Home Flowers Signs of degenerative changes in the lateral meniscus. Degenerative damage to the medial meniscus. Dystrophic changes in the knee joint

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Signs of degenerative changes in the lateral meniscus. Degenerative damage to the medial meniscus. Dystrophic changes in the knee joint

The meniscus is the cartilaginous lining at the joint. He is best known for his knee joint. Degenerative changes in the menisci of the knee joint often develop, and this can permanently deprive a person of an active life. Why do they appear, and how to deal with them?

A few words about the meniscus

So, the bones of the lower extremities are fixed and held by two meniscus cartilages, from the front and back sides (medial and lateral). They also play the role of a shock absorber, which means they prevent numerous injuries to the knee that could occur during movement. Without them, the articulation would be unstable.

The meniscus, along with the elbow, is one of the most mobile joints in the entire skeleton. But without healthy lower extremities, the very possibility of movement, of walking, becomes questionable. The menisci have an anterior and a posterior portion (horns), as well as a central zone (body). At the anterior horn and closer to the edges, the meniscus tissue structure is most fully saturated with collagen.

Degenerative processes of the meniscus are divided into 5 types:

Rupture of meniscus ligaments. In this case, the knee becomes unnaturally mobile in all directions. This can cause a dislocation, fracture, or other injury. The very integrity of the joint when the ligaments are ruptured is not broken.
Meniscopathy. This is the most classic case, when the cartilage gradually becomes thinner and ceases to perform its functions. The root cause may be arthrosis, gout and other diagnoses of the patient.
Meniscus tear. The cartilage is displaced from its anatomically correct position. The person becomes limited in movement.
Cystosis. With this disease, formations are formed in the cartilage cavity that interfere with the normal functioning of the meniscus. Over time, they deform and all surrounding tissues.
Degenerative rupture of part of the meniscus. This can be either the cartilage body itself or its horns.

The most common degenerative changes occur in the posterior horn of the medial meniscus. They are based on long-term microtraumas and chronic diseases, that is, these are physiological damages.

The reasons

More often they talk about provoking factors that contribute to the appearance of degenerative processes in the menisci.

Elderly age

Over time, the blood supply to all organs is disturbed and the bone structures feel it among the first. If we add to this the deterioration of the joint, which every person of venerable age invariably has, then there are already prerequisites for the emergence of meniscus pathology.

Athletes

Most sports are somehow connected with the movements of the lower extremities. These are runners, and football players, and skiers. If such movements are performed for wear, then they will not bring benefits to the body. Especially often problems with menisci are diagnosed in dancers. Dance movements especially often lead to injuries, in particular, dislocation and subluxation of cartilage, including both menisci at once.

flat feet

Incorrect anatomy of the foot can change and worsen the condition of the entire musculoskeletal system, especially the spine, pelvis and knees. Degenerative-dystrophic changes in the knee joint is only one of the possible diagnoses in such a patient.

Inflammatory diseases

They can either occur directly in the joint (arthritis) or be localized in other organs (tuberculosis, syphilis). Of course, they do not lead to manifestations in the area of the knee joint soon, but in this case, the likelihood of degenerative consequences that are difficult to treat increases.

Harvesting, weeding the beds and other gardening and field work are often carried out in the "squatting" position. These people do not suspect how dangerous their position is for the knee joint, in particular, for the meniscus.

Other reasons

The list continues:

Persons who squat or stand for long periods of time. In the squatting position, all vessels and nerve endings are pinched. In a standing position, stagnation also occurs in this joint, which negatively affects its condition.
congenital anomalies. So, even ordinary walking with knee dysplasia, that is, the wrong position of the bones in the joint, provokes the initiation and progression of degenerative changes.
Metabolic diseases. This is not only gout, familiar to everyone, in which the deposition of uric acid salts completely disrupts the nutrition of the joint, but also hypothyroidism, cirrhosis of the liver and many other diagnoses.
Injuries. The specialist will ask about them first of all. If there is a history of damage to the articular parts of the knee, then the likelihood of developing degenerative processes is very high.

By the way, if it was the injury that caused degenerative changes, the doctor will clarify the movements that led to this. So, degenerative damage to the inner meniscus occurs when the lower leg is sharply rotated with a large amplitude of movement directed outward. Inward rotation damages the lateral meniscus.

Injuries to the meniscus can sometimes be combined with injuries to other joints, such as the anterior cruciate ligament. Traumatologists see this combination regularly.

Degrees of damage

In total, 4 types of joint condition are noted:

Zero degree. If a person sees these words in his card, then he can calm down. Zero degree is an absolutely healthy meniscus without any changes. All its structures work without deviations.
First degree. Changes are only inside the meniscus, but they do not reach the outer shell. For this reason, such injuries are very poorly diagnosed by traditional methods - x-rays and even ultrasound. X-ray will be informative in cases where the damage has already affected the bone structure. The most informative for degenerative changes of the 1st degree is magnetic resonance imaging, which will very clearly indicate the difference in the density of the joint structure. Degenerative signs on MRI are enough to initiate appropriate treatment.
Second degree. There is a more extensive meniscus lesion, but it still does not reach the outer shell. These changes in some cases can be seen on ultrasound. Sometimes a specialist doubts what kind of severity to determine the disease in a particular patient, and he writes "1-2 degrees according to stoller." The second degree according to stoller is a rupture of the meniscus, but in this case, a violation of the integrity of the meniscus has not yet been recorded.
Third degree. This is the 2nd degree in stoller. The rupture at the 3rd degree of joint damage can be complete or partial, which determines the tactics of therapy by the doctor.

Symptoms

Degenerative changes appear gradually, and therefore all sensations grow over a long time. At first, pain in the knee appears only during exercise, especially when going up or down stairs. Then the person can detect a violation of the movement of the knee joint, the amplitude may change. A little later, "sound" symptoms are added to them - a crunch, a creak when moving, especially slow. In the last stage, the normal shape of the knee changes.

External changes in degenerative destruction of the meniscus do not appear immediately, but only when the anatomy of the knee changes. This does not apply to injuries in which swelling and redness appear almost instantly.

The most striking symptoms appear as a result of a meniscus injury:

sharp, severe pain that does not go away even at rest;
the appearance of swelling in the knee area;
hemorrhage into the joint cavity (hemarthrosis);
pathological movement of the joint (too active, in all directions, or, conversely, restriction if you want to bend the knee).

By the way, the restriction of movement of the knee depends on the localization of degenerative changes. So, if the anterior horn and the body of the meniscus are damaged, the extension of the joint is blocked, and if the posterior horn is deformed, flexion is limited.

Treatment

Therapy will depend on how badly the cartilage plate is damaged. If the changes are minimal, then conservative methods are sufficient. First, you need to give the joint rest, remove the load from it. Secondly, it is necessary to start pharmaceutical treatments. Anti-inflammatory drugs. Ibuprofen, Diclofenac, Nimesulide and other non-steroidal PVAs will help to quickly relieve inflammation if it has become the root cause of degenerative changes.

Painkillers. They not only reduce pain, but also help relieve swelling. Muscle relaxants. They relieve muscle spasms and reduce motor activity for the duration of therapy. Chondroprotectors. They restore the structure of cartilage tissue and the joint as a whole, contribute to its strengthening.

If there is hemarthrosis, then it is necessary to remove blood clots in the joint cavity to allow it to recover normally. To do this, use a puncture (puncture) and pump out the accumulated blood. Immediately after this, the vacated cavity is washed with an antiseptic solution or glucocorticosteroids are administered, which prevent the accumulation of fluid. To prevent the cavity from being filled with lymph and blood again, it is necessary to wear an elastic bandage on the knee for some time, under the pressure of which these processes will be impossible.

Unfortunately, conservative methods are not always effective, and relapses often occur.

If degeneration has taken a serious turn, then surgical intervention is indispensable. Arthroscopy is a minimally invasive surgical procedure that allows you to restore the joint in a very short time. If the doctor has prescribed arthroscopy, then you should not try to do without it. It is the only true method of treating third-degree meniscal injury (second according to stoller), but can be prescribed in milder cases.

The knee joint is the most frequently operated on, which is understandable. The knees, along with the elbows, a person uses much more than the rest of the joints of the skeleton.

Today, this operation has been brought to perfection, and the skill of surgeons is at a very high level. During the operation, the doctor will perform plastic surgery of the joint, that is, remove the destroyed tissues and connect healthy areas. Here you can also remove adhesions, particles of cartilage, as well as align the edge of the damaged cartilage. The operation is minimally invasive and effective.

The mandatory methods of treatment include exercise therapy. The joint must remain mobile, the ligaments must be strong, and the muscles must be powerful. A set of exercises in a medical institution is selected for a specific patient, for a particular case. Physiotherapy also gives good therapeutic results: shock wave treatment, iontophoresis, magnetotherapy.

Degenerative changes in the menisci are always easier to treat at a very early stage. Not everyone comes to see a doctor at the first signs of pain, and therefore the processes in many become chronic. Fortunately, modern medicine allows you to restore the integrity of the meniscus, and proper rehabilitation will consolidate the result for many years.

The human body is often compared to cars: the heart is the engine, the stomach is the fuel tank, and the brain sets the whole device in motion. Where are the shock absorbers in humans? Of course, in places that experience increased stress: there are cartilaginous discs between the vertebrae, and in the knee joint there are as many as two “shock absorbers” - menisci. Lateral (external) and medial (internal). The results of degenerative changes in the menisci, although they will not stop the activity of the body as a whole, will certainly deliver a lot of unpleasant sensations.

Degenerative changes are anatomical damage to an organ resulting from trauma, atypical joint structure, or disease. Meniscus degeneration is most often the result of trauma, sometimes even unobvious: one bad rotation of the lower leg can cause damage to the cartilage disc, which is accompanied by severe pain.

Most often, due to the anatomical structure, the medial meniscus undergoes degeneration. If the external cartilage, which dampens the movement of the knee joint, does not have a rigid fixation and shifts to any side if necessary, then the medial one is rigidly fixed in the joint, and its horns are in close proximity to the condyles. One sharp turn of the lower leg - and the meniscus does not have time to escape from the displaced process of the bone, the result is its damage or rupture.

