Each of our knees has two menisci. One on the inside (meniscus medial) and another on the outside (lateral meniscus). Seen from above, the menisci have the “C” shape. They are made up of fibrocartilage similar to cartilage of our ears. The menisci are structures with little vascularization (they receive little blood), which means that many meniscal lesions are unable to heal. to heal.
Initially, it was thought that the menisci were of little use and when suffered injuries were routinely removed. Today we know that the menisci have a important contribution to a healthy knee, with an important role in joint joint stability, transmission of forces between the femur and tibia and lubrication of the joint.
There are basically two types of meniscus injuries, also known as meniscal tears. Acute ruptures are most common in young, active patients which are normally associated with the practice of sport and are the result of a movement torsion. On the other hand, we also have degenerative lesions, which are more frequent in a slightly older population (usually from the age of from the age of 40) and often appear after small movements (squatting, slight twisting or falling, prolonged kneeling, etc.). The complaints most frequently related to meniscus injuries are pain, joint swelling (swelling) and irregularities in the movement of the knee (such as feeling something inside the knee or feeling the joint locked).
An orthopaedic knee surgeon from our team will want to know the story of your injury and determine what signs and symptoms you have. He will then carry out a physical assessment of your knee, looking for the presence of pain on the side of inside or outside the knee and whether the knee has fluid inside it. There are specific tests to diagnose meniscal lesions, the most common being used the McMurray test. Finally, your orthopaedic knee surgeon will request complementary diagnostic tests, which consist of carrying out a Magnetic Resonance Imaging (MRI). MRI will allow you to assess the integrity of your menisci, ligaments and cartilage.
There are many factors that have to be taken into consideration before choosing the treatment for a meniscus injury. The orthopaedic knee surgeon will consider the their level of activity, age, location and type of meniscus injury, time elapsed since the injury, the symptoms it presents and other associated injuries. If the injury the meniscus is stable, there is no knee blockage or other associated injuries, the first approach is often conservative treatment (without surgery). You will be recommended to wear walking crutches for a few days, but as soon as possible start flexing and extending the knee. Many Sometimes it is necessary to carry out physiotherapy sessions with the aim of reducing inflammation, recover joint mobility and strengthen the muscles around the joint. knee. In cases where conservative treatment is not effective, when we are unstable meniscus lesions or when we have associated lesions, such as an anterior cruciate ligament anterior cruciate ligament injury, we have to consider surgery.
Meniscus surgeries are performed using a surgical technique called arthroscopy. This surgery involves making three small holes in the knee which will allow the introduction of a camera and working instruments within the knee. After visualizing and exploring your meniscus injury, the knee surgeon will decide to whether it is possible to repair the meniscus or whether it will be necessary to regularize the meniscus lesion. The meniscus injuries can only be repaired if the meniscus is in good condition and there is blood supply in the area of the tear (there is no blood in the entire meniscus and where there is no blood, there can be no healing). If the conditions, the option will usually be to repair the meniscus using various various systems that allow stitches to be made in the meniscus, closing the lesion and leading to healing. If repair is not possible, the only option to reduce pain is to removing the part of the meniscus that is torn and causing pain (regularizing the meniscus), trying to leave as much of the meniscus healthy as possible.
In the case of meniscus regularization, after surgery you can mobilize your knee immediately without limitations, do partial weight-bearing and walk with 2 crutches (between 5 and 15 days). You can start driving as soon as you have good mobility and no pain no fluid inside the knee. We recommend a short period of physiotherapy to recover muscle mass and joint mobility. It is expected that he will be able to start again impact sports activity around 4 to 6 weeks after surgery (in the case of of the lateral meniscus, this period may be slightly longer). In the case of meniscus repair, recovery is a little slower. As a rule, we recommend wearing crutches for 4 to 6 weeks, applying little force with the foot on the ground and must not bend the knee more than 90º during this period. It will be intensive physiotherapy is needed to regain mobility and strength muscle. Impact activities can only be started at 4 months after the birth. surgery. It should be noted that although meniscus repair is undoubtedly the best long-term solution for your long-term solution for your knee, there is a chance that your meniscus will not heal and of having to undergo surgery again. Studies show that around 1 in 5 repairs will fail.
Removing the meniscus will lead to increased pressure inside your knee. This increase can lead to wear and tear of the cartilage and the development of arthrosis of the knee. For this reason, in active patients, repair is preferred meniscus, but sometimes this is not possible. For people with pain in the side of the knee where the meniscus has been removed, there is a surgical solution that can improve complaints. This technique is called meniscal transplantation and consists of placement of a cadaver meniscus inside the knee, in the place where there was a lack of meniscus tissue. Meniscus transplantation can help reduce the symptoms of pain and improving knee function in people with a lack of meniscus tissue. By restoring absorption of impacts and the distribution of loads on the knee, can help to delay the progression of arthritis in certain cases.
We created this concept to give it our full attention. The complexity of the knee joint requires careful assessment and differentiated knowledge.
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