The knee is the largest joint in our body. Each knee has two menisci located between the femur and the tibia. One of them is located on the inside of the knee, called the medial meniscus or internal meniscus, and the other, the lateral meniscus or external meniscus is on the outside of the knee. The two menisci are fibrocartilaginous structures, that is, elastic cushions. Its function is to dampen the friction between the articular surfaces, stabilize and accommodate the bone surfaces and distribute the forces and synovial fluid.
What do meniscal tears produce?
A tear in the menisci produces irregular surfaces that irritate the joint causing pain, inflammation, rigidity, and joint block.
The medial or internal meniscus is more vulnerable to injury than the lateral meniscus. The medial meniscus is injured 5-7 times more than the lateral meniscus because it supports 60-70% of body weight.
What is the cause of an internal meniscal tear?
Regarding the causes of an internal meniscus injury, it is necessary to differentiate the injuries in young people, in older patients and in workers who carry out their work with the knee flexed.
-The menisci of young people are usually very elastic and resistant, so injuries usually occur during sports due to a high-intensity trauma with knee torsion.
-Meniscal injuries in older people are consequences of previous degenerative processes. The menisci over the years weaken, lose resistance, flexibility and elasticity, become dehydrated. Consequently, injuries do not require high-intensity trauma. Usually, the trauma is minimal, it gives very few symptoms, but the discomfort is permanent.
What are the symptoms of an internal meniscal tear?
The symptoms are different in young people suffering from high-intensity trauma and in middle-aged people with degenerative rupture.
In young people, the main symptoms are pain, joint block, balance and stability failures, and crunches. The patient is referring to severe trauma.
Internal meniscus tears in middle-aged people occur when kneeling and then trying to get up, turning around in bed, getting up from a chair. The patient has intermittent pain that will force him to take pain relievers for months.
How is an internal meniscal tear treated?
The main objective of the treatment is to reduce the pain and inflammation of the joint, but the recovery of the functionality and mobility of the knee must also be objective. Treatment can be conservative or surgical depending on several factors that must be assessed by a specialist.
If the tear is small and can regenerate itself and there is no joint block, the appropriate treatment will be conservative. Conservative treatment includes physical therapy, anti-inflammatory and pain relievers, collagen-based supplements, hyaluronic acid, chondroitin, glucosamine, or if necessary, infiltrations in the knee area. The typical candidate for conservative treatment is a patient over 50 years or older, who reports long-standing pain without a clear traumatic history. Pain is not accompanied by a joint block or effusion. Normally X-rays show signs of osteoarthritis and the MRI confirms the degenerative-type meniscal tear. In these cases, surgical treatment is not recommended, as it could even worsen the symptoms and the progression of the disease.
Surgical treatment of the internal meniscus tear is indicated if the patient is young, an athlete has a limitation in knee movement or blockage or stability failure and cannot recover his activity level with conservative treatment. The intervention is performed through arthroscopy, a minimally invasive intervention. Surgery may include partial meniscectomy or suture of the meniscus.
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Doctors Specialising in Hip and Knee Surgery
Gorav trained in London and specialist fellowships were undertaken at …