Degenerative changes can be different:

If you are haunted by aching pain in the knee, which then disappears, then appears with renewed vigor - we can already assume the presence of changes in the meniscus. About 90% of pathologies of the knee joint are due to damage to the "shock absorber".

Symptoms largely depend on the nature of the pathology. Tears are accompanied by severe pain, blockade of the leg in a bent state and swelling. With serious damage to the medial meniscus, hemorrhage into the articular cavity often occurs - hemarthrosis. Significant swelling and severe pain are also characterized by meniscal cysts.

Tears, detachments from the place of attachment are often chronic and are manifested by the periodic appearance of pain and a feeling of interference in movement.

There is such a diagnostic test: go up and down a ladder or slope. With pathology of the meniscus, when moving down, the pain in the knee increases.

The chronic course is also characterized by secondary degenerative-dystrophic transformations in the medial meniscus, that is, those that have arisen due to other pathologies of the body or diseases. Often in such cases there are clicks and rolls * of the joint in motion after a long rest, sometimes there is pain in the knees. The increase in symptoms occurs gradually as the cartilage layer thins and salts or uric acid crystals accumulate in it (the latter - with gout). In the absence of adequate treatment, the final stage of meniscopathy becomes contracture - a stable violation (restriction) of joint mobility.

* Rentals - sensations of pathological mobility, instability and displacement of the articular surfaces of the bones.

Common to all types of meniscus degeneration are the following symptoms:

pain,
swelling,
blockage of the joint in a bent position or sensation of a foreign body in the knee,
clicks and crunches,
swelling of the knees with a long absence of movement.

The anatomical features of the location and structure of the menisci determine the high incidence of pathologies both among young people and among people of mature age. Most often, athletes, ballerinas, dancers suffer from ruptures, injuries and cysts - that is, people who are in constant motion and experience high loads.

More possible reasons:

Diagnostics

With acute injuries of the meniscus, there is usually no doubt - blockade of the knee in a characteristic position, pain and clicks during straightening make it possible to establish the correct diagnosis in 90% of cases.

It is not always possible to determine degenerative-dystrophic transformations during examination due to the absence of clear symptoms and, often, a positive reaction to special tests. In such cases, resort to instrumental research methods:

Treatment Methods

Therapy for degenerative changes in the menisci depends entirely on the nature of the damage. Acute injuries serve as a direct indication for the use of conservative methods of treatment:

First of all, the joint is punctured, eliminating its swelling and restoring mobility. Sometimes several procedures are required, since active exudation (release of inflammatory fluid) in the joint lasts up to three to four days.
Analgesics are prescribed, preference is given to narcotic drugs (Promedol and its derivatives), because other drugs in this case, as a rule, are not able to relieve the patient of pain.
Chondroprotectors provide the body with the necessary substances to restore the damaged area of the meniscus.
Anti-inflammatory drugs.
At the stage of rehabilitation, physiotherapeutic methods serve as an auxiliary means - ozocerite, UHF, iontophoresis, shock wave therapy.
For 14 days, a splint is applied to the straightened leg, which ensures fixation of the joint in the required position.

In case of ruptures, surgical intervention is indicated: through two miniature incisions, instruments are inserted into the knee joint and the damaged area is sutured. A serious injury may necessitate the removal of the cartilage lining of the joint and its replacement with an artificial one. All surgical manipulations are performed only after the signs of inflammation have subsided.

Chronic dystrophies, joint dysplasia and abnormal development of the ligamentous apparatus require exclusively surgical treatment.

If the cause of degeneration is chronic diseases such as rheumatism and gout, along with surgical methods, the underlying disease is also treated (diets, immunocorrectors and other methods).

Degenerative transformations of the menisci is a fairly common pathology that requires immediate medical attention. The functioning of the joint in the future depends on the timeliness of treatment, and delays can cause the spread of dystrophic processes to other elements of the joint. Therefore, do not postpone the visit to the doctor, take care of yourself and be healthy!

A degenerative change is a violation of the normal structure of the meniscus, leading to a partial or complete loss of its functions. The cause of the pathology can be injuries, active sports, hard physical work or excessive stress on the knee joint. Degenerative processes in the meniscus can be a consequence of the natural aging of the body.

Degenerative changes in the knee joints are common among the elderly, athletes and overweight people. The process usually involves cartilage, ligaments, menisci, synovial membrane. In severe cases, the articular surfaces of the bones that form the knee joint are damaged.

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The development of degenerative processes in the menisci can be triggered by their frequent trauma, displacement, impaired blood supply and/or nutrition. Most often, the pathology develops against the background of chronic inflammatory and degenerative-destructive diseases of the joints. It can also be caused by traumatic injuries to the knee.

Deforming osteoarthritis is the most common disease of the musculoskeletal system. Pathology develops predominantly in people over 50 years of age. Among people over the age of 60, it is detected in 97% of cases. The knee joints are affected in 70-80% of patients with osteoarthritis.

Gonarthrosis is characterized by degenerative-dystrophic changes in almost all structures of the knee joint. The menisci are damaged due to poor blood supply, lack of nutrients in the synovial fluid, and constant trauma from dilapidated cartilage.

Factors contributing to the development of gonarthrosis:

excess body weight;
heavy physical work;
hormonal and metabolic disorders;
postmenopausal period;
previous knee surgery;
inflammatory diseases of the joints;
osteoporosis.

Deforming gonarthrosis can lead to permanent disability and disability in just a few years. According to statistics, this happens in 25% of patients within 5 years from the moment the first symptoms of the pathology appear. Early diagnosis and timely treatment help to avoid undesirable consequences.

Meniscus degeneration is detected in 27% of patients with deforming gonarthrosis of the 1st degree. At later stages - 2, 3 stages - pathology develops in almost all patients.

Frequent trauma or any damage to the meniscus can lead to the development of degenerative processes in it. A provoking factor can be a sharp movement or an unsuccessful turn of the lower leg. In trauma, the medial meniscus, located on the inside of the joint, is most often affected. This is due to the peculiarities of its structure and localization, which do not allow it to avoid pinching by the condyles of the femur.

Post-traumatic meniscus degeneration is more common in athletes, hard workers, and people who lead an overly active lifestyle. Pathology can be detected at any age.

Do not confuse degeneration with traumatic ruptures, tears, tears, etc. The former are characterized by a long, slowly progressive course with further development of complications. The second arise acutely due to trauma.

Degeneratively altered menisci are torn with particular ease. But traumatic injuries themselves often cause degenerative changes. These two pathologies are interrelated and often develop in parallel.

The cause of meniscus dystrophy can be rheumatoid or gouty arthritis, brucellosis, tuberculosis, yersiniosis. The development of pathology can also provoke hypothyroidism, systemic vasculitis and some connective tissue diseases (scleroderma, systemic lupus erythematosus, etc.).

Degenerative-dystrophic changes in the menisci that occur against the background of other diseases are commonly called meniscopathies.

Pathology is differentiated according to the localization of foci of degeneration. They can be found both in the body and in the anterior or posterior horns. Most often, degenerative changes are detected in the posterior horn of the medial meniscus. This is due to the peculiarities of its structure and location.

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Depending on the severity of pathological changes, 4 stages of degeneration are distinguished. They can only be detected and identified using magnetic resonance imaging (MRI).

Stoller classification:

0 degree - characterized by the absence of pathological changes;
I degree - in the thickness of the meniscus, focal changes are noticeable that do not reach its edges;
II degree - the presence of a linear focus of destruction, not reaching the edges of the meniscus;
III degree - the pathology reaches one of the edges, which leads to a tear.

We can talk about a true meniscus rupture if the III degree of degeneration according to Stoller is revealed.

Table 1. The most common consequences of degenerative changes

Pathology	Description	Symptoms
Gap	It is characterized by a violation of the integrity of the meniscus in the region of the body, anterior or posterior horn	Severe pain in the knee, preventing the patient from walking normally. If the posterior horn is damaged, it becomes difficult for a person to bend the leg, the anterior one - to unbend
Separation	A pathologically altered meniscus or its fragment is completely detached from its attachment site	The articular mouse formed as a result of detachment migrates through the synovial cavity, often causing blockade of the knee joint. A person has severe pain and limited mobility of the knee
hypermobility	Manifested by abnormal mobility of both menisci due to rupture of the transverse ligament of the knee that connects them	Aching pain in the knee, aggravated by walking, running, squatting, going down stairs and other physical activity
Cyst	The pathology is characterized by the formation of a meniscus in the cartilage filled with a liquid cavity	May be asymptomatic for a long time. When a cyst ruptures in the knee, there is usually a sharp pain

Meniscus tears can be traumatic or degenerative. The appearance of the latter is usually preceded by aching pain, stiffness and discomfort in the knee for several months or even years.

Menisci are important structures of the knee joint. They play a huge role in distributing the load and providing the desired stability of the knee. It is thanks to them that the knee joint can work and function normally. Their degeneration leads to pain, instability and impaired mobility of the lower limb. The knee joint becomes loose, and its functioning is gradually impaired.

With the appearance of complications (ruptures, separations, etc.), a person experiences pain, discomfort and a feeling of instability in the joint. Unpleasant sensations are aggravated when descending stairs and squatting. Some patients complain of the appearance of characteristic clicks, a crunch and a feeling of movement of a foreign body in the knee during movements.

Damage and deformation of the menisci contribute to the appearance of degenerative-dystrophic processes in other structures of the joint. As a result, a person develops deforming osteoarthritis.

The simplest method for diagnosing pathology is radiography of the knee joints in 2 projections. But it is informative only in the last stages of deforming osteoarthritis. The degeneration itself cannot be seen on radiographs, but one can only suspect it by the presence of indirect signs.

