The knee joint is equipped with two disc-shaped menisci. The menisci buffer shocks and distribute the load on the joint surface between the thigh and lower leg. Meniscus damage usually refers to a meniscus tear, a meniscus contusion or degenerative meniscus damage.
Below you will find further information and selected specialists for meniscus damage.
The menisci are fibrous cartilage cushions in the shape of a C. They lie like a wedge between the joint surfaces of the femur and tibia in the knee joint. Here they ensure
They are also important for joint stability and protect the knee from overloading. The human knee is equipped with two menisci. They are called the outer meniscus and the inner meniscus.
Cross-section of the knee viewed from above, menisci on the left and right © bilderzwerg / Fotolia
The menisci only become noticeable through pain when they are overloaded or injured.
The meniscus is only well supplied with blood in its peripheral zone (the red zone). This makes the cartilage cushions more susceptible to injury, as they can dry out and become brittle. Tissue damage also heals more poorly.
Damage to the meniscus is one of the most common sports injuries. The lesions primarily occur during sports that put a lot of strain on the knee. These include above all
A meniscus injury is usually triggered by a rapid rotation of the knee joint or during intensive flexion and extension movements. These movements cause the free edge of the meniscus to come between the joint bodies. This results in a partial or complete tear of the meniscus.
On the other hand, there is wear-related degenerative meniscus damage. They develop slowly from middle age onwards due to previous damage and unfavorable loads.
Axial misalignment and obesity are important risk factors. However, certain occupational groups, such as tilers, also often suffer from meniscus damage. Their kneeling activities put excessive strain on the menisci.
Orthopaedics distinguishes between different forms of meniscus damage. One of the most common is meniscus rupture (meniscus tear). The inner meniscus is more frequently affected by damage than the outer meniscus. Depending on the direction of the tear, a distinction is made between
are distinguished.
A meniscus tear can occur in completely different ways © bilderzwerg / Fotolia
A less serious type of meniscus damage is a meniscus contusion. It is usually caused by sports injuries and heals after a break of around three weeks.
The disc meniscus is one of the congenital diseases. During embryonic development, the menisci are formed as disks. In the course of childhood, they degenerate from the center to the edges, creating the typical crescent shape.
In the outer meniscus, this degradation can stop early, so that the meniscus remains as a disk. The shape is unfavorable to mechanical stress. This means that the meniscus cannot evade certain movements. There is a risk of a painful snapping phenomenon. This usually appears between the ages of 6 and 8.
In severe cases, tears can develop that extend to the capsule and lead to the loss of large parts of the outer meniscus. For this reason, the disc meniscus should be considered in good time in children with snapping and blockage-like symptoms.
The meniscus also wears out over time. Its fibers lose elasticity and stability. As the meniscus tissue rolls out further and further, it increasingly loses its circumference and ultimately tears.
Doctors then speak of a degenerative meniscopathy, which is later accompanied by the development of osteoarthritis. In addition to axial misalignments (e.g. knock knees and bow legs), overloading is also a common cause of degenerative meniscus damage.
A typical symptom of an acute meniscus tear is abrupt pain. Swelling also forms on the affected knee.
If there is a lesion to the inner meniscus, the pain often occurs in the inner joint space. In the case of injuries to the outer meniscus, on the other hand, those affected suffer from pressure pain in the outer joint space.
In the case of a partial meniscus tear, there is a risk that part of the meniscus will become trapped. This in turn results in a painful knee blockage. Sometimes cracking or snapping noises can also be heard.
In the case of degenerative meniscus damage, the symptoms are usually less pronounced. Knee pain occurs particularly during exertion. There is often also a feeling of instability.
The best place to go for an examination if meniscus damage is suspected is the orthopaedic surgeon. They will first ask the patient about their symptoms and carry out a physical examination of the knee.
During this procedure, special flexion and rotation tests are carried out to check the functionality of the menisci. In most cases, the physical examination already provides sufficient information. It is also important to rule out other injuries such as a meniscus contusion or joint cartilage damage.
As a secondary symptom, the irritation causes inflammation of the joint with an effusion. If there is a large joint effusion in the knee, a puncture can provide relief and reduce pain. The doctor uses a hollow needle to remove fluid, which is then analyzed for components such as
is examined.
An X-ray examination is only useful if there is a suspicion of injuries to the bone or variations in shape. The best examination results can be achieved with magnetic resonance imaging(MRI). An MRI allows a precise assessment of cartilage, bone and soft tissue.
An arthroscopy(knee endoscopy) can be performed if there are any further uncertainties. A meniscus tear can already be operated on with this procedure.
The way in which meniscus damage is treated depends on the extent of the injury. The following also play an important role
Not every impairment of the meniscus requires surgery. For example, minor lesions that do not involve an impingement are usually treated with immobilization and physiotherapy.
However, surgery is necessary if the meniscus damage is extensive and there is instability or mechanical problems. Without surgery, there is a risk of cartilage damage and osteoarthritis.
The operation is usually performed as part of an arthroscopy. The patient is given either a partial or general anesthetic. Depending on the injury, the procedure can be performed on an inpatient or outpatient basis. Open knee operations are rarely required any more.
The video shows the procedure for an arthroscopic meniscus repair:
The aim of meniscus surgery is to remove parts of the meniscus that
In this way, tears can be removed in a controlled manner and the edges of the tears gently smoothed. This part of the operation must be carried out as gently as possible, as every functional part of the meniscus is still needed.
Following the operation, knee movements or sporting activities are slowly restored. Depending on the surgical procedure, it can take several weeks to three months before the knee is fully functional again.
Do not take meniscus damage lightly. A medical consultation is advisable,
The controversial discussions about the usefulness of meniscus operations are unfortunately characterized by cost pressure and one-sided interpretation of studies. In principle, all treatment methods should always be considered. In the case of degenerative meniscus damage, conservative treatment is therefore always recommended first.
The clearer the mechanical symptoms are, the higher the success rate of surgery. However, acute traumatic meniscus tears can only heal conservatively if they are surgically stitched immediately after the injury.
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