Treatments for meniscus damage

Treatment overview

A severely damaged meniscus should be treated as quickly as possible in order to preserve the still healthy tissue and secondary diseases such as

  • Joint effusions or
  • Prevent entrapment.

If, on the other hand, there is only a slight sign of wear on a meniscus or minimal tears (so-called microtraumas), which do not cause any discomfort to the patient, one can wait for treatment, as this often recovers on its own and the knee returns relatively quickly without medical intervention becomes fully operational.

Whether a treatment is useful or not depends on the one hand

  • Extent of the disease and on the other hand of the
  • individual wishes and the
  • Life of an affected person.

Therefore, the advantages and disadvantages of a treatment should always be carefully weighed against each other with a doctor, whereby the final decision naturally lies with the patient.

Illustration of the meniscus

Illustration of the right knee joint from the front (A) and view of the menisci from above (B)
  1. Inner meniscus -
    Meniscus medialis
  2. Inner articular knot
    (Shinb.) -
    Medial condyle
  3. Transverse ligament of the knee joint -
    Lig. Transversum genus
  4. Kneecap ligament -
    Ligamentum patellae
  5. Bursa - Bursa
  6. Outer meniscus -
    Lateral meniscus
  7. Outer joint nodules
    (Shinb.) -
    Lateral condyle
  8. Anterior cruciate ligament -
    Lig. Cruciatum anterius
  9. Posterior cruciate ligament -
    Ligamentum cruciatum posterius
  10. Femur - Femur
  11. Shin - Tibia
  12. Kneecap - patella

You can find an overview of all Dr-Gumpert images at: medical illustrations

Meniscus OP

In principle there is two different surgical options to treat a more severe meniscus injury:

  • Either one repaired the damage or
  • the broken part of the meniscus is taken out and then possibly through a Implant to replace again.

Restoration of the meniscus is only possible if the tear or other injury is not too large. For this variant, the crack should also be in the area near the edge. The reason for this is that this part of the cartilage disc is still supplied by vessels and can therefore usually heal well after an operation.

The repair is done either using

  • Screws,
  • special Pens or
  • Arrows,
  • sometimes the job can be simple sewn become.

This option should always be sought initially. However, if this is not possible, a larger surgery occur. If part of the meniscus is actually torn off, it must be away depending on the type of damage it can become Partial distance of a small piece, in bad cases the entire meniscus be taken out. Depending on how big the removed piece is and how the remaining after the surgical procedure Functionality of Knee joint is assessed, it may be necessary to have one Implant to use. In extreme cases there is also the option of using a Meniscus transplant to be carried out, which is particularly suitable for younger patients.

Meniscus treatment without surgery

The most meniscus injuries will be operated on. These are mostly traumatic injurieswhich happened during sport. Sports that are very demanding on the knees are particularly often the cause of such meniscus ruptures. These are sports such as football or skiing. It is a matter of Twisting and falling injuries.
But also degenerative processes can Damage meniscal cartilageso ultimately a Age- or work-related wear results. In tilers, for example, meniscopathy is recognized as an occupational disease.
Now, however, must not forcibly operated on every disease or injury to the menisci become.

Basically you can all minor injuries, Which hardly or completely symptom-free are, conservative be treated.
There is a physiotherapy therapy With Exercises to stabilize the knee and Promote mobility.
Also can Inflammatory and pain relieving ointment dressings Relieve discomfort.

At smaller cracks or degenerative wear in the outer zone surgery is not always necessary on the meniscus. The outer zone of the meniscus is well supplied with blood and therefore has a good chance of healing even with conservative treatment in the case of minor damage, whereas the inner zone, which is not well supplied with blood, has a poorer prognosis. Components of conservative treatment are alongside Physiotherapy and physiotherapy, Protection, adequate cooling, Pain medication and the Injection of cortisone preparations. The latter have an anti-inflammatory effect. In addition to the cortisone preparations, there are also the so-called NNon-steroidal anti-inflammatory drugs. These are non-cortisone drugs with anti-inflammatory effects. They are also used for treatment.

It is very important in conservative treatment that To protect the knee joint sufficiently and in one adequate painless way of movingso that mobility is promoted step by step. Especially with joint wear and tear, osteoarthritis, it is important to relieve the joints. Overweight patient is recommended to her To reduce weight, as being overweight puts additional strain on the joints.

physical therapy

Physiotherapy for meniscus diseases.

Require meniscal injuries of any kind post- or partially also preoperatively physiotherapy or physiotherapy treatment.
Physiotherapy exercises vary depending on what type of injury is involved. The following is a brief overview of the sequence and type of physiotherapy exercises after meniscus injuries. However, these can of course differ from the individual treatment at the physiotherapist and are just an example of what possibilities there are.
The target physiotherapy is that Restore mobility of the knee joint as free as possible and one fluid movement to make it possible again for the patient. Therapy is ongoing gradually and its complexity increases with increasing mobility of the affected knee.
Patients who only have one Meniscus contusion or those who have only had a partial resection of the damaged meniscus can start physiotherapy as soon as possible. However, if a major procedure was necessary, such as a synthetic or biological meniscus implant, physiotherapy can be postponed for months after the procedure.

There are different approaches to movementthat promote mobility and stabilization of the knee joint. Some examples with explanations follow.
1. Quadriceps training:
Of the Quadriceps femoris muscle is the big muscle on the Front of the thigh. In detail they are four muscleswhich in a common terminal tendon at the Kneecap apply. The quadriceps femoris is a Extensor in the knee joint and is important for straightening the body from a crouch. also it stabilizes the kneecap. Strength exercises help stabilize the knee and promote mobility. For example, while lying down, you can alternately tense one front of the thigh and then the other for a few seconds. The process is repeated several times.
2. Passive mobilization of the kneecap:
While sitting, the kneecap is carefully gripped with both hands with legs outstretched and gently pushed to the side by a few millimeters. Do not move up or down! If there is pain, the exercise should be stopped. This promotes the mobility of the kneecap. 3. Squats:
Only with freedom from pain! You stand hip-width apart and bend your knees as low as you can. If this causes pain, stop the exercise.

It is fundamentally important that after meniscus injuries to recovery a lot of exercise is good. The Movement, however, must not be painful or stressful. If walking is very painful, you can still use walking aids in the first few days after the operation, for example.

Duration of treatment

The duration of treatment depends on the Causes and the nature of the complaints.
Minor injuries or bruises to the menisci can be symptom-free after a few days. Such injuries are also not an indication for an operation. Knee joint arthrosis are chronic degenerative signs of wear and tear of the articular cartilage and usually have to be treated for years.

Meniscus resection:
Smaller operations on the menisci, such as a meniscus resection, require physiotherapy for a few weeks as aftercare that However, the ability to work is usually after 1 to 2 weeks restored.
Meniscus suture:
The situation is different with meniscrefixation (meniscus sutures). Here is one longer follow-up treatment necessary. In the first few weeks after the operation, an extension splint is worn to keep the knee still. About after 3 weeks the movement is resumed. Complete freedom of movement in sports is given after about 6 months. Lighter sporting activities can already be started after 2 months.
Meniscus implantation:
The time until the partial load is a little longer here, so about Rest for 5 to 6 weeks must be adhered to. Accordingly, physiotherapy is shifted backwards a little, whereby overall freedom of movement should also be restored after about half a year.