Degenerative changes in the medial meniscus 1 tbsp. Degenerative changes in the menisci

19.10.2020

The meniscus is the cartilaginous lining at the joint. He is best known for his knee joint. Degenerative changes in the menisci of the knee joint often develop, and this can permanently deprive a person of an active life. Why do they appear, and how to deal with them?

A few words about the meniscus

So, the bones of the lower extremities are fixed and held by two meniscus cartilages, from the front and back sides (medial and lateral). They also play the role of a shock absorber, which means they prevent numerous injuries to the knee that could occur during movement. Without them, the articulation would be unstable.

The meniscus, along with the elbow, is one of the most mobile joints in the entire skeleton. But without healthy lower extremities, the very possibility of movement, of walking, becomes questionable. The menisci have an anterior and a posterior portion (horns), as well as a central zone (body). At the anterior horn and closer to the edges, the meniscus tissue structure is most fully saturated with collagen.

Degenerative processes of the meniscus are divided into 5 types:

Rupture of meniscus ligaments. In this case, the knee becomes unnaturally mobile in all directions. This can cause a dislocation, fracture, or other injury. The very integrity of the joint when the ligaments are ruptured is not broken.
Meniscopathy. This is the most classic case, when the cartilage gradually becomes thinner and ceases to perform its functions. The root cause may be arthrosis, gout and other diagnoses of the patient.
Meniscus tear. The cartilage is displaced from its anatomically correct position. The person becomes limited in movement.
Cystosis. With this disease, formations are formed in the cartilage cavity that interfere with the normal functioning of the meniscus. Over time, they deform and all surrounding tissues.
Degenerative rupture of part of the meniscus. This can be either the cartilage body itself or its horns.

The most common degenerative changes occur in the posterior horn of the medial meniscus. They are based on long-term microtraumas and chronic diseases, that is, these are physiological damages.

Causes

More often they talk about provoking factors that contribute to the appearance of degenerative processes in the menisci.

Elderly age

Over time, the blood supply to all organs is disturbed and the bone structures feel it among the first. If we add to this the deterioration of the joint, which every person of venerable age invariably has, then there are already prerequisites for the emergence of meniscus pathology.

Athletes

Most sports are somehow connected with the movements of the lower extremities. These are runners, and football players, and skiers. If such movements are performed for wear, then they will not bring benefits to the body. Especially often problems with menisci are diagnosed in dancers. Dance movements especially often lead to injuries, in particular, dislocation and subluxation of cartilage, including both menisci at once.

flat feet

Incorrect anatomy of the foot can change and worsen the condition of the entire musculoskeletal system, especially the spine, pelvis and knees. Degenerative-dystrophic changes in the knee joint is only one of the possible diagnoses in such a patient.

Inflammatory diseases

They can either occur directly in the joint (arthritis) or be localized in other organs (tuberculosis, syphilis). Of course, they do not lead to manifestations in the area of the knee joint soon, but in this case, the likelihood of degenerative consequences that are difficult to treat increases.

Harvesting, weeding the beds and other gardening and field work are often carried out in the "squatting" position. These people do not suspect how dangerous their position is for the knee joint, in particular, for the meniscus.

Other reasons

The list continues:

Persons who squat or stand for long periods of time. In the squatting position, all vessels and nerve endings are pinched. In a standing position, stagnation also occurs in this joint, which negatively affects its condition.
congenital anomalies. So, even ordinary walking with knee dysplasia, that is, the wrong position of the bones in the joint, provokes the initiation and progression of degenerative changes.
Metabolic diseases. This is not only gout, familiar to everyone, in which the deposition of uric acid salts completely disrupts the nutrition of the joint, but also hypothyroidism, cirrhosis of the liver and many other diagnoses.
Injuries. The specialist will ask about them first of all. If there is a history of damage to the articular parts of the knee, then the likelihood of developing degenerative processes is very high.

By the way, if it was the injury that caused degenerative changes, the doctor will clarify the movements that led to this. So, degenerative damage to the inner meniscus occurs when the lower leg is sharply rotated with a large amplitude of movement directed outward. Inward rotation damages the lateral meniscus.

Injuries to the meniscus can sometimes be combined with injuries to other joints, such as the anterior cruciate ligament. Traumatologists see this combination regularly.

Degrees of damage

In total, 4 types of joint condition are noted:

Zero degree. If a person sees these words in his card, then he can calm down. Zero degree is an absolutely healthy meniscus without any changes. All its structures work without deviations.
First degree. Changes are only inside the meniscus, but they do not reach the outer shell. For this reason, such injuries are very poorly diagnosed by traditional methods - x-rays and even ultrasound. X-ray will be informative in cases where the damage has already affected the bone structure. The most informative for degenerative changes of the 1st degree is magnetic resonance imaging, which will very clearly indicate the difference in the density of the joint structure. Degenerative signs on MRI are enough to initiate appropriate treatment.
Second degree. There is a more extensive meniscus lesion, but it still does not reach the outer shell. These changes in some cases can be seen on ultrasound. Sometimes a specialist doubts what kind of severity to determine the disease in a particular patient, and he writes "1-2 degrees according to stoller." The second degree according to stoller is a rupture of the meniscus, but in this case, a violation of the integrity of the meniscus has not yet been recorded.
Third degree. This is the 2nd degree in stoller. The rupture at the 3rd degree of joint damage can be complete or partial, which determines the tactics of therapy by the doctor.

