elevation exercise should be started to prevent quadriceps muscle from atrophy, and two weeks later, the quadriceps muscle should start to walk on the ground, and the normal function can be resumed 2~3 months after the surgery. 3.Arthroscopic application Arthroscopy can be used for the treatment of meniscus injury, meniscus edge tear can be repaired with suture, usually partial meniscectomy, retaining the uninjured part. For early suspected meniscus injury, emergency arthroscopic examination is feasible, early treatment of meniscus injury, shorten the course of treatment, improve the therapeutic effect, reduce the occurrence of injurious arthritis. Through arthroscopic surgery is less traumatic and faster recovery. The disease in Chinese medicine is paralysis, which is mainly due to exertion, trauma, infection and other reasons to the body’s low immunity, deficiency of internal organs, wind, cold, dampness, the evil gas to take advantage of the invasion of the body stagnation of joints, meridians and so on. Because the kidney is the main bone essence, nourish the marrow. If the kidney is not enough, can not master bone, nourish the marrow can appear bone disease; liver main meridians, dominate the body ligaments and joints movement, such as liver yang on the hyperactivity, liver blood insufficiency can appear tendon pain, numbness, flexion and extension difficulties, etc.; the spleen main transport, the main muscle, if the spleen is not transport, can not nourish the skin can appear muscle and joint tissues pain and atrophy. Therefore, the treatment of such diseases should first regulate the function of the five viscera and six bowels, treating both the symptoms and the root cause in order to achieve the purpose of healing and rehabilitation. Sixth, treatment 1, conservative treatment traditional treatment methods mainly through massage to promote local blood circulation, so that the pain symptoms are relieved, but because the traditional treatment can not solve the problem from the root, can not completely cure meniscus injury. 2.Surgery Surgery is the most effective way to completely cure meniscus injury, surgical treatment through the removal of the damaged meniscus, take out the free meniscus fragments, from the root to cure the meniscus injury, the introduction of arthroscopic surgery in the clinic for minimally invasive treatment of meniscus injury opens up a broad prospect, at present, many outstanding athletes in the international meniscus injury are treated and rehabilitated by arthroscopic surgery. Hospital treatment 3, hospital treatment Ordinary orthopedic hospital treatment can only give patients with general painkillers, anti-inflammatory injections (penicillin, etc.), or pumping fluid. The patients can only be treated with general painkillers, anti-inflammatory injections (penicillin, etc.), or fluid pumping, and closed (sodium vitrate). Many patients are advised by doctors to choose surgical treatment, such as: arthroscopy, liquid knife, knife and other meniscal chondroplasty, mainly to remove the infected meniscal cartilage, although the removal of meniscal cartilage, but can not remove the inflammation of the joint cavity memory, the remaining meniscal cartilage and synovium will continue to be inflammatory, which is why there will be a reason for the accumulation of fluid after surgery. 4, physical therapy acupuncture cupping, acupuncture, massage and other physical therapy modalities can improve local blood circulation, play the role of blood circulation and blood stasis, relaxation of tendons and collaterals, for the sequelae of cardiovascular and cerebrovascular diseases, rheumatism and rheumatoid rheumatism late recovery effect is remarkable. But only auxiliary treatment; meniscus injury and general joint paralysis is not quite the same, it is mainly aseptic inflammation of the joints, simple activation of blood circulation and remove blood stasis, soothing the tendons and collaterals can not get rid of aseptic inflammation at all from the root. 5.Traditional topical treatment Traditional plasters: meniscus injury belongs to the category of aseptic inflammation, ordinary plasters can only play a role in activating blood circulation and removing blood stasis, can not eliminate the aseptic inflammation, the treatment of meniscus injuries is ineffective. Treatment precautions: most patients believe that bone and joint diseases should be more exercise, which will help the recovery of the disease, but meniscus injury because of the specificity of the disease, so it is not suitable for sports and exercise; do not be too tired, can not be cold. 6, massage therapy (1) loose tendon method: the operator in the soft tissues around the knee joint using point press release, split tendon rationalization method for 3-5 minutes (the back side of the knee joint can be used prone position). (2) Patellofemoral method: the operator first kneads the patella on the patellar body (kneading the patella with the thumb, and then scraping around the patella). (3) Expansion of the knee: the operator moves the knee several times, places the forearm of one hand on the back side of the knee as a fulcrum, flexes the knee as much as possible, then removes the arm as a fulcrum, and then directly flexes the knee 2-3 times. Early diagnosis and timely treatment, there is no large hematoma, the symptoms are not serious, such as no knee joint “card”, “interlocking” phenomenon, the quadriceps muscle has no atrophy phenomenon, middle-aged and elderly patients or the doctor according to the MRI judgement of the patient does not need to operate, can not be operated. The patients can be operated without surgery. Some of these people can participate in sports like normal people, but also after one and a half to two years. 2, athletes or sports enthusiasts still want to continue to play sports, will generally recommend surgery, but surgery is not a simple matter, in addition to the high cost, the recovery process should also be personal scientific rehabilitation exercise. In addition, can not be unaware of is that the operation itself is a regular larger trauma, a small number of people will be postoperative knee function to a certain degree of limitation. 3, in addition to pay attention to the sports posture and the intensity of the exercise, pay attention to sports protection, such as wearing sports protective gear to prevent accidental injury in sports. 4, in daily life, everything should have to foresee the possibility of accidents, make full use of the tools around to help reduce the risk of meniscus injury caused by accidents. For example, when getting on and off the bus or going up and down the stairs, don’t be in too much of a hurry, you can use the handrail to help stabilize your body and then take a step, and for those who have occupational habits, it’s best to change the posture of your labor every once in a while and take a short break.