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Knee joint. Injury of a meniscus
The knee joint is formed of a patella and a femoral tibial bone. The joint surface of a bone is covered with cartilaginous tissue with a number of strong sheaves. Sliding at bending extension of a knee is provided with availability of joint liquid and a synovial membrane. At the movement stability of a joint depends on sheaves, muscles of a joint and intra joint hryashchik – meniscuses. Musculoskeletal system diseases often arise at injury of joints, and in a particular and meniscuses.
The meniscus is the cartilaginous laying between joints which is stabilizing a knee joint and carrying out a role of a peculiar shock-absorber. In the course of walking meniscuses clench and change a form. Meniscuses are divided into two look. Outside or lateral, reminding a letter Oh, more mobile, than internal and, therefore, more rare exposed to an injury. An internal meniscus or medial, more static and connected with a lateral internal linking of a knee joint, in a form similar to a letter C. The medial meniscus is more often subject to frequent injuries together with a sheaf. Meniscuses connect a cross sheaf in front of a joint.
Injury of meniscuses is the most widespread type of an injury of a knee joint which most often is found at men and athletes, is more rare – in life.
Symptoms of injury of a meniscus of a knee joint
Injury of meniscuses happens acute and chronic, respectively symptoms of injury of a meniscus differ depending on its type. Its main manifestations are listed below:
- the patient complains of sharp pain, all knee in the beginning, then pain is localized, depending on what meniscus is injured, with outside or the interior of a knee joint;
- the movement is sharply limited, the patient does not feel or feels small pain when the leg is bent, in extension attempt pain amplifies;
- the joint increases in volume, an indicator that treatment needs to be begun immediately;
- at extension appears feeling of click, an infiltration of a capsule and the appeared exudate in a cavity of a joint it is possible to grope a hand. These symptoms of injury of a meniscus appear for 2-3 weeks of a disease;
- when fixing a knee joint at an angle of 150 degrees and attempt to bend a leg, the patient feels sharp pain.
- at chronic damage of the patient feels the dull ache in a knee joint amplifying during descent down a ladder.
Diagnosis of injuries of meniscuses
Diagnosis is based on detailed inquiry of the patient and survey. Because of transparency of meniscuses for X-ray, the roentgenoscopy is ineffective. The endoscopic arthroscopy or a magnetic resonance tomography helps to establish the diagnosis.
Treatment of injury of a meniscus of a knee joint
For first-aid treatment at damages of a knee joint and a meniscus, the fixing tire is imposed, anesthesia and delivery of the patient is carried out to a traumatologic hospital.
If necessary, from a knee joint blood is removed and conservative treatment is carried out. For 4 weeks the plaster bandage, after removal – recovery therapy is applied.
If conservative treatment is inefficient, MRT (magnetic and resonant tomography) is recommended to carry out. If necessary, the arthroscopy of a knee joint becomes. It is the low-traumatic method of surgical intervention which became an integral part in modern diagnosis and treatment of a set of forms of intra joint pathologies, it is a treatment method now, it is considered "the gold standard".
This diagnosis of injuries of meniscuses is also simultaneous therapy. The arthroscopy is a research of a cavity of a joint by means of the special optical device during which, whenever possible, sewing together of the injured meniscus is carried out. If sewing together is impossible, and also at localization of damages to extravasated part, make full or partial removal of a meniscus. Removal of a meniscus or a meniscectomy, most often, in 80% of cases, it is possible during an arthroscopy, in other cases the surgeon is forced to resort to an arthrotomy, i.e. open operation.
In lack of an opportunity to carry out an arthroscopy the puncture of a knee joint at which novocaine solution is entered is carried out. Then, special receptions set the restrained meniscus, the patient at the same time has to be in a prone position on an orthopedic table. The surgeon-traumatologist has to make the movements, the return to those movements which led to an injury. As soon as the meniscus becomes on the place, all movements in a joint are recovered at once. After the meniscus is set, treatment does not come to an end. For fixing of a leg the plaster bandage is applied, and the injured leg at the same time is bent under a certain corner in a knee joint.
The immobilization term after treatment of injury of a meniscus and imposing of gypsum was carried out, makes 3 weeks. After a cast removal appoint physical therapy and physiotherapy exercises. In cases if the patient has repeated blockade of a joint, such state is called old injury of a meniscus. At old injury of a meniscus usually there is an inflammation of an internal cover of a joint called by a synovitis, there is a constant aching joint pain which amplifies when walking, and especially, during descent on a ladder. Development of the associated disease damaging a knee joint such as the dissecting osteochondrosis of joint surfaces or illness of Keniga is possible. Such state practically always, leads to frequent blockade of a joint. There is a need of removal of "a joint muscle" in the surgical way. After the performed operation, the pressure bandage or a plaster splint is applied a leg. Important condition of recovery is early occupation by remedial gymnastics.
Complications at injuries of meniscuses
At complication development of the deforming arthrosis, premature wear of an intra joint cartilage or blockade of a knee joint is possible. Suddenly arising oxycinesias. Perhaps, treatment will require an operative measure.
Prevention of injury of meniscuses
As prevention of injury of a meniscus to everyday life it is recommended to be more careful at run, walking, rise and descent on a ladder. Women are recommended to go in steadier footwear. Athletes at sports activities recommend use of special retentive bandages (kneecaps) if there is no opportunity to apply them, it is possible for an insurance, to bandage knee joints an elastic roller. Prevention of injury of meniscuses gives the chance to avoid an injury in 9 of 10 cases.
Section: Orthopedics and traumatology