Modern methods for diagnosing degenerative changes in the menisci of the knee joint:

ultrasound. It is a non-invasive and highly informative research method that allows you to see almost all structures of the knee joint (ligaments, tendons, meniscus cartilage, hyaline cartilage). The advantage of ultrasound diagnostics is the absence of radiation exposure to the body;
MRI. A modern method that allows to detect meniscus degeneration and other pathological changes in the knee joint at the earliest stages. Magnetic resonance imaging is widely used to diagnose deforming arthrosis;
arthroscopy. An invasive research method that allows you to examine the cavity of the knee joint from the inside. It is mainly used for severe knee injuries. In 70% of cases, diagnostic arthroscopy turns into a therapeutic one. During such an operation, doctors, under visual control, eliminate tears and other dangerous consequences of an injury.

To slow down the development of degenerative processes, patients are prescribed corticosteroids, chondroprotectors, hyaluronic acid preparations, and agents that restore the normal composition of the synovial fluid. The most effective is their intra-articular administration. For local injection therapy (LIT), Diprospan, Kenalog, Alflutop, Noltrex, Cel-T and some other agents are most often used.

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With degenerative changes in the medial or lateral meniscus, accompanied by a rupture, the patient requires surgical intervention. The operation is performed by arthroscopy.

In childhood, pathology is most often the result of dysplasia - improper formation of the knee joint during fetal development. The baby is born with defects in the structure of bones, cartilage, muscles and ligaments. All this subsequently causes the development of degenerative changes in the menisci.

In contrast to adults, in children with injuries, the lateral meniscus is more often damaged. Blockades of the knee joint in childhood and adolescence are rare.

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Menisci are layers inside the knee joint between the surfaces of the bones of the thigh and lower leg in the form of a crescent, consisting of cartilage tissue.
There are medial (inner) and lateral (outer) menisci. Conventionally, in the meniscus of the knee joint (ISS), the posterior horn, anterior horn and body are isolated.
Cartilage discs evenly distribute the load on the knee joint, reduce surface friction and act as a shock absorber when moving.
Degenerative changes are the loss of function and the process of reverse development of cartilage resulting from trauma, developmental anomalies, or after a disease. The outer meniscus is less prone to injury than the inner meniscus due to better mobility.

separation of cartilage at the attachment site;
rupture of the body, anterior or posterior horn;
excessive mobility in case of damage to the intermeniscal ligaments;
cyst formation;
meniscopathy - degenerative-dystrophic changes that develop after injuries.

Types of dystrophic lesions

Degenerative changes in the ISS occur in people of all ages. The risk group includes patients whose activities are associated with active movements: ballerinas, athletes, dancers.

changes in the development and formation of tissues (dysplasia);
gout, rheumatism, osteoarthritis, bone tuberculosis and other diseases affecting the knee joint;
sprain;
flat feet (change in the shape of the foot);
excessive physical activity;
obesity.

Symptoms of lesions of the meniscus of the knee joint depend on the causes of the disease.
Distinguish between acute and chronic knee injury.
The main symptoms include swelling of the joint, redness, limited mobility, pain. In severe injuries, blood can enter the joint cavity.

The duration of the acute stage depends on the causes of the disease.
After ten to fourteen days, the acute stage becomes chronic. At this stage, the patient complains of pain, aggravated by movement. A characteristic feature is the appearance of a crunch and clicks when walking, when feeling, the articular roller is determined. Cartilage tissues become thinner, joint instability develops, thigh and lower leg muscles atrophy. The patient is advised to lie more so as not to load the injured leg.
If left untreated, meniscopathy may develop contractures (restriction of joint mobility).

pain syndrome;
puffiness;
restriction and stiffness of movements;
clicks and crunch when bending and unbending the knee;
blockade of the articulation in a bent position.

In the first degree of dystrophic changes in the cartilaginous tissue, minor damage to the horn, swelling and soreness of the knee occur. After three weeks, the symptoms described above disappear. The development of the first degree of dystrophic changes in the medial meniscus is possible with injuries resulting from jumping, squatting with a heavy load, moving along an inclined plane.
In the second (severe) degree, the intensity of pain increases, swelling of the tissues increases. Blood accumulates in the joint bag, the meniscus horn breaks off and its parts enter the joint cavity, causing blockade of movements. At this stage, a surgical operation is indicated.

Damage to the lateral ISS is more common in childhood and adolescence.
Main symptoms:
pain in the tissue area of the collateral ligament;
a pronounced inflammatory process in the synovial membrane (synovitis);
discomfort and pain in the area of the peroneal fold;
decreased muscle tone of the anterior femoral part.

If the external cartilage is torn, then the knee is at a 90° angle and the patient can unlock it himself. The symptoms of this pathology are mild and difficult to diagnose due to the inconsistency of pain. There is a congenital anatomical anomaly, which is sometimes confused with a rupture of cartilage tissue - a disk-shaped (solid) lateral meniscus. When torn, the cartilage is in the shape of a disk. A continuous external meniscus is determined mainly in adolescents, but also occurs in older people.
The most common damage to the internal ISS is the rupture of its middle part with the integrity of the ends.

Types of damage:
rupture of the ligament that fixes the organ;
rupture of the cartilage itself;
cartilage rupture.
Blocking the knee with limiting its flexion temporarily provokes the separation of the anterior horn of the ISS with pinching. After unlocking, movement in the joint is restored. A more serious injury, in which blocking, bending and popping out of the knee joint occurs, includes injury to the posterior horn of the internal meniscus.

Acute injuries of the ISS in 85–90% of cases are diagnosed by characteristic signs:
blockade of the knee joint in a certain position of the leg;
the appearance of pain and clicks when trying to straighten the lower limb.

To clarify the diagnosis, resort to instrumental research:
With the help of x-rays, the stage of degenerative damage is determined. At the first degree, the image shows an uneven narrowing of the joint gap, at the second - bone growths appear on the articular surfaces.
Having made an MRI and CT scan, the degree of damage and tissues of the knee joint are determined in a three-dimensional image: articular surfaces, ligamentous apparatus, articular cavity and bones. In the sagittal (imaginary vertical) plane, the cartilage lining is butterfly-shaped. When ruptured, the meniscus adjoins the posterior cruciate ligament, enters the intercondylar fossa of the femoral bone, and the symptom of "double posterior cruciate ligament" is determined.
Arthroscopy allows you to determine the condition of tissues and joint (synovial) fluid using an endoscope inserted into the joint cavity through minimal incisions.

Methods of therapy for changes in the ISS depend on the causes, stage and form of disorders. Acute injuries are treated conservatively.
The patient immediately after the injury must be provided with complete rest.
Apply a cold compress or ice pack to the inner thigh.
To stop a strong pain syndrome, narcotic analgesics are used, since other painkillers do not bring relief to the patient.
The injured limb is immobilized (immobilized) by applying a plaster cast for two weeks.
In order to eliminate edema and restore movement in the knee joint, it is punctured. In the first three to four days of active release of fluid (exudate) into the joint capsule, the cavity is punctured several times.

The duration of treatment for degenerative-dystrophic changes in the menisci is from six to twelve months.
With the blockade, the knee joint is repositioned (reduced) using manual methods.
To restore the damaged cartilage tissue of the ISS, hyaluronic acid and chondroprotectors are prescribed.
Non-steroidal anti-inflammatory drugs are used to relieve pain and signs of inflammation (keyver, dona, sinarta, ibuprofen, indomethacin).
To reduce edema and speedy recovery of the damaged ISS of the first-second degree, ointments are used externally on the skin (dolgit, diclofenac, voltaren).
Physiotherapeutic procedures (UHF, shock wave therapy, ozocerite, iontophoresis) and exercise therapy are prescribed.
Massage of the affected area of the knee has a good restorative effect.

With the second degree of severity of degenerative changes in the internal meniscus (ruptures, displacement, separation of the anterior and posterior horns of the ISS, cartilage crushing), surgical intervention is indicated.
It includes: removal of cartilage of a completely or damaged horn, suturing of the gap, fixation of detached horns, transplantation (transplantation).
A minimally invasive surgical procedure includes arthroscopy, in which an arthroscope is inserted through two incisions up to one centimeter, the torn part of the meniscus is removed and its inner edge is aligned.

In transplantation, the following prostheses are most often used:
A sliding prosthesis is used to replace worn-out internal or external ISS.
Surface substitutes are used for more pronounced destruction (abrasion) of cartilage tissue.
With the help of a rotational prosthesis, fixed with pins in the femur and tibia, the knee joint is replaced.
A hinged prosthesis allows replacing the entire joint and guaranteeing its stabilization.
All operations are carried out only after reducing the signs of acute inflammation.
After the surgical operation, rehabilitation measures are carried out to restore the functions of the knee joint, namely: therapeutic exercises, massage and physiotherapy.
Physical activity for the operated patient is categorically contraindicated.

In the treatment of degenerative injuries of the ISS, a significant role is given to therapeutic exercises and massage, due to the fact that the restoration of damaged tissues occurs faster with adequate physical activity, prevents the development of contractures and allows you to return the lost range of motion in the joint.
Exercise therapy during immobilization is carried out for intact sections of the lower limb, and when removing a plaster cast or splint, gymnastics is aimed at restoring the joint. The load is gradually increased by adding exercises with weights and on simulators.

Goals of rehabilitation:
pain reduction;
improvement of blood circulation;
return of muscle tone of the injured limb;
restoration of the full range of motion of the knee joint.
A set of exercises, their intensity, is developed by the doctor individually for each patient, based on the complexity of the disease and the injury.
With conservative treatment of meniscal injuries, exercise therapy begins two to three weeks after the injury, and after surgery - two months later.

If a person takes care of his health and adheres to basic preventive measures, then the risk of ISS injuries is reduced by 90–95% of cases.
It is necessary to go in for sports in stable, well-fixed and comfortable sports shoes that can minimize the risk of falling.
For even and safe distribution of the load, fix the knee with special pads (knee pads, orthoses, bandages) or an elastic bandage.
Before physical work or sports, it is necessary, gradually increasing the range of movements, to warm up, warming up the muscles and joints.
Control body weight, do exercises and eat rationally, but do not overeat, as excess weight increases the load on the joints.

