Knee pain: when the meniscus is broken

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Knee pain: In case of meniscus injury, see a doctor

Meniscus injuries are among the most common causes of knee problems. Just one wrong movement can be enough to cause the meniscus to tear. With knee pain, it is important not to ignore it and to go to the doctor early. Otherwise there is a risk of consequential damage.

Meniscal injuries mostly due to accidents Meniscal injuries are among the most common causes of knee problems. The wrong movement can cause the meniscus to tear. Rainer Siebold, specialist for orthopedics and trauma surgery in Heidelberg, said: "In younger people, meniscus injuries mostly occur as a result of an accident, for example due to sports or traffic accidents." These injuries usually led directly to knee pain. In older people, meniscal injuries can also be a result of signs of wear.

Important function in the knee joint The two menisci that are found in the human knee are called the inner and outer meniscus. These crescent-shaped cartilages, which are located between the thigh and lower leg, fulfill an important function in the knee joint, because they serve as shock absorbers and pressure distributors and adapt the different structures of the thigh and lower leg to each other. This protects the joint from wear. If the meniscus is injured and also partially torn off, the joint can block. Then those affected could no longer bend or extend the knee properly. In addition, the joint sometimes swells.

Some sports pose a high risk of injury According to Siebold, opposing sports pose a high risk of meniscal injury. In addition, frequent stop-and-go movements and changes of direction, such as in soccer, handball, basketball, volleyball or even skiing, are dangerous. However, the cause of meniscal injuries is not solely accidents, they can also result from years of wear and tear and decades of stress. Because over time, the acting forces change the structure of the cartilage and then it can happen that the meniscal tissue rubs up and damages the articular cartilage. "Many patients experience pain when going down stairs when they crouch or sit up from a deep crouch, usually on the inside of the knee," says Thomas Pauly, chief physician of the Clinic for Orthopedics and Rheumatology at St. Elisabeth Hospital in Meerbusch ( North Rhine-Westphalia).

Wear sometimes at a relatively young age Even simple bending or easier repositioning can lead to tearing of the meniscus and sudden pain in the event of previous damage. Sometimes the meniscus changes due to wear at a relatively young age, for example at 40 or even earlier. "It varies from person to person and depends on the individual nature of the fabric," said Pauly. In addition, lack of exercise, obesity, and obesity promote wear, as do jobs that require working on your knees or crouching. Meniscus injuries need to be treated not only because of the pain. Paul explained: "A torn meniscus is always the beginning of osteoarthritis, the progressive destruction of the joint." If the cause is an injury, surgery is usually an option. Then either the tear can be sewn or damaged parts of the meniscus can be removed.

Different surgical options As a rule, both surgeries were carried out gently by means of articulation, for which only small punctiform incisions were necessary. A meniscus suture could enable complete preservation of the meniscus, whereby the chances of success are greatest in the long term. However, it depends on the location and type of injury, the age and physical fitness of the patient and other factors whether a tear can be sewn. If small parts of the meniscus are removed during an operation, the patient can often put a full load on the knee shortly after the operation. With a meniscal suture that needs to heal longer, a little more patience is required. In the first three to six weeks, assistants were required to relieve the knee joint.

With partial meniscus removal, high risk for later osteoarthritis Siebold warns against only opting for partial removal because of the faster reusability: "A patient who already has a partial meniscus loss as an adolescent or younger adult has a very high risk of later osteoarthritis . “If a tear is due to wear, there is no prospect that the meniscus can be healed again by sewing and thus be fully preserved. In such cases, the surgeon tries to stabilize the tear by removing the unstable parts and leaving as much meniscus as possible.

Sometimes an operation does not work anymore. In addition, an operation may not work if a meniscal injury has not been treated and the articular cartilage has been damaged a lot. "You would then try medication and physiotherapy to get the pain under control and delay artificial replacement as long as possible," said Pauly. Occasionally, additional physiotherapy treatment would be required to get fit again after an operation. As a rule, this will be prescribed if the healing process does not proceed optimally on its own, says the resident physiotherapist and rehabilitation trainer at the regional footballer VfB Lübeck, Sascha Knappe.

Healing needs rest In addition, it is important that the times specified by doctors and therapists for protection and relief are strictly observed. Knappe emphasized: “If something is supposed to heal, it also needs rest.” However, patients often claim to be fit again just as quickly as they know it from competitive athletes. The sports therapist explained: "However, the physical requirements for lymphatic drainage, blood circulation and joint-stabilizing muscles for competitive athletes are completely different." (Ad)

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Video: Is Your Knee Pain Coming From a Meniscus Tear or Ligament StrainTear? How to Tell.

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