Symptoms

Degenerative changes appear gradually, and therefore all sensations grow over a long time. At first, pain in the knee appears only during exercise, especially when going up or down stairs. Then the person can detect a violation of the movement of the knee joint, the amplitude may change. A little later, "sound" symptoms are added to them - a crunch, a creak when moving, especially slow. In the last stage, the normal shape of the knee changes.

External changes in degenerative destruction of the meniscus do not appear immediately, but only when the anatomy of the knee changes. This does not apply to injuries in which swelling and redness appear almost instantly.

The most striking symptoms appear as a result of a meniscus injury:

sharp, severe pain that does not go away even at rest;
the appearance of swelling in the knee area;
hemorrhage into the joint cavity (hemarthrosis);
pathological movement of the joint (too active, in all directions, or, conversely, restriction if you want to bend the knee).

By the way, the restriction of movement of the knee depends on the localization of degenerative changes. So, if the anterior horn and the body of the meniscus are damaged, the extension of the joint is blocked, and if the posterior horn is deformed, flexion is limited.

Treatment

Therapy will depend on how badly the cartilage plate is damaged. If the changes are minimal, then conservative methods are sufficient. First, you need to give the joint rest, remove the load from it. Secondly, it is necessary to start pharmaceutical treatments. Anti-inflammatory drugs. Ibuprofen, Diclofenac, Nimesulide and other non-steroidal PVAs will help to quickly relieve inflammation if it has become the root cause of degenerative changes.

Painkillers. They not only reduce pain, but also help relieve swelling. Muscle relaxants. They relieve muscle spasms and reduce motor activity for the duration of therapy. Chondroprotectors. They restore the structure of cartilage tissue and the joint as a whole, contribute to its strengthening.

If there is hemarthrosis, then it is necessary to remove blood clots in the joint cavity to allow it to recover normally. To do this, use a puncture (puncture) and pump out the accumulated blood. Immediately after this, the vacated cavity is washed with an antiseptic solution or glucocorticosteroids are administered, which prevent the accumulation of fluid. To prevent the cavity from being filled with lymph and blood again, it is necessary to wear an elastic bandage on the knee for some time, under the pressure of which these processes will be impossible.

Unfortunately, conservative methods are not always effective, and relapses often occur.

If degeneration has taken a serious turn, then surgical intervention is indispensable. Arthroscopy is a minimally invasive surgical procedure that allows you to restore the joint in a very short time. If the doctor has prescribed arthroscopy, then you should not try to do without it. It is the only true method of treating third-degree meniscal injury (second according to stoller), but can be prescribed in milder cases.

The knee joint is the most frequently operated on, which is understandable. The knees, along with the elbows, a person uses much more than the rest of the joints of the skeleton.

Today, this operation has been brought to perfection, and the skill of surgeons is at a very high level. During the operation, the doctor will perform plastic surgery of the joint, that is, remove the destroyed tissues and connect healthy areas. Here you can also remove adhesions, particles of cartilage, as well as align the edge of the damaged cartilage. The operation is minimally invasive and effective.

The mandatory methods of treatment include exercise therapy. The joint must remain mobile, the ligaments must be strong, and the muscles must be powerful. A set of exercises in a medical institution is selected for a specific patient, for a particular case. Physiotherapy also gives good therapeutic results: shock wave treatment, iontophoresis, magnetotherapy.

Degenerative changes in the menisci are always easier to treat at a very early stage. Not everyone comes to see a doctor at the first signs of pain, and therefore the processes in many become chronic. Fortunately, modern medicine allows you to restore the integrity of the meniscus, and proper rehabilitation will consolidate the result for many years.

The human body is often compared to cars: the heart is the engine, the stomach is the fuel tank, and the brain sets the whole device in motion. Where are the shock absorbers in humans? Of course, in places that experience increased stress: there are cartilaginous discs between the vertebrae, and in the knee joint there are as many as two “shock absorbers” - menisci. Lateral (external) and medial (internal). The results of degenerative changes in the menisci, although they will not stop the activity of the body as a whole, will certainly deliver a lot of unpleasant sensations.

Degenerative changes are anatomical damage to an organ resulting from trauma, atypical joint structure, or disease. Meniscus degeneration is most often the result of trauma, sometimes even unobvious: one bad rotation of the lower leg can cause damage to the cartilage disc, which is accompanied by severe pain.

Most often, due to the anatomical structure, the medial meniscus undergoes degeneration. If the outer cartilage, which dampens the movement of the knee joint, does not have a rigid fixation and shifts to any side if necessary, then the medial cartilage is rigidly fixed in the joint, and its horns are in close proximity to the condyles. One sharp turn of the lower leg - and the meniscus does not have time to escape from the displaced process of the bone, the result is its damage or rupture.

Degenerative changes can be different:

If you are haunted by aching pain in the knee, which then disappears, then appears with renewed vigor - we can already assume the presence of changes in the meniscus. About 90% of pathologies of the knee joint are due to damage to the "shock absorber".