Degenerative changes in the ISS are very common and are manifested by various types of pathologies, some of which require immediate medical attention to clarify the diagnosis and prescribe adequate treatment. A timely visit to a specialist will help preserve the functionality of the knee and prevent the involvement of other joint tissues in the pathological process.

Degenerative changes in the menisci of the knee joint occur for various reasons, the most common of them: excessive loads and dystrophic processes that develop in elderly patients. These cartilage pads perform an important function - they protect the hard tissues of the joint. In addition, the menisci act as shock absorbers. They take on a significant part of the load, due to which the structure of articular cartilage and bone heads is preserved longer.

There are lateral (outer) and medial (inner) meniscus. Both cartilages may undergo changes. Degenerative processes usually develop under the influence of a number of factors:

congenital pathologies;
joint diseases;
injury.

Most often, the pathology of the meniscus develops in old age, when the structure of cartilage tissues changes.

The risk group also includes people who regularly experience significant physical exertion: professional athletes, loaders, etc. Any careless movement can lead to degenerative changes in the lateral meniscus or medial cartilage. In case of injury, the integrity of the ligaments is violated, and the cartilaginous and bone tissues are affected. The changed position of the bones or torn ligaments cause redistribution of the load on the joint. As a result, mucinous degeneration of the meniscus develops.

The nature of pathological processes can be different. Sometimes a cyst develops in the meniscus - this is a neoplasm in the cartilaginous tissues, inside of which fluid is contained. This condition is defined as mucoid degeneration.

There is another type of pathology - meniscopathy. In this case, there are dystrophic changes in the structure of cartilaginous tissues caused by a chronic disease of the musculoskeletal system (osteoarthritis, rheumatism) or trauma.

In addition, degenerative damage to the inner meniscus or outer cartilage can occur. Effects:

detachment from the attachment point;
excessive mobility;
violation of the integrity of the meniscus.

Signs in any of the cases will be different. The more severe the damage, the more pronounced the pain.

Most types of joint pathologies affect the menisci. With injuries, symptoms appear immediately. If degenerative processes are the result of a disease of the musculoskeletal system, discomfort increases gradually. Damage to the medial meniscus may be accompanied by hemorrhage into the joint cavity. This condition is called hemarthrosis. Symptoms common to all pathologies:

pain of varying intensity;
puffiness;
skin redness;
extraneous sounds (clicks) that appear in the knee area when moving;
change in the shape of the joint;
difficulty in movement, there is a feeling of interference in the knee;
blockade of the leg, which manifests itself in a bent position.

If mucoid degeneration occurs, edema occurs. This condition is accompanied by intense pain. The most common sign of degenerative-dystrophic processes is an extraneous sound (click) emitted by the joint during movement.

With injuries, rentals usually occur - conditions in which excessive mobility in the knee is felt. This may be due to displacement, separation from the place of attachment of the meniscus.

With injuries, pathology is much easier to identify, since in this case the symptoms appear acutely. Damage to the outer meniscus happens more often because this cartilage is more mobile.

If there is a blockade of the joint at a certain position, a crunch occurs, in most cases this means that a pathology develops in the meniscus. But moderate degenerative and dystrophic processes are not so obvious, which complicates the diagnosis. Signs may not appear soon, but only if the disease of the musculoskeletal system develops strongly enough.

To confirm the diagnosis in case of damage to the external or internal meniscus, an additional examination is prescribed:

Radiography. In this case, the pathological process can be determined using a contrast agent.
MRI. More accurate method. With its help, the degree of wear of cartilaginous tissues, as well as their damage, is detected in a timely manner.
CT scan.
Endoscopy. With the help of an arthroscope, an internal examination of the knee joint is performed. This method allows you to identify pathology when examining tissues using a small video camera, which is inserted into the articular cavity and transmits the image to the monitor.

For most types of pathologies in the menisci of the knee joint, conservative treatment is ineffective. This method can improve the condition with deformations of the medial cartilage. Medications help prevent the development of pathology: stop the inflammatory process, eliminate pain and swelling. However, if the question is how to treat the joint with degenerative changes in the meniscus, you should know that conservative therapy does not completely cure the knee.

When the first symptoms appear, it is necessary to reduce the load on the affected joint. First you need to eliminate the signs of the acute form of the disease, since in this state it is forbidden to carry out any manipulations. To exclude displacement, a fixing bandage or splint is applied for 2 weeks.

With hemarthrosis, a puncture is indicated. This procedure removes the accumulated blood. Due to this, swelling, pain intensity decreases, mobility partially returns.

Prescribe analgesics. These drugs relieve pain. This is not always possible to do using non-steroidal drugs (Ibuprofen, Diclofenac), therefore, with pronounced degenerative processes in the meniscus, narcotic drugs are prescribed - Promedol and the like. In some cases, it is recommended to use anti-inflammatory drugs. Glucocorticosteroids are injected into the joint.

After removing the tire, when the manifestations of an acute condition have been eliminated, they proceed to the next stage - physiotherapeutic procedures (phonophoresis, UHF, ozocerite, iontophoresis), as well as exercise therapy.

Physical exercise strengthens the muscles, which helps to reduce the load on the joint and menisci in particular. At the initial stage, static exercises are performed. In this case, there is no load on other parts of the body, only the muscles of the affected limb are involved.

These are drugs of a special group. They are offered in different forms: injections, tablets. The main purpose of such drugs is the restoration of cartilage tissue, the cessation of degenerative processes. In addition, chondroprotectors significantly reduce the likelihood of developing pathology in the future. They deliver nutrients to the joint.

With degenerative changes in the meniscus, the following is prescribed:

Protecon. This combination drug relieves pain, prevents the development of inflammation, restores cartilage tissue.
Don. A drug that affects the metabolic processes in cartilage.
Teraflex. The composition includes substances that are related to the compounds contained in cartilage tissue. Indications for use: any degenerative-dystrophic processes in the joints, which are the result of chronic diseases, such as osteoarthritis.
Artron. The drug helps to restore cartilage exposed to intense physical exertion, as well as injuries and diseases of a different nature.

Serious pathologies (highly developed degenerative processes, deformation, detachment from the place of attachment) cannot be treated with a conservative method. In such cases, the joint is restored by surgery. The entire knee may need to be replaced with a prosthesis. Use a sliding, rotational, hinged or superficial prosthesis.

Article publication date: 03/24/2014

Article last updated: 03/29/2019

What are degenerative meniscus changes?

Degenerative changes can be different:

detachment from the place of attachment;
rupture of the horns and body of the meniscus;
excessive mobility as a result of rupture of intermeniscal ligaments;
cyst - the formation of cavities filled with fluid inside the cartilage;
meniscopathy - dystrophic changes that develop under the influence of minor injuries, as well as a complication of gout, osteoarthritis, rheumatism, tuberculosis and a number of other diseases.

Characteristic symptoms

If you are pursued by aching, which then disappears, then appears with renewed vigor - it can already be assumed that there are changes in the meniscus. About 90% of pathologies of the knee joint are due to damage to the "shock absorber".

Symptoms largely depend on the nature of the pathology. Tears are accompanied by severe pain, blockade of the leg in a bent state and swelling. With a serious one, hemorrhage often occurs in the articular cavity -. Significant swelling and severe pain are also characterized by meniscal cysts.

Tears, detachments from the place of attachment are often chronic and are manifested by the periodic appearance of pain and a feeling of interference in movement.

There is such a diagnostic test: go up and down a ladder or slope. With pathology of the meniscus, when moving down, the pain in the knee increases.

The chronic course is also characterized by secondary degenerative-dystrophic transformations in the medial meniscus, that is, those that have arisen due to other pathologies of the body or diseases. Often in such cases there are clicks and rolls * of the joint in motion after a long rest, sometimes there is pain in the knees. The increase in symptoms occurs gradually as the cartilage layer thins and salts or uric acid crystals accumulate in it (the latter - with gout). In the absence of adequate treatment, the final stage of meniscopathy becomes - a stable violation (limitation) of joint mobility.

* Rentals - sensations of pathological mobility, instability and displacement of the articular surfaces of the bones.

Common to all types of meniscus degeneration are the following symptoms:

pain,
swelling,
blockage of the joint in a bent position or sensation of a foreign body in the knee,
clicks and crunches,
swelling of the knees with a long absence of movement.

Causes of degeneration

More possible reasons:

dysplasia - abnormal formation of the knee joint;
gout, syphilis, tuberculosis, rheumatism and other diseases that can affect the joints;
sprains, as well as their incorrect formation;
flat feet (low depreciation of the foot is compensated by an increased load on the knee);
high physical activity;
excess weight.

Diagnostics

MRI allows you to get a three-dimensional image of all tissues of the knee: the articular surfaces of the bones, the ligamentous apparatus and the joint itself.
During arthroscopy, an endoscope is inserted into the joint cavity through a miniature incision, with the help of which the state of tissues and synovial fluid is monitored (on the monitor).

Treatment Methods

Therapy for degenerative changes in the menisci depends entirely on the nature of the damage. Acute injuries serve as a direct indication for the use of conservative methods of treatment:

First of all, the joint is punctured, eliminating its swelling and restoring mobility. Sometimes several procedures are required, since active exudation (release of inflammatory fluid) in the joint lasts up to three to four days.
Analgesics are prescribed, preference is given to narcotic drugs (Promedol and its derivatives), because other drugs in this case, as a rule, are not able to relieve the patient of pain.
Chondroprotectors provide the body with the necessary substances to restore the damaged area of the meniscus.
Anti-inflammatory drugs.
At the stage of rehabilitation, physiotherapeutic methods serve as an auxiliary means - ozocerite, UHF, iontophoresis, shock wave therapy.
For 14 days, a splint is applied to the straightened leg, which ensures fixation of the joint in the required position.

Chronic dystrophies, joint dysplasia and abnormal development of the ligamentous apparatus require exclusively surgical treatment.

If the cause of degeneration is chronic diseases such as rheumatism and gout, along with surgical methods, the underlying disease is also treated (diets, immunocorrectors and other methods).

Owner and responsible for the site and content: Afinogenov Alexey.

