Knee Pain When the meniscus is broken

Knee pain: Meniscus injury to the doctor

06/02/2014

The most common causes of knee problems include meniscal injuries. Even a wrong move can be enough and cause the meniscus to break. If you have a knee pain, do not ignore it and go to the doctor early. Otherwise threatened consequential damage.

Meniscal injuries mostly due to accidents
Meniscal injuries are among the most common causes of knee problems. Already with a wrong movement there is a danger that the meniscus ruptures. Rainer Siebold, Specialist in Orthopedics and Traumatology in Heidelberg, explained: „In younger people, meniscal injuries usually occur due to accidents, such as sports or traffic accidents.“ These injuries usually led directly to knee joint pain. In elderly people, meniscal injuries can also be a result of signs of wear.

Important function in the knee joint
The two menisci, which are found in the human knee, are called inner and outer meniscus. These crescent-shaped cartilages, located between the thigh and lower leg, perform an important function in the knee joint because they act as shock absorbers and pressure distributors and adapt the different structures of the upper and lower leg to each other. This protects the joint from wear. If the meniscus is injured and additionally partially ruptured, the joint may become blocked. Then sufferers could no longer bend or stretch the knee properly. In addition, the joint swells sometimes.

Some sports pose a great risk of injury
According to Siebold, sports with an opposing influence pose a major risk of meniscus injuries. In addition, frequent stop-and-go movements and changes of direction such as football, handball, basketball and volleyball or skiing are dangerous. The cause of meniscal injuries is not just accidents, they can also be caused by years of wear and decades of stress. Because over time, the acting forces change the structure of the cartilage and then it could happen that the meniscus tissue rubs and damages the articular cartilage. „Many patients feel pain falling down the stairs when squatting or straightening out of the deep squat, usually on the inside of the knee“, Thomas Pauly, Chief Physician of the Department of Orthopedics and Rheumatology at St. Elisabeth Hospital in Meerbusch (North Rhine-Westphalia).

Wear sometimes at a relatively young age
Even a simple bending or a lighter representation can lead to tearing of the meniscus and sudden pain in case of previous damage. Sometimes the meniscus changes due to wear already at a relatively young age, for example at 40 or even earlier. „This varies from person to person and depends on the individual nature of the tissue“, Pauly explained. In addition, lack of exercise, obesity and obesity promote the wear as well as occupations that need to be worked on the knees or in the squat. Meniscal injuries do not necessarily have to be treated just 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, usually an operation is considered. Then either the tear stitched or damaged parts of the meniscus can be removed.

Different operation options
As a rule, both operations were performed gently by means of joint mirroring, for which only small punctate cuts were necessary. A complete maintenance of the meniscus could enable a meniscal suture, 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 a minor portion of the intervention removes parts of the meniscus, the patient may often be fully restored to the knee shortly after surgery. With a meniscus suture, which has to heal longer, however, a little more patience is needed. So in the first three to six weeks assistants were required to relieve the knee joint.

With meniscus partial removal high risk for later arthrosis
However, Siebold warns against deciding on a partial distance only because of the faster reusability: „A patient who already has a meniscal component loss as a teenager or younger adult has a very high risk of later osteoarthritis.“ If a tear is caused by wear, there is no chance that the meniscus will heal itself again by sewing and thus be completely preserved. In such cases, the surgeon attempts to stabilize the tear by removing the unstable parts and leaving as much meniscus as possible.

Sometimes, surgery does not help
In addition, an operation may not work if a meniscal injury has not been treated and the articular cartilage has already been damaged. „One would then try with drugs and physiotherapy to get the pain under control and delay an artificial joint replacement as long as possible“, so Pauly. Sometimes also a physiotherapeutic treatment is required to become fit again after an operation. As a rule, these are then prescribed if the healing process does not go by itself optimally, according to the resident physiotherapist and rehab coach at the football regional board VfB Lübeck, Sascha Knappe.

Healing needs rest
In addition, it is important that the times laid down by physicians and therapists are consistently observed for protection and relief. Knabe emphasized: „When something is supposed to heal, it also needs rest.“ However, patients often claim to be fit as fast as they know it from competitive athletes. The sports therapist explained: „But the physical conditions regarding lymphatic drainage, blood circulation and joint-stabilizing muscles in competitive athletes are quite different.“ (Ad)