Symptoms largely depend on the nature of the pathology. Tears are accompanied by severe pain, blockade of the leg in a bent state and swelling. With serious damage to the medial meniscus, hemorrhage into the articular cavity often occurs - hemarthrosis. Significant swelling and severe pain are also characterized by meniscal cysts.

Tears, detachments from the place of attachment are often chronic and are manifested by the periodic appearance of pain and a feeling of interference in movement.

There is such a diagnostic test: go up and down a ladder or slope. With pathology of the meniscus, when moving down, the pain in the knee increases.

The chronic course is also characterized by secondary degenerative-dystrophic transformations in the medial meniscus, that is, those that have arisen due to other pathologies of the body or diseases. Often in such cases there are clicks and rolls * of the joint in motion after a long rest, sometimes there is pain in the knees. The increase in symptoms occurs gradually as the cartilage layer thins and salts or uric acid crystals accumulate in it (the latter - with gout). In the absence of adequate treatment, the final stage of meniscopathy becomes contracture - a stable violation (restriction) of joint mobility.

* Rentals - sensations of pathological mobility, instability and displacement of the articular surfaces of the bones.

Common to all types of meniscus degeneration are the following symptoms:

pain,
swelling,
blockage of the joint in a bent position or sensation of a foreign body in the knee,
clicks and crunches,
swelling of the knees with a long absence of movement.

The anatomical features of the location and structure of the menisci determine the high incidence of pathologies both among young people and among people of mature age. Most often, athletes, ballerinas, dancers suffer from ruptures, injuries and cysts - that is, people who are in constant motion and experience high loads.

More possible reasons:

Diagnostics

With acute injuries of the meniscus, there is usually no doubt - blockade of the knee in a characteristic position, pain and clicks during straightening make it possible to establish the correct diagnosis in 90% of cases.

It is not always possible to determine degenerative-dystrophic transformations during examination due to the absence of clear symptoms and, often, a positive reaction to special tests. In such cases, resort to instrumental research methods:

Treatment Methods

Therapy for degenerative changes in the menisci depends entirely on the nature of the damage. Acute injuries serve as a direct indication for the use of conservative methods of treatment:

First of all, the joint is punctured, eliminating its swelling and restoring mobility. Sometimes several procedures are required, since active exudation (release of inflammatory fluid) in the joint lasts up to three to four days.
Analgesics are prescribed, preference is given to narcotic drugs (Promedol and its derivatives), because other drugs in this case, as a rule, are not able to relieve the patient of pain.
Chondroprotectors provide the body with the necessary substances to restore the damaged area of the meniscus.
Anti-inflammatory drugs.
At the stage of rehabilitation, physiotherapeutic methods serve as an auxiliary means - ozocerite, UHF, iontophoresis, shock wave therapy.
For 14 days, a splint is applied to the straightened leg, which ensures fixation of the joint in the required position.

In case of ruptures, surgical intervention is indicated: through two miniature incisions, instruments are inserted into the knee joint and the damaged area is sutured. A serious injury may necessitate the removal of the cartilage lining of the joint and its replacement with an artificial one. All surgical manipulations are performed only after the signs of inflammation have subsided.

Chronic dystrophies, joint dysplasia and abnormal development of the ligamentous apparatus require exclusively surgical treatment.

If the cause of degeneration is chronic diseases such as rheumatism and gout, along with surgical methods, the underlying disease is also treated (diets, immunocorrectors and other methods).

Degenerative transformations of the menisci is a fairly common pathology that requires immediate medical attention. The functioning of the joint in the future depends on the timeliness of treatment, and delays can cause the spread of dystrophic processes to other elements of the joint. Therefore, do not postpone the visit to the doctor, take care of yourself and be healthy!

A degenerative change is a violation of the normal structure of the meniscus, leading to a partial or complete loss of its functions. The cause of the pathology can be injuries, active sports, hard physical work or excessive stress on the knee joint. Degenerative processes in the meniscus can be a consequence of the natural aging of the body.

Degenerative changes in the knee joints are common among the elderly, athletes and overweight people. The process usually involves cartilage, ligaments, menisci, synovial membrane. In severe cases, the articular surfaces of the bones that form the knee joint are damaged.

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The development of degenerative processes in the menisci can be triggered by their frequent trauma, displacement, impaired blood supply and/or nutrition. Most often, the pathology develops against the background of chronic inflammatory and degenerative-destructive diseases of the joints. It can also be caused by traumatic injuries to the knee.

Deforming osteoarthritis is the most common disease of the musculoskeletal system. Pathology develops predominantly in people over 50 years of age. Among people over the age of 60, it is detected in 97% of cases. The knee joints are affected in 70-80% of patients with osteoarthritis.

Gonarthrosis is characterized by degenerative-dystrophic changes in almost all structures of the knee joint. The menisci are damaged due to poor blood supply, lack of nutrients in the synovial fluid, and constant trauma from dilapidated cartilage.

Factors contributing to the development of gonarthrosis:

excess body weight;
heavy physical work;
hormonal and metabolic disorders;
postmenopausal period;
previous knee surgery;
inflammatory diseases of the joints;
osteoporosis.