Your comments and questions to the doctor:

Julia | 03.10.2019 at 08:19

Good afternoon. I really want to know your opinion. My daughter, 13 years old, had an injury 2 years ago, on alpine skiing, an unsuccessful knee rotation led to Chondromalacia of the patella of the 2nd stage, a degenerative change in the posterior horn of the medial meniscus of the knee joint, synovitis. We have been given this diagnosis. The doctor prescribed a course of treatment with chondroprotectors (dona, structum500, piaskledin300). Tell me, please, these drugs will not harm a child of 13 years old (in the instructions, the restrictions are up to 18 years). And what treatment would you recommend. Thank you very much in advance.

Olga | 09/14/2019 at 16:13

Good evening. What is the relationship between gout and menisci? Or rather, why menisci can hurt because of gout, as written in your article. And what to do to stop meniscus degeneration. I was diagnosed with this 2 years ago.

Sergei Lopukhov | 08/27/2019 at 07:34

I play football. The result of an MRI of the knee joint: MRI signs of degenerative changes in the anterior cruciate
ligaments.
MRI signs of injury to the posterior horn of the medial meniscus, grade II according to Stoller. MR-
signs of degenerative changes in the lateral meniscus.

Svetlana | 07/21/2019 at 10:50

Hello.
MRI of the right knee joint in standard projections received T2 WI and RDFSaT.
Joint congruence is preserved. The joint space is moderately narrowed. The contours of the bones are even. The structure of the bones is homogeneous. Articular cartilage without visible defects. In the joint cavity, suprapatellar and deep ifrapatellar bags, a large effusion is determined. The patellar ligaments are preserved, the displacement of the patella is not determined. The tendon of the four head muscles of the thigh and the own ligament of the patella is not interrupted, their structure is homogeneous.
The height of the medial meniscus is reduced, a slightly hyperintense signal is detected in the structure of the posterior horn, which does not pass to the articular surfaces. The height of the lateral meniscus is somewhat reduced, the structure is homogeneous. The anterior cruciate ligament is preserved. The posterior cruciate ligament showed no signs of injury. The course of the medial collateral ligament is preserved, the structure is homogeneous. The course of the lateral collateral ligament is not interrupted, the structure is not changed. The hamstring tendon is not interrupted.
Conclusion: MRI picture of medial meniscus degeneration. Synovitis
Do I need an operation?
Sincerely, S.

Svetlana | 07/01/2019 at 12:10

good afternoon, doctor. Girl, 12 years old, has been doing judo for 2 years.
X-shaped. Apparently there was an injury, but she didn’t feel it. And then she began to notice that her knee hurts when she sits for a long time. MRI: tendonitis of the patellar tendon. Variant of the patella structure (significant in the development of patellar insufficiency). degenerative and post-traumatic changes, meniscite) Initial manifestations of degenerative changes in the joint. I would like to know how to treat it, what are the consequences, whether it is possible to continue playing sports (after all, when she moves, nothing hurts).

Alla | 03/29/2019 at 16:41

Hello. On a series of MR-tomograms weighted by T1 and T2 in three projections, T2-tirm and PD-FS (fat suppression), bone-traumatic changes are not determined.
The structure of the bone tissue is not changed, uniform. The cortical layer of bones at the level of the study is even and clear.
In the cavity of the joint, its bags of inversions, a slightly increased amount of fluid is determined, somewhat more pronounced in the patella inversion and in the posterior parts of the joint.
The joint space is not narrowed, the congruence of the articular surfaces of the bones that make up the joint is preserved.
There is some unevenness of the articular cartilage of the patella in the central sections, without signs of a decrease in its height. Articular cartilage in other departments is not reduced in height, uniform.
The lateral meniscus is of regular shape, not reduced in height, its boundaries are clear, even, the MR signal is homogeneous.
The medial meniscus is regular in shape, not reduced in height, its boundaries are even, clear, the MR signal is heterogeneous, mainly in the region of the posterior horn, due to the presence of an area of increased MR signal that does not interrupt the boundaries of the meniscus.
The anterior cruciate ligament can be traced throughout, without features.
The posterior cruciate ligament can be traced throughout, without features.
The integrity of the collateral ligaments is preserved, their contours are even, clear, the signal is not changed.
Own ligament of the patella without features.
Goff intensity without singularities.
Visible soft tissues without pronounced changes.

CONCLUSION: MR-signs of degenerative changes in the medial meniscus (grade 2), mild synovitis. Indirect MRI - signs of initial manifestations of chondromalacia of the patella (grade 1).
Thanks in advance.

Zinaida | 03/17/2019 at 08:15

Good day! I am 51 years old. In 2015, the uterus and ovaries were removed. And after the operation, my weight reached 93 kg, before the operation it was 80. My height is 162. I drink femoston 1/5. I am struggling with weight, but so far there are no special results .. until I let it increase any more. But this is a small digression from my problem.
A year ago, my knees started hurting. Previously, they didn’t bother me much, they crunched a little, but I didn’t feel much pain. Did an MRI. And this is the result I got. I would very much like to know your opinion. Please tell me if you need surgery (knee arthroscopy) or you can get by with a conservative method. Thanks in advance for your reply!
MRI EXAMINATION OF THE KNEE JOINTS № 0191
(MagFinder 0.32Tl)

Left knee joint. On the obtained images in the joint cavity, the upper inversion is determined by an additional significant amount of effusion. Subchondral sclerosis of the articular surfaces that form the knee joint. The joint space is narrowed. The intercondylar eminences, the upper and lower poles of the patella are pointed. MRI signal from the bone marrow of the femur, tibia and patella is not changed. Hyaline cartilage is preserved.
In the posterior horn of the internal meniscus, with the transition to the body of the meniscus, an irregularly shaped hyperintense area is determined, which communicates with the tibial plateau.
In the posterior horn of the external meniscus, a linear, slightly hyperintense area is defined, which runs along the plateau of the tibia and does not come out on its surface.
The anterior cruciate ligament can be traced fragmentarily, at the site of its attachment to the tibia, a limited accumulation of fluid is visualized, at the site of its attachment to the femur, an area of inhomogeneous MR signal.
The external lateral ligament is deformed, heterogeneous, with hyperintense inclusions.
The posterior cruciate and internal lateral ligaments are intact.

Conclusion: Rupture of the anterior cruciate ligament. Chronic damage to the posterior horn and the body of the internal meniscus against the background of degenerative changes. Deforming osteoarthritis of the left knee joint 1 tbsp. Degenerative changes in the posterior horn of the outer meniscus. signs of synovitis. Tenosynovitis of the anterior cruciate ligament. Tendonitis of the external lateral ligament.

Right knee joint. An additional significant amount of effusion is determined on the obtained images in the joint cavity, upper inversion, crow's foot pouch. A limited accumulation of fluid is visualized in the popliteal region measuring 18.2x73.6 mm.
Subchondral sclerosis of the articular surfaces that form the knee joint, marginal bone growths. The joint space is narrowed. Intercondylar eminences are pointed. The MRI signal from the bone marrow of the femur is heterogeneous. Hyaline cartilage is preserved.
In the posterior horn of the internal meniscus, an irregularly shaped hyperintense area is determined, communicating with the tibial plateau.
In the posterior horn of the external meniscus, a linear, slightly hyperintense area is defined, which runs along the plateau of the tibia and does not come out on its surface.
In the projection of the anterior horn of the outer meniscus, a limited accumulation of fluid measuring 5.2x8.4 mm is determined. In the projection of the posterior horn of the outer meniscus, there is a similar accumulation of fluid measuring 5.1x8.1x12 mm.
The anterior cruciate ligament can be traced along its entire length, deformed, heterogeneous, torn, in the place of its attachment to the tibia, a limited accumulation of fluid is visualized, in the place of its attachment to the femur, a patch of inhomogeneous MR signal.
The external lateral ligament is deformed, heterogeneous, with hyperintense inclusions.
The posterior cruciate and internal lateral ligaments are intact.

Conclusion: Chronic damage to the posterior horn of the internal meniscus against the background of degenerative changes. PCC damage. Deforming osteoarthritis of the right knee joint 2 tbsp. Degenerative changes in the posterior horn of the outer meniscus. signs of synovitis. Parameniscal cysts of the external meniscus. Tenosynovitis of the anterior cruciate ligament. Tendonitis of the external lateral ligament. Baker's cyst.

Olga | 03/06/2019 at 07:01

Good afternoon. My daughter in 2012. I had an injury to my right knee joint and was in the hospital with a gibs. During these years, if he turns around uncomfortably or stumbles with his right foot, then his knee hurts. They made an MRI conclusion: at the time of the study, the MRI picture of the gap
anterior cruciate ligament of the right knee. Intra-articular vypod. Vypod in the suprapatellar suture. Degenerative changes in articular cartilage with areas of chondromalacia. Damage. posterior horn of the medial meniscus (Stoller class III). I would like to hear a professional opinion, do you need surgery? daughters 39 years old Inv. childhood 2 gr.

Natalia | 02/19/2019 at 09:35

Good afternoon.
Started to disturb the right knee 3 years ago. There were no injuries. Previously, once every 3-4 months, then more and more often, now maybe once or twice a week. When turning the right leg outward (while the body remains stationary), the knee is blocked and I cannot move my leg. There is no pain, only stiffness and fear. After about a minute, through force I move my leg and there is a click in the place of the knee and everything falls into place. There is no pain.
A month ago, I started running on a treadmill to maintain my figure.
I went to an orthopedist and ordered an MRI. The result of MRI is a picture of degenerative damage to the lateral and medial menisci of the II degree. Degenerative damage to the anterior cruciate and lateral collateral ligaments. Gonarthrosis I st.
The doctor forbade running more expensive, only light physical activity. He ordered Don to drink for 6 weeks, and if changes do not occur, he is offered to do the blockade.
I want to hear your opinion on my diagnosis and treatment options. And is it really impossible to use a treadmill, maybe you can leave walking on it?
I will be grateful for the answer

Faith | 04.02.2019 at 12:08

Good afternoon! I have gonarthrosis of the knee joint. Degenerative damage to the menisci. They suggested doing an operation. But they said it wouldn't help much. Tell me what to do?

Maria | 02/03/2019 at 10:27

Hello. My son is 13 years old, fell ill in May 2018. Pain and lameness of the left knee appeared, the knee swells when walking for a long time. Larsen-Johanson syndrome, arthritis of the left knee joint. Act.1.fn 1. Examination: MRI picture of osteochondropathy of the patella, dystrophic changes in the tendon of the patella (Larsen-Johanson syndrome,) moderate degenerative changes in the medial meniscus; effusion in the joint cavity. X-ray images are signs of bilateral Larsen-Johanson syndrome, bilateral insertional tendinopathy of the patellar ligament (changes are more pronounced on the left.) Treatment of rheumatologists and orthopedists contradict each other. Treated: nemisulide 50 mg 1 time per day for a month, physiotherapy, folk remedies horseradish leaf wrap. Wearing a corset. The child also has combined flat feet.

Enter your name | 01/30/2019 at 11:44

Hello, I have echo signs of degenerative-dystrophic changes in the right knee joint of the 2nd degree. chondromallations of the 2nd degree. degenerative changes in the menisci. I am a full 57 years old. I got up on a chair and got this injury. Please tell me how can I cure this without orerative intervention? Thanks in advance!))

Nina | 01/24/2019 at 20:52

Good afternoon! I am 31 years old. I have been doing it myself in the gym 3 times a week for 2 years with interruptions during pregnancy, before pregnancy I was engaged in dancing. For the first time in my life, I decided to start running and immediately ran 5 km at the end of October (it was already cool and it was pouring light rain). Not immediately, but after a couple of days, the right knee on the outer right side ached (when descending the stairs or when you sit for a long time or in the evening after activity). I have been on treatment for three months now, but the pain does not go away. Alflutop injections for 10 days, Mexidol injections for 10 days, chondroprotectors chondroguard for 10 days, ointment and vitamins, physiotherapy, massage, exercise therapy, aertal for 7 days. X-ray protocol: Rg- signs of osteoarthritis of the right knee joint of 1-2 degrees. OS. Fabella along the posterior-lateral surface of the lateral condyle of the femur. MRI protocol: visible pathological changes were not revealed. Moderately pronounced degenerative changes in the posterior horn of the medial meniscus. Which study to believe: X-ray or MRI? What exactly is knee pain? The orthopedist offers prp-therapy to the joint. But I did not find positive reviews about it. The rheumatologist says in no case any injections into the joint, I think this is not the case. Whom to listen to? What other treatment will help in my case?

Love | 01/22/2019 at 05:43

Hello. Three years ago I slipped, there was pain and swelling of the knee, and it hurt from time to time. I took diclofenac and the pain stopped. Didn't go to the hospital. But recently it started to hurt a lot, I did an MRI, Conclusion: partial damage to the anterior cruciate ligament. Partial rupture of the posterior horn of the medial meniscus of the 3rd degree. Dystrophic changes in the anterior horn of the lateral meniscus of the 2nd degree. Solitary parameniscal cysts of the medial meniscus. Minor synovitis. Gonarthrosis 1 degree. Baker's cyst. Please tell me what to do with this diagnosis. Thank you!

Tatyana | 12/19/2018 at 07:36

Question to Alex admin on 12/17/2018 at 11:51 am (previously posted by Tatyana on 12/15/2018 at 8:28 pm)
Thank you very much for your answer. Swimming is contraindicated for degenerative changes in the menisci?
Is it better to start swimming now or wait? A sudden aggravation occurred in mid-November of that year, on both knees. Now I walk normally, I am engaged in exercises. Are injections highly desirable? After all, concomitant diseases are unlikely to be allowed, for example: hypertension of the 1st degree, all sorts of other things, ... nodular goiter (postoperative hypothyroidism), mastopathy ...

Tatyana | 12/15/2018 at 20:28

Dear doctors!
I am 59 years old, now I walk, it hurts a little, as I slept, I forget about the illness. Stiffness in the morning.
Conclusion of the ultrasound of the knee joints.:
Anterior access
Suprapatellar bag of the right joint - 3.0x0.7cm, left joint 7.0x 1.5cm
Synovial membrane of the right joint -2mm, left joint -3-4mm
The effusion in the torsion of the right knee joint is visualized in a moderate amount,
left - largely, inhomogeneous
The articular surfaces of the femur and tibia are uneven: with sharpened edges of the condyles on the right and with osteophytes on the left
Hyaline cartilage of the articular surface of the medial and lateral condyles
of the femur of a heterogeneous structure, with an uneven clear contour, thickness:
on the right - 1.6 mm on the lateral condyle, 1.3 mm on the medial condyle; (N= 2.6mm and
more)
on the left - 1.4mm on the lateral condyle, 1.1mm on the medial condyle (N= 2.6mm and
more)
Own ligaments of the patella of a homogeneous structure, uniform thickness. Tendons of the quadriceps femoris with a fibrous component
Medial/lateral access
Lateral ligaments with fibrous component (more in left IJ)
Menisci with hypo- and hyperechoic component, the greatest changes (stratification) -
in the posterior horn of the medial meniscus of the left joint
The iliac-tibial tract at the site of attachment to the tibia and tendon of the popliteal muscle and biceps femoris without structural changes.
Posterior access
Popliteal cyst on the right: 1.7x0.3cm. left-3.0x0.7cm and 2.9x0.5cm
CONCLUSION: US signs of bilateral sipovit (more on the left), Baker's cysts (on the right, an unfilled cyst) and gonarthrosis. Degenerative changes in the medial meniscus on the left-2-3st, menisci on the right and lateral meniscus on the left-2st, as well as lateral ligaments. Tendinosis of the tendons of the quadriceps femoris.
There was an exacerbation due to the brush, now it has subsided. There is no way to bend your knees less than 90 degrees, a month has already passed. In conclusion, why not a word about the condition of the menisci...?? The recommendation is this: to undergo magnetotherapy (I go), NVSP ointment, I chose ibuprofen + Dimexide. If magnetic therapy does not help, I will be offered injections for three months with Hyaluronic Acid. I wanted Piascledin, I took a course a long time ago, and I liked that I forgot about the crunch. And now I almost do not feel the crunch. Or is it already like a placebo with such destruction? Only synovitis does not allow to bend completely. What should I do next? The left knee suffered more, the right one began to hurt a week later. Both are so sudden. Yes, I fell this year, the last time in September, but on one knee. And also arthrosis of the wrist joint on both sides, but tolerable.
Can you exercise on an exercise bike? Thanks in advance. I'm desperate.

Gulnara | 05.12.2018 at 18:40

Good afternoon doctor! I am 48 years old. I have never been involved in sports, 4 months ago I hit my knee on a stone. MRI results: - articular surfaces are congruent.
- In the posterior horn of the medial meniscus, the damage zone is of the type of delamination with its dislocation to the outside by 1/3; manifestations of degenerative changes in the lateral meniscus;
- cartilaginous surfaces of articular bones are minimally unevenly thinned;
- cruciate ligaments are not changed, the usual signal;
- the medial collateral ligament is edematous; another joint-forming ligamentous apparatus without visible changes;
- medial tibial epiphysis and medial femoral condyle with areas of bone marrow edema; epiphyses with minimal osteophytes, visible sections of the metaphyses of articular bones are not changed;
- the shape of Goff's fat body is not changed, signs of edema in the tibiofibular portion;
- moderate overproduction in torsion and joint cavity;
- there are no zones of potological intensity in the patella, its contours are clear, even, the cartilage is not changed;
- there are no zones of pathological signal intensity in the popliteal fossa;
-periarticular soft tissues are swollen from the anterior and lateral surfaces.
CONCLUSION: MR- signs of osteoarthritis of the left knee joint 1 tbsp according to Zecker; condition after puncture; damage to the posterior horn of the medial meniscus with its dislocation to the outside by 1/3 (Stollor III) degenerative changes in the lateral meniscus; contusion bone marrow edema in the medial femoral condyle and medial tibial epiphysis; signs of distortion of the medial collateral ligament; moderate suprapatellar bursitis, synovitis.
The doctor said that he needed to have an operation. But the surgeon with whom I wanted to do the operation will be able to perform it only in a month and a half. Is it worth it to rush and do it with another surgeon, just because of the urgency. I remind you that 4 months have already passed since the injury. I wore a tutor for almost a month. Now my knee continues to hurt and I can’t fully walk and bend my knee. And with such an MRI conclusion, is it possible to stitch the meniscus or will it be necessary to remove the damaged part of the meniscus? What would be better in my case - to sew or remove the damaged part of the meniscus? Can I take Glucosamines before surgery? Really looking forward to the answer! Thanks in advance!

Sergei | 29.11.2018 at 11:52

Hello! Sometimes when straightening the left knee, a sharp pain was felt, which immediately passed. After the MRI, they wrote in the conclusion: Dystrophic changes in the horn of the medial meniscus, arthrosis of the 0th degree. Periodically I drink a course of chondroprotectors and pierced the course of Alfuton. The pain went away for a while, but now it's back. Please tell me what to do in my case? Is it possible to cure a joint with conservative methods?

Elena | 11/20/2018 at 05:22

Good afternoon. I suffer from pain in my right knee after a fall (I went skiing).
MRI showed: degenerative changes in the meniscus I st according to Stoller. Infringement of the posterior sections of Goff's fat body. Mediopatellar fold syndrome. Minimal articular protrusion.
A consultation with an orthopedic traumatologist was scheduled.
The pain in the rut is aching, especially in the evening and at night, especially after exercise.

Valentine | 11/14/2018 at 10:27 am

Hello. I had an MRI of my left knee.
Conclusion: Osteoarthritis grade 2, Degenerative changes in the medial meniscus grade 3, lateral meniscus grade 2, Synovitis, Bone marrow edema of the medial condyle of the tibia.
Can you advise something?
Thank you!

Claudia | 29.10.2018 at 20:19

HELLO! My knee hurts a lot, I have been suffering for a whole month, painkillers do not help, Fermatron plus pumped, does not help. got an mri. Conclusion MR picture of degenerative changes in the internal meniscus of the 2nd degree according to stoller. degenerative changes in the lateral meniscus of the 1st degree. moderate degenerative changes in the anterior cruciate ligament. suggest surgery. Please tell me what to do?