Deforming gonarthrosis can lead to permanent disability and disability in just a few years. According to statistics, this happens in 25% of patients within 5 years from the moment the first symptoms of the pathology appear. Early diagnosis and timely treatment help to avoid undesirable consequences.

Meniscus degeneration is detected in 27% of patients with deforming gonarthrosis of the 1st degree. At later stages - 2, 3 stages - pathology develops in almost all patients.

Frequent trauma or any damage to the meniscus can lead to the development of degenerative processes in it. A provoking factor can be a sharp movement or an unsuccessful turn of the lower leg. In trauma, the medial meniscus, located on the inside of the joint, is most often affected. This is due to the peculiarities of its structure and localization, which do not allow it to avoid pinching by the condyles of the femur.

Post-traumatic meniscus degeneration is more common in athletes, hard workers, and people who lead an overly active lifestyle. Pathology can be detected at any age.

Do not confuse degeneration with traumatic ruptures, tears, tears, etc. The former are characterized by a long, slowly progressive course with further development of complications. The second arise acutely due to trauma.

Degeneratively altered menisci are torn with particular ease. But traumatic injuries themselves often cause degenerative changes. These two pathologies are interrelated and often develop in parallel.

The cause of meniscus dystrophy can be rheumatoid or gouty arthritis, brucellosis, tuberculosis, yersiniosis. The development of pathology can also provoke hypothyroidism, systemic vasculitis and some connective tissue diseases (scleroderma, systemic lupus erythematosus, etc.).

Degenerative-dystrophic changes in the menisci that occur against the background of other diseases are commonly called meniscopathies.

Pathology is differentiated according to the localization of foci of degeneration. They can be found both in the body and in the anterior or posterior horns. Most often, degenerative changes are detected in the posterior horn of the medial meniscus. This is due to the peculiarities of its structure and location.

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Depending on the severity of pathological changes, 4 stages of degeneration are distinguished. They can only be detected and identified using magnetic resonance imaging (MRI).

Stoller classification:

0 degree - characterized by the absence of pathological changes;
I degree - in the thickness of the meniscus, focal changes are noticeable that do not reach its edges;
II degree - the presence of a linear focus of destruction, not reaching the edges of the meniscus;
III degree - the pathology reaches one of the edges, which leads to a tear.

We can talk about a true meniscus rupture if the III degree of degeneration according to Stoller is revealed.

Table 1. The most common consequences of degenerative changes

Pathology	Description	Symptoms
Gap	It is characterized by a violation of the integrity of the meniscus in the region of the body, anterior or posterior horn	Severe pain in the knee, preventing the patient from walking normally. If the posterior horn is damaged, it becomes difficult for a person to bend the leg, the anterior one - to unbend
Separation	A pathologically altered meniscus or its fragment is completely detached from its attachment site	The articular mouse formed as a result of detachment migrates through the synovial cavity, often causing blockade of the knee joint. A person has severe pain and limited mobility of the knee
hypermobility	Manifested by abnormal mobility of both menisci due to rupture of the transverse ligament of the knee that connects them	Aching pain in the knee, aggravated by walking, running, squatting, going down stairs and other physical activity
Cyst	The pathology is characterized by the formation of a meniscus in the cartilage filled with a liquid cavity	May be asymptomatic for a long time. When a cyst ruptures in the knee, there is usually a sharp pain

Meniscus tears can be traumatic or degenerative. The appearance of the latter is usually preceded by aching pain, stiffness and discomfort in the knee for several months or even years.

Menisci are important structures of the knee joint. They play a huge role in distributing the load and providing the desired stability of the knee. It is thanks to them that the knee joint can work and function normally. Their degeneration leads to pain, instability and impaired mobility of the lower limb. The knee joint becomes loose, and its functioning is gradually impaired.

With the appearance of complications (ruptures, separations, etc.), a person experiences pain, discomfort and a feeling of instability in the joint. Unpleasant sensations are aggravated when descending stairs and squatting. Some patients complain of the appearance of characteristic clicks, a crunch and a feeling of movement of a foreign body in the knee during movements.

Damage and deformation of the menisci contribute to the appearance of degenerative-dystrophic processes in other structures of the joint. As a result, a person develops deforming osteoarthritis.

The simplest method for diagnosing pathology is radiography of the knee joints in 2 projections. But it is informative only in the last stages of deforming osteoarthritis. The degeneration itself cannot be seen on radiographs, but one can only suspect it by the presence of indirect signs.

Modern methods for diagnosing degenerative changes in the menisci of the knee joint:

ultrasound. It is a non-invasive and highly informative research method that allows you to see almost all structures of the knee joint (ligaments, tendons, meniscus cartilage, hyaline cartilage). The advantage of ultrasound diagnostics is the absence of radiation exposure to the body;
MRI. A modern method that allows to detect meniscus degeneration and other pathological changes in the knee joint at the earliest stages. Magnetic resonance imaging is widely used to diagnose deforming arthrosis;
arthroscopy. An invasive research method that allows you to examine the cavity of the knee joint from the inside. It is mainly used for severe knee injuries. In 70% of cases, diagnostic arthroscopy turns into a therapeutic one. During such an operation, doctors, under visual control, eliminate tears and other dangerous consequences of an injury.

To slow down the development of degenerative processes, patients are prescribed corticosteroids, chondroprotectors, hyaluronic acid preparations, and agents that restore the normal composition of the synovial fluid. The most effective is their intra-articular administration. For local injection therapy (LIT), Diprospan, Kenalog, Alflutop, Noltrex, Cel-T and some other agents are most often used.

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With degenerative changes in the medial or lateral meniscus, accompanied by a rupture, the patient requires surgical intervention. The operation is performed by arthroscopy.

In childhood, pathology is most often the result of dysplasia - improper formation of the knee joint during fetal development. The baby is born with defects in the structure of bones, cartilage, muscles and ligaments. All this subsequently causes the development of degenerative changes in the menisci.

In contrast to adults, in children with injuries, the lateral meniscus is more often damaged. Blockades of the knee joint in childhood and adolescence are rare.

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Menisci are layers inside the knee joint between the surfaces of the bones of the thigh and lower leg in the form of a crescent, consisting of cartilage tissue.
There are medial (inner) and lateral (outer) menisci. Conventionally, in the meniscus of the knee joint (ISS), the posterior horn, anterior horn and body are isolated.
Cartilage discs evenly distribute the load on the knee joint, reduce surface friction and act as a shock absorber when moving.
Degenerative changes are the loss of function and the process of reverse development of cartilage resulting from trauma, developmental anomalies, or after a disease. The outer meniscus is less prone to injury than the inner meniscus due to better mobility.

separation of cartilage at the attachment site;
rupture of the body, anterior or posterior horn;
excessive mobility in case of damage to the intermeniscal ligaments;
cyst formation;
meniscopathy - degenerative-dystrophic changes that develop after injuries.

Types of dystrophic lesions

Degenerative changes in the ISS occur in people of all ages. The risk group includes patients whose activities are associated with active movements: ballerinas, athletes, dancers.

changes in the development and formation of tissues (dysplasia);
gout, rheumatism, osteoarthritis, bone tuberculosis and other diseases affecting the knee joint;
sprain;
flat feet (change in the shape of the foot);
excessive physical activity;
obesity.

Symptoms of lesions of the meniscus of the knee joint depend on the causes of the disease.
Distinguish between acute and chronic knee injury.
The main symptoms include swelling of the joint, redness, limited mobility, pain. In severe injuries, blood can enter the joint cavity.

The duration of the acute stage depends on the causes of the disease.
After ten to fourteen days, the acute stage becomes chronic. At this stage, the patient complains of pain, aggravated by movement. A characteristic feature is the appearance of a crunch and clicks when walking, when feeling, the articular roller is determined. Cartilage tissues become thinner, joint instability develops, thigh and lower leg muscles atrophy. The patient is advised to lie more so as not to load the injured leg.
If left untreated, meniscopathy may develop contractures (restriction of joint mobility).

pain syndrome;
puffiness;
restriction and stiffness of movements;
clicks and crunch when bending and unbending the knee;
blockade of the articulation in a bent position.

In the first degree of dystrophic changes in the cartilaginous tissue, minor damage to the horn, swelling and soreness of the knee occur. After three weeks, the symptoms described above disappear. The development of the first degree of dystrophic changes in the medial meniscus is possible with injuries received when jumping, squatting with a heavy load, moving along an inclined plane.
In the second (severe) degree, the intensity of pain increases, swelling of the tissues increases. Blood accumulates in the joint bag, the meniscus horn breaks off and its parts enter the joint cavity, causing blockade of movements. At this stage, a surgical operation is indicated.

Damage to the lateral ISS is more common in childhood and adolescence.
Main symptoms:
pain in the tissue area of the collateral ligament;
a pronounced inflammatory process in the synovial membrane (synovitis);
discomfort and pain in the area of the peroneal fold;
decreased muscle tone of the anterior femoral part.

If the external cartilage is torn, then the knee is at a 90° angle and the patient can unlock it himself. The symptoms of this pathology are mild and difficult to diagnose due to the inconsistency of pain. There is a congenital anatomical anomaly, which is sometimes confused with a rupture of cartilage tissue - a disk-shaped (solid) lateral meniscus. When torn, the cartilage is in the shape of a disc. A continuous external meniscus is determined mainly in adolescents, but also occurs in older people.
The most common damage to the internal ISS is the rupture of its middle part with the integrity of the ends.

Types of damage:
rupture of the ligament that fixes the organ;
rupture of the cartilage itself;
cartilage rupture.
Blocking the knee with limiting its flexion temporarily provokes the separation of the anterior horn of the ISS with pinching. After unlocking, movement in the joint is restored. A more serious injury, in which blocking, bending and popping out of the knee joint occurs, includes injury to the posterior horn of the internal meniscus.

Acute injuries of the ISS in 85–90% of cases are diagnosed by characteristic signs:
blockade of the knee joint in a certain position of the leg;
the appearance of pain and clicks when trying to straighten the lower limb.