Anna | 10/15/2018 at 08:57

Hello, if you answer I will be very grateful to you.
The right knee is very disturbing, as a result, two MRI scans were performed with a difference of a year:
1 MRI conclusion: MRI picture of partial traumatic damage to the ACL and internal lateral articular ligaments, damage / degeneration of the medial meniscus (Stoller .2 class), gonarthrosis (grade 1), causing contusion changes in adjacent bones, lateralization of the kneecap, edema of the paraarticular tissue.
2MRI was compared by a radiologist with 1: MO-picture of lateral subluxation of the patella against the background of moderate hyperplasia of the femoral condyles, moderate degenerative changes in the ACL at the site of rupture of the posterior cruciate ligament in the upper third of the initial degenerative changes in the menisci. When compared with the previous MRI - no significant changes.
The doctor in the city hospital in my city says that you just need to smear the knee. The doctor from MONIKI wrote in the conclusion that arthroscopic resection of the lateral meniscus and ACL plasty is needed. Tell me what to do? Is an operation required? Thanks!!

Geser | 10.10.2018 at 03:08

Hello! at the summer Olympics, he injured his knee joint, had an MRI. The results are - MRI signs of degeneration 2 tbsp. anterior horn of the lateral meniscus. synovitis. Mediopatellar synovial fold. Small focus of enostosis of the tibia. Please tell me what to do in my case

Fania | 09.10.2018 at 03:29

Conclusion mri. Degenerative changes in the posterior horn of the medial meniscus, cysts in the popliteal fossa. What treatment do I need. I don't remember any major injuries.

Alex admin | 08.10.2018 at 11:10

Hello Kundyz. Degenerative changes are not completely cured, they can and should be slowed down. Treatment must be comprehensive. Prescribes treatment orthopedist or traumatologist. What is needed for effective treatment is described in this article.

Alex admin | 08.10.2018 at 11:07

Hello Ruslan. You don't need an operation. Contact your local doctor (orthopedist or traumatologist) to prescribe treatment: anti-inflammatory pills and / or injections, physiotherapy (laser, magnet), applications, therapeutic massage, etc. Give the joints temporary rest and no stress or weight lifting.

What is a meniscus? This is a kind of shock absorber, which is a cartilaginous gasket. Each meniscus, shaped like a horseshoe, consists directly of the body and horns (posterior and anterior) that close the "crescent".

Where are these cartilage pads located? In those places that experience increased stress, namely in such joints as:

knee, that is, between the femur and tibia (small and large) bones;
sternoclavicular (meaning the articulation of the arm with the chest);
temporomandibular (connection of the base of the skull with the lower jaw);
acromioclavicular (that is, the articulation of the articular surface of the clavicle with the scapula).

There are two cartilage pads connected by a transverse ligament:

Medial (that is, internal cartilage). It is connected to the side located on the inside. The medial meniscus is slightly mobile.
Lateral (that is, the outer cartilage). It is wider and more mobile than the inner meniscus. As a result, his injury occurs much less frequently.

The menisci are extremely important elements of the knee. They perform the function of distributing the load and allow the body to be in a stable state. In the case of their degeneration, the patient experiences debilitating pain and instability when moving. Over time, a progressive disease can lead to the fact that the mobility of the lower limb will be completely lost.

What are degenerative changes in the medial meniscus? How to deal with them? Are there preventive measures for the disease? Let's figure it out.

What are the medial and lateral menisci

These are anatomical injuries that could occur due to:

atypical structure of the joint;
diseases;
injury.

Moreover, it is the medial meniscus that is most often injured due to its rigid fixation and the impossibility of displacement in one direction or another without serious consequences for the knee joint. The horns of the internal cartilage are located quite close to the condyles (that is, thickenings, of which there are two on the tibia: medial and lateral), which creates a difficult situation in case of any displacement of the bone process. And as a result - either a rupture of the meniscus, or its damage.

Aching pain syndrome in the knee, discomfort and stiffness in movement with a torn meniscus can be felt for many months or even years.

Degenerative changes in the medial meniscus are violations observed in the structure of the organ, which inevitably lead to the loss of its functionality (partial, and sometimes complete).

Types of meniscus lesions

There are several of them:

Rupture either of the body itself, or of the posterior or anterior horns. With degenerative changes in the posterior horn of the medial meniscus, it is quite difficult for the patient to bend the knee, and if the functioning of the anterior horn is impaired, it is difficult to extend the knee joint.
Tearing of the meniscus (or part of it) at the point of attachment. This damage can completely block the work of the knee joint.
Rupture of the cruciate or menisci, which is characterized by excessive mobility of the cartilage pads.
The formation of a pathological cavity (that is, a cyst) in the body of the meniscus. It can develop completely asymptomatically for a long time.
Changes of a degenerative-dystrophic nature that can develop after an injury (that is, meniscopathy).

Degenerative changes in the posterior horn of the medial meniscus, the anterior horn, or even the body itself can be diagnosed in people belonging to different age categories (even children). The risk group includes primarily those whose professional activities involve active movements. These are dancers, ballet dancers and athletes. But other people should take care of themselves too.

Stages of the disease

Degenerative changes in the medial meniscus of the knee joint undergo several stages of their development:

Sharp. Its duration depends on the causes that provoked the disease.
Chronic. It is in this stage that the acute form can smoothly flow in 1.5-2 weeks. At this stage, the patient complains of pain, clicking and crunching in the knee joint, which only get worse. In the knee area, the articular ridge can be palpated.

Classification of damage to cartilage pads

There are 4 degrees of meniscus degeneration according to the classification, which was introduced into medical practice by American orthopedist Stephen Stoller. Moreover, it is unlikely that it will be possible to accurately identify damage to the cartilage pads by eye: this can only be done with the help of MRI. So, the degrees of meniscus degeneration are as follows:

0 degree. No pathological changes are observed, that is, it is simply the norm.
1 degree. In this case, some focal pathologies are observed, but not reaching the edges of the cartilage lining. Degenerative changes in the medial meniscus of the 1st degree are characterized by minor damage to the cartilage tissue of the horn and can very often develop as a result of injuries sustained in the process of walking on an inclined plane, squatting with a load or jumping. The patient has swelling of the knee joint, and he feels pain in it.
2 degree. The presence of a linear focus of damage to the cartilage lining is observed. Degenerative changes in the medial meniscus of the 2nd degree are characterized by tissue swelling and pain, which only increase. In the bag of the knee, there is an accumulation of blood and a detachment of the horn of the meniscus, parts of which enter the joint cavity, thereby blocking the motor function of the organ. 2nd degree involves operational measures.
3 degree Damage reaches one of the edges of the meniscus, leading to its rupture.

Degenerative changes in the medial meniscus 2 tbsp. and 1 tbsp. - these are borderline lesions, but the 3rd degree is a real meniscus rupture. Do not bring the situation with your health to critical! Take care of yourself.

Possible causes of the development of the disease

The reasons for the development of degenerative changes in the medial meniscus can be:

Diseases such as bone tuberculosis, gout, osteoarthritis, syphilis, rheumatism and other pathologies in the presence of which joints are affected.
Sprain.
Physical activity in large volumes - whether it's work in the country for arranging beds or just playing sports.
Frequent knee injury.

The presence of excess weight.
Dysplasia (that is, abnormal development) of the knee joint.
Displacement of the cartilage lining.
Flat feet (drooping of the transverse or longitudinal arches of the foot). In this case, the load on the knee joint increases.
Circulatory disorders in the extremities.
The result of the natural aging of the body as a whole.

Symptoms of pathology

The main signs of degenerative changes in the medial meniscus:

A pronounced inflammatory process (that is, redness and swelling).
Pain is sharp and aching.
Some limitation in movement.
The presence of discomfort and a feeling of instability in the knee joint.
Sensation of a foreign body in the knee.
The appearance of a crunch and clicks with any attempt to straighten the leg, for example, when squatting or going down stairs.
Decreased muscle tone in the thigh area.
Blockade of the knee joint in a certain position of the leg, for example, when bending.

Important! At the first signs of degenerative changes in the posterior horn of the medial meniscus, its body, the anterior horn of the outer cartilage lining, or all at once, you should contact a medical institution for help.

What to do if you have a knee injury

First of all, you must immediately call "emergency help". Next, do the following:

We put the patient to bed, providing him with complete rest.

On the inner surface of the thigh, we apply either a cold compress, or something from the freezer wrapped in cotton.
We give the patient painkillers.

Diagnostics

If the patient has a knee joint injury, which manifests itself quite clearly, then it is not difficult for a specialist to determine the pathology. If the damage is moderate and does not occur in an obvious form, then the diagnosis becomes more complicated. In this case, the following types of instrumental research are prescribed (based on the signs of degenerative changes in the medial meniscus):

MR-tomography and CT, which can be used to assess the severity of pathological changes in the knee joint. A three-dimensional image allows you to do this with a high degree of accuracy.
Radiography. In the course of the study, a picture of the knee joint is obtained in two projections, which allows you to determine the stage of the pathology. The disadvantage of radiography is that degeneration can be determined solely by indirect signs, that is, the method does not give an accurate picture of the pathological process.
ultrasound. It is highly informative and non-invasive. With this method, almost all elements of the knee joint can be observed. With ultrasound, the radiation load on the body is completely absent.
arthroscopy. With the help of a special device (endoscope) inserted into the cavity of the knee joint through small incisions, the specialist determines the state of the synovial (articular) fluid and tissues of the knee. Through a video camera, a picture of what is happening, the specialist observes on the monitor.

On a note! The diagnostic procedure smoothly turns into a therapeutic one, since in the process it eliminates the dangerous consequences of an injury, including tears or avulsions.

Treatment of degenerative changes

Treatment of degenerative changes in the medial meniscus depends on the causes of joint damage and the existing disorders. It can be either conservative or surgical. But first of all, experts do the following:

In the case of blockade of the knee joint, manual therapy is used to reduce the joint.
In the first 3-4 days after the injury, exudate is actively released into the joint bag - liquid. Specialists take this fluid (do a puncture) several times in order to reduce swelling and restore motor function. After the procedure, the joint cavity is washed with antiseptic agents.
Often, at the beginning of treatment (in order to reduce the load on the damaged cartilage lining), the knee joint is fixed using either a special orthopedic apparatus or a plaster cast.

Medical treatment should be comprehensive:

Hormone therapy. The drugs of this group have an anti-inflammatory effect and are especially good for rheumatic pathologies (for example, Hydrocortisone or Diprospan). The best effect is achieved with the direct injection of the drug into the joint cavity.

Painkillers. For example, to relieve inflammation or pain, drugs such as Ibuprofen, Dona, Kaver or Sinarta give a good effect (all of them belong to the group of nonsteroidal drugs).
Muscle relaxants. They are prescribed to reduce the joint load and relieve muscle spasm (for example, Mydocalm).
Chondroprotectors. Preparations such as "Chondroitin", "Glucosamine" or hyaluronic acid contribute to the fastest restoration of the functioning of the meniscus.
Various ointments help fight edema (for example, Voltaren, Dolgit or Diclofenac).

Important! All drugs can only be prescribed by a doctor. Remember: self-medication is dangerous.

A good effect in the fight against the disease is given by physiotherapeutic methods:

Electrophoresis. Using this procedure, it is possible to cover the damaged surface with small particles of the drug, thereby ensuring their deep penetration into tissue cells.
Iontophoresis. This procedure, based on the process of ion migration under the influence of a small direct current, allows you to eliminate puffiness.
ultrasound therapy.
UHF.
Shock wave therapy.
Applications with mountain wax(ozocerite) or paraffin.
exercise therapy.

Do not forget about such a simple method as massage of the damaged area of the knee.

Operative measures are prescribed in case of formation of cysts, multiple ruptures of menisci and necrosis. The following operations can be performed:

Arthroscopy. In this case, through two small (up to 1 cm) incisions, a special device called an arthroscope is inserted and the damage is removed. This surgery is referred to as minimally invasive surgery.
Replacement of a damaged meniscus with a prosthesis.

Important! All operations are carried out only after acute inflammation of the knee joint has been removed. The operated person should avoid any physical activity.

In order for the results of treatment to be positive, it is necessary to contact a medical institution for help in a timely manner. Moreover, it is necessary to tune in to long-term therapy, since in order to cope with degenerative-dystrophic changes in the menisci, it will take about 0.5-1 year.

Do you need rehabilitation

Of course, it is needed, especially after operational measures. What is rehabilitation aimed at?

restoration of muscle tone of the injured limb;
normalization of blood circulation;
reduction of pain syndrome;
restoration of the functioning of the knee joint in full.

A set of exercises and the frequency of their implementation are developed for each patient individually, guided by the severity of the injury or the complexity of the pathology. Moreover, after surgical intervention, exercise therapy begins 2 months after the operation, and with conservative treatment - 15-20 days after the injury.

Prevention

To avoid degenerative changes in the medial meniscus, simple precautions should be taken:

Eat a balanced diet, exercise and constantly monitor body weight. Excess weight adversely affects the joints.
To avoid trouble with the knee, it is better to fix it with an elastic bandage or special pads.
You should not abruptly engage in physical work or sports: you must first warm up the muscles, kneading them and gradually increasing the load.
More often undergo a general examination in order to identify pathologies that contribute to the development of degenerative changes in the cartilage lining, and begin their timely treatment.
We recommend that you wear comfortable shoes to exercise in order to reduce the risk of falling to zero.

Degenerative changes in the menisci of the knee joint are changes that have occurred due to injury, past disease. Also, the cause of destruction can be congenital anomalies of the structure or a long-term lack of necessary substances.

The structure of the meniscus

The knee is the joint that experiences the most stress throughout life. It is the second most mobile joint after the vertebrates. It is his person who bends and unbends most of all in his life. The structure of the knee joint is quite complex. It consists of cartilaginous elements, muscles and bones:

2 menisci.
Patella (sesamoid bone or patella).
Ligaments.
Articular cartilage.
Parts of the tibia.
Parts of the femur.

Cartilage performs a shock-absorbing role, while bones and muscles perform a motor role.

Causes of degeneration

The most common cause of degenerative changes are still injuries, such as:

damage to one of the menisci;
fracture of the sesamoid bone;
dislocation of the joint;
sprain or even rupture of the knee ligaments;
fracture of the patella.

Knee injuries are one of the most painful and long-lasting injuries. And after them there are consequences in the form of degenerative changes. It is after knee injuries that athletes most often leave the sport forever.

Injury

As a rule, pain in the knee indicates a problem in the meniscus. The meniscus is a layer of cartilage between bones that acts as a shock absorber. It is not so easy to damage it in ordinary life, for this you need to make a rather strong jump or get a strong blow, for example, from a collision with a car. Often the meniscus is damaged by such people:

professional athletes;
dancers;
people with bone disease;
elderly people with fragile cartilage tissues.

There are only two menisci: lateral and medial, that is, external and internal. Types of meniscal injuries:

tearing off the meniscus;
meniscopathy;
rupture of the horn or body of the meniscus;
neoplasms of a cystic nature inside the meniscus or on it.

The medial meniscus is more often prone to degeneration, it is also internal, this is facilitated by its location. It is in such a position that it experiences a load more than the external one.

The external can be damaged as follows:

sharply unbending the bent knee;
with a strong blow to the knee;
from hitting a sharp edge.

And internal with strong jumps and improper exercise technique. Also, the following factors can provoke a gap:

excess weight;
bone tuberculosis;
wrong gait;
wearing heels;
flat feet.

Degenerative changes in the medial meniscus are often manifested by increasing aching pain in the knees. Now passing, then returning with renewed vigor.

Important! A sign of a degenerative meniscus tear is always a sharp, sharp pain that subsides over time, which can give a deceptive feeling that everything worked out.

Other symptoms of a torn meniscus in the knee include:

edema;
clicks in the knees;
limitation of joint mobility;
discomfort and pain during prolonged immobility of the knee.

The meniscus looks like the letter “C” will turn over, because of this structure, the main body and two horns are distinguished in it - the back and the front. It can rupture both in the main body and in the posterior or anterior horn.

Degenerative changes in the posterior horn of the medial meniscus are the most dangerous. The peculiarity of the posterior horn is that it is not subject to regeneration, since it feeds only on the joint fluid, and has no blood vessels. For the same reason, such an injury is more difficult to diagnose, since there may be practically no edema. And the longer you do not take action, the greater the likelihood that a torn meniscus cannot be restored. In this case, the torn edges will become uneven, and liquid will accumulate around them.

If you do not go to the doctor for more than 4 weeks, the pain will decrease. But this will happen not because the meniscus has completely healed, but because the gap has passed into a chronic stage. And it is not easy to determine whether there was a gap, even with a thorough examination. This injury is typical for running and walking on an uneven surface, so a person, having received it, may simply not notice this, and moving away from a sharp pain, continue running or walking, aggravating his situation.

Dystrophic changes in the knee joint

In addition to injuries, the knees can also suffer from cartilage degeneration. This is the depletion, flaking, or deformity of the hyaline cartilage or menisci.

Hyaline cartilage acts as a ligament for joint movement. Joints without lubrication during movement will rub against each other and be damaged, as a result of which they become inflamed. This process is called osteoarthritis. In its severe manifestation, bone fragments can even break off during friction.

Thinning is diagnosed by ultrasound if the thickness of this cartilage becomes less than 2 mm. It happens that the cartilage does not become thinner, but exfoliates, this will not be visible on ultrasound, then a puncture will be prescribed.

The menisci also consist of cartilage and can be prone to dystrophy. In this case, they change their structure and surface. Their surface may become uneven, fragments break off. This is well shown by ultrasound.

It happens that the injury occurred just on the basis of dystrophic changes, since the knee joint has become not as stable as before.

Diagnostics

It is dangerous to self-medicate and self-diagnose knee injuries, especially in the event of an injury. Methods of professional diagnostics are:

tomography;
magnetic resonance imaging;
x-ray;
taking a puncture.

According to the results of radiography, three degrees of damage are distinguished. They are based on determining the deviation of the angle at which the knee joint is located:

1 degree - a change in the angle of not more than a third of the original.
Grade 2 - a change is already more than a third or half, but the integrity of the menisci is 2 tbsp. saved.
Grade 3 - the angle is completely broken, fragments are observed.

According to the results of magnetic resonance imaging, 4 degrees are distinguished:

0 degree - no degenerative changes are observed.
1 degree - a point signal comes from the meniscus that does not reach the surface.
Grade 2 - the edge of the surface is still not achieved, but the formation is at 2st. no longer point, but linear.
Grade 3 - the signal passes to the very edge, a violation of the integrity of the meniscus is detected.

In case of knee injuries, the patient goes to a rheumatologist, who makes a diagnosis and prescribes treatment, most often conservative. If it does not help, then he will refer to a narrower specialist - an orthopedic surgeon.

Treatment

Treatment can be difficult, expensive and lengthy, but it is definitely worth it. If you do not start treating a person on time, then you can completely deprive yourself of the opportunity to fully walk. Usually prescribed complex therapy:

physiotherapy;
drug treatment;
tire fixation.

There are cases when an operation is indispensable, it is performed by an orthopedic surgeon. During the operation, either the damaged part is cut off, or one of the menisci is completely removed, or it is sewn up.

Fact! Removing the meniscus is an extreme measure, because without it, the knee in old age will collapse faster, and you can forget about serious sports.

The meniscus performs an important function in the body - it is a shock absorber for the legs. It, like the entire knee joint, you need to try to protect:

Strengthen the muscles of the knee joint.
Set the exercise technique with a professional trainer, and only with improvements can you use the knee exercises on the video.
Wear the right shoes.
Eat foods rich in collagen and elastin.

The necessary macronutrients are found in many foods, but most of them are in jelly and seafood.