To clarify the diagnosis, resort to instrumental research:
With the help of x-rays, the stage of degenerative damage is determined. At the first degree, the image shows an uneven narrowing of the joint gap, at the second - bone growths appear on the articular surfaces.
Having made an MRI and CT scan, the degree of damage and tissues of the knee joint are determined in a three-dimensional image: articular surfaces, ligamentous apparatus, articular cavity and bones. In the sagittal (imaginary vertical) plane, the cartilage lining is butterfly-shaped. When ruptured, the meniscus adjoins the posterior cruciate ligament, enters the intercondylar fossa of the femoral bone, and the symptom of "double posterior cruciate ligament" is determined.
Arthroscopy allows you to determine the condition of tissues and joint (synovial) fluid using an endoscope inserted into the joint cavity through minimal incisions.

Methods of therapy for changes in the ISS depend on the causes, stage and form of disorders. Acute injuries are treated conservatively.
The patient immediately after the injury must be provided with complete rest.
Apply a cold compress or ice pack to the inner thigh.
To stop a strong pain syndrome, narcotic analgesics are used, since other painkillers do not bring relief to the patient.
The injured limb is immobilized (immobilized) by applying a plaster cast for two weeks.
In order to eliminate edema and restore movement in the knee joint, it is punctured. In the first three to four days of active release of fluid (exudate) into the joint capsule, the cavity is punctured several times.

The duration of treatment for degenerative-dystrophic changes in the menisci is from six to twelve months.
With the blockade, the knee joint is repositioned (reduced) using manual methods.
To restore the damaged cartilage tissue of the ISS, hyaluronic acid and chondroprotectors are prescribed.
Non-steroidal anti-inflammatory drugs are used to relieve pain and signs of inflammation (keyver, dona, sinarta, ibuprofen, indomethacin).
To reduce edema and speedy recovery of the damaged ISS of the first-second degree, ointments are used externally on the skin (dolgit, diclofenac, voltaren).
Physiotherapeutic procedures (UHF, shock wave therapy, ozocerite, iontophoresis) and exercise therapy are prescribed.
Massage of the affected area of the knee has a good restorative effect.

With the second degree of severity of degenerative changes in the internal meniscus (ruptures, displacement, separation of the anterior and posterior horns of the ISS, cartilage crushing), surgical intervention is indicated.
It includes: removal of cartilage of a completely or damaged horn, suturing of the gap, fixation of detached horns, transplantation (transplantation).
A minimally invasive surgical procedure includes arthroscopy, in which an arthroscope is inserted through two incisions up to one centimeter, the torn part of the meniscus is removed and its inner edge is aligned.

In transplantation, the following prostheses are most often used:
A sliding prosthesis is used to replace worn-out internal or external ISS.
Surface substitutes are used for more pronounced destruction (abrasion) of cartilage tissue.
With the help of a rotational prosthesis, fixed with pins in the femur and tibia, the knee joint is replaced.
A hinged prosthesis allows replacing the entire joint and guaranteeing its stabilization.
All operations are carried out only after reducing the signs of acute inflammation.
After the surgical operation, rehabilitation measures are carried out to restore the functions of the knee joint, namely: therapeutic exercises, massage and physiotherapy.
Physical activity for the operated patient is categorically contraindicated.

In the treatment of degenerative injuries of the ISS, a significant role is given to therapeutic exercises and massage, due to the fact that the restoration of damaged tissues occurs faster with adequate physical activity, prevents the development of contractures and allows you to return the lost range of motion in the joint.
Exercise therapy during immobilization is carried out for intact sections of the lower limb, and when removing a plaster cast or splint, gymnastics is aimed at restoring the joint. The load is gradually increased by adding exercises with weights and on simulators.

Goals of rehabilitation:
pain reduction;
improvement of blood circulation;
return of muscle tone of the injured limb;
restoration of the full range of motion of the knee joint.
A set of exercises, their intensity, is developed by the doctor individually for each patient, based on the complexity of the disease and the injury.
With conservative treatment of meniscal injuries, exercise therapy begins two to three weeks after the injury, and after surgery - two months later.

If a person takes care of his health and adheres to basic preventive measures, then the risk of ISS injuries is reduced by 90–95% of cases.
It is necessary to go in for sports in stable, well-fixed and comfortable sports shoes that can minimize the risk of falling.
For even and safe distribution of the load, fix the knee with special pads (knee pads, orthoses, bandages) or an elastic bandage.
Before physical work or sports, it is necessary, gradually increasing the range of movements, to warm up, warming up the muscles and joints.
Control body weight, do exercises and eat rationally, but do not overeat, as excess weight increases the load on the joints.

Degenerative changes in the ISS are very common and are manifested by various types of pathologies, some of which require immediate medical attention to clarify the diagnosis and prescribe adequate treatment. A timely visit to a specialist will help preserve the functionality of the knee and prevent the involvement of other joint tissues in the pathological process.

Degenerative changes in the menisci of the knee joint occur for various reasons, the most common of them: excessive loads and dystrophic processes that develop in elderly patients. These cartilage pads perform an important function - they protect the hard tissues of the joint. In addition, the menisci act as shock absorbers. They take on a significant part of the load, due to which the structure of articular cartilage and bone heads is preserved longer.

There are lateral (outer) and medial (inner) meniscus. Both cartilages may undergo changes. Degenerative processes usually develop under the influence of a number of factors:

congenital pathologies;
joint diseases;
injury.

Most often, the pathology of the meniscus develops in old age, when the structure of cartilage tissues changes.

The risk group also includes people who regularly experience significant physical exertion: professional athletes, loaders, etc. Any careless movement can lead to degenerative changes in the lateral meniscus or medial cartilage. In case of injury, the integrity of the ligaments is violated, and the cartilaginous and bone tissues are affected. The changed position of the bones or torn ligaments cause redistribution of the load on the joint. As a result, mucinous degeneration of the meniscus develops.

The nature of pathological processes can be different. Sometimes a cyst develops in the meniscus - this is a neoplasm in the cartilaginous tissues, inside of which fluid is contained. This condition is defined as mucoid degeneration.

There is another type of pathology - meniscopathy. In this case, there are dystrophic changes in the structure of cartilaginous tissues caused by a chronic disease of the musculoskeletal system (osteoarthritis, rheumatism) or trauma.

In addition, degenerative damage to the inner meniscus or outer cartilage can occur. Consequences:

detachment from the attachment point;
excessive mobility;
violation of the integrity of the meniscus.

Signs in any of the cases will be different. The more severe the damage, the more pronounced the pain.

Most types of joint pathologies affect the menisci. With injuries, symptoms appear immediately. If degenerative processes are the result of a disease of the musculoskeletal system, discomfort increases gradually. Damage to the medial meniscus may be accompanied by hemorrhage into the joint cavity. This condition is called hemarthrosis. Symptoms common to all pathologies:

pain of varying intensity;
puffiness;
skin redness;
extraneous sounds (clicks) that appear in the knee area when moving;
change in the shape of the joint;
difficulty in movement, there is a feeling of interference in the knee;
blockade of the leg, which manifests itself in a bent position.

If mucoid degeneration occurs, edema occurs. This condition is accompanied by intense pain. The most common sign of degenerative-dystrophic processes is an extraneous sound (click) emitted by the joint during movement.

With injuries, rentals usually occur - conditions in which excessive mobility in the knee is felt. This may be due to displacement, separation from the place of attachment of the meniscus.

With injuries, pathology is much easier to identify, since in this case the symptoms appear acutely. Damage to the outer meniscus happens more often because this cartilage is more mobile.

If there is a blockade of the joint at a certain position, a crunch occurs, in most cases this means that a pathology develops in the meniscus. But moderate degenerative and dystrophic processes are not so obvious, which complicates the diagnosis. Signs may not appear soon, but only if the disease of the musculoskeletal system develops strongly enough.

To confirm the diagnosis in case of damage to the external or internal meniscus, an additional examination is prescribed:

Radiography. In this case, the pathological process can be determined using a contrast agent.
MRI. More accurate method. With its help, the degree of wear of cartilaginous tissues, as well as their damage, is detected in a timely manner.
CT scan.
Endoscopy. With the help of an arthroscope, an internal examination of the knee joint is performed. This method allows you to identify pathology when examining tissues using a small video camera, which is inserted into the articular cavity and transmits the image to the monitor.

For most types of pathologies in the menisci of the knee joint, conservative treatment is ineffective. This method can improve the condition with deformations of the medial cartilage. Medications help prevent the development of pathology: stop the inflammatory process, eliminate pain and swelling. However, if the question is how to treat the joint with degenerative changes in the meniscus, you should know that conservative therapy does not completely cure the knee.

When the first symptoms appear, it is necessary to reduce the load on the affected joint. First you need to eliminate the signs of the acute form of the disease, since in this state it is forbidden to carry out any manipulations. To exclude displacement, a fixing bandage or splint is applied for 2 weeks.

With hemarthrosis, a puncture is indicated. This procedure removes the accumulated blood. Due to this, swelling, pain intensity decreases, mobility partially returns.

Prescribe analgesics. These drugs relieve pain. This is not always possible to do using non-steroidal drugs (Ibuprofen, Diclofenac), therefore, with pronounced degenerative processes in the meniscus, narcotic drugs are prescribed - Promedol and the like. In some cases, it is recommended to use anti-inflammatory drugs. Glucocorticosteroids are injected into the joint.

After removing the tire, when the manifestations of an acute condition have been eliminated, they proceed to the next stage - physiotherapeutic procedures (phonophoresis, UHF, ozocerite, iontophoresis), as well as exercise therapy.

Physical exercise strengthens the muscles, which helps to reduce the load on the joint and menisci in particular. At the initial stage, static exercises are performed. In this case, there is no load on other parts of the body, only the muscles of the affected limb are involved.

These are drugs of a special group. They are offered in different forms: injections, tablets. The main purpose of such drugs is the restoration of cartilage tissue, the cessation of degenerative processes. In addition, chondroprotectors significantly reduce the likelihood of developing pathology in the future. They deliver nutrients to the joint.

With degenerative changes in the meniscus, the following is prescribed:

Protecon. This combination drug relieves pain, prevents the development of inflammation, restores cartilage tissue.
Don. A drug that affects the metabolic processes in cartilage.
Teraflex. The composition includes substances that are related to the compounds contained in cartilage tissue. Indications for use: any degenerative-dystrophic processes in the joints, which are the result of chronic diseases, such as osteoarthritis.
Artron. The drug helps to restore cartilage exposed to intense physical exertion, as well as injuries and diseases of a different nature.

Serious pathologies (highly developed degenerative processes, deformation, detachment from the place of attachment) cannot be treated with a conservative method. In such cases, the joint is restored by surgery. The entire knee may need to be replaced with a prosthesis. Use a sliding, rotational, hinged or superficial prosthesis.

What are degenerative meniscus changes?

Degenerative changes can be different:

detachment from the place of attachment;
rupture of the horns and body of the meniscus;
excessive mobility as a result of rupture of intermeniscal ligaments;
cyst - the formation of cavities filled with fluid inside the cartilage;
meniscopathy - dystrophic changes that develop under the influence of minor injuries, as well as a complication of gout, osteoarthritis, rheumatism, tuberculosis and a number of other diseases.

Characteristic symptoms

Tears, detachments from the place of attachment are often chronic and are manifested by the periodic appearance of pain and a feeling of interference in movement.

There is such a diagnostic test: go up and down a ladder or slope. With pathology of the meniscus, when moving down, the pain in the knee increases.

* Rentals - sensations of pathological mobility, instability and displacement of the articular surfaces of the bones.

Common to all types of meniscus degeneration are the following symptoms:

pain,
swelling,
blockage of the joint in a bent position or sensation of a foreign body in the knee,
clicks and crunches,
swelling of the knees with a long absence of movement.

Causes of degeneration

More possible reasons:

dysplasia - abnormal formation of the knee joint;
gout, syphilis, tuberculosis, rheumatism and other diseases that can affect the joints;
sprains, as well as their incorrect formation;
flat feet (low depreciation of the foot is compensated by an increased load on the knee);
high physical activity;
excess weight.

Diagnostics

MRI allows you to get a three-dimensional image of all tissues of the knee: the articular surfaces of the bones, the ligamentous apparatus and the joint itself.
During arthroscopy, an endoscope is inserted into the joint cavity through a miniature incision, with the help of which the state of tissues and synovial fluid is monitored (on the monitor).

Treatment Methods

Therapy for degenerative changes in the menisci depends entirely on the nature of the damage. Acute injuries serve as a direct indication for the use of conservative methods of treatment:

First of all, the joint is punctured, eliminating its swelling and restoring mobility. Sometimes several procedures are required, since active exudation (release of inflammatory fluid) in the joint lasts up to three to four days.
Analgesics are prescribed, preference is given to narcotic drugs (Promedol and its derivatives), because other drugs in this case, as a rule, are not able to relieve the patient of pain.
Chondroprotectors provide the body with the necessary substances to restore the damaged area of the meniscus.
Anti-inflammatory drugs.
At the stage of rehabilitation, physiotherapeutic methods serve as an auxiliary means - ozocerite, UHF, iontophoresis, shock wave therapy.
For 14 days, a splint is applied to the straightened leg, which ensures fixation of the joint in the required position.

Chronic dystrophies, joint dysplasia and abnormal development of the ligamentous apparatus require exclusively surgical treatment.

If the cause of degeneration is chronic diseases such as rheumatism and gout, along with surgical methods, the underlying disease is also treated (diets, immunocorrectors and other methods).

Degenerative changes in the menisci are its anatomical damage that occurs after injury, a previous disease or an atypical structure of the joints. Most often, pathological changes in the menisci occur as a result of injuries, when the cartilage disc is damaged and provokes attacks of pain. Degenerative damage to the inner meniscus occurs more often in men than in women. It appears in almost half of the cases.

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General information

The human body is an extremely complex mechanism and its work must always be adjusted. Articular cartilage act as shock absorbers that normalize and facilitate joint mobility. Cartilaginous tissue, being in the knee joint in the form of menisci, helps to reduce surface friction, improve joint rotation and limit mobility. There are two menisci in the knee joint: external (lateral) and internal (medial).

Degenerative changes in the cartilage pads of the knee joint are characteristic lesions that are the result of injuries (often in athletes), they can be complicated by the course of the disease or structural features of the joint. Among all joint diseases, degenerative changes in the meniscus are in the first place.

Signs of change are:

rupture of the horns and the body of the meniscus itself;
the formation of a hollow cyst, which is filled with fluid;
the development of meniscopathy, the process of degeneration that occurs as a result of rheumatism, tuberculosis;
cartilage detachment;
rupture of the ligaments that connect the menisci.

The meniscus is called the cartilaginous layer inside the knee joint, which mainly performs a shock-absorbing function. Ruptures of the joint linings can occur after injuries that occur in young people during physical exertion, and can also be degenerative, which occur in older people and can develop without injury against the background of degenerative changes in the meniscus, which is a variant of the course of knee arthrosis.

Lack of treatment for a traumatic rupture can lead to the fact that it later becomes a chronic pathology.

To diagnose a meniscus rupture, an ultrasound, MRI is necessary. Meniscus tears can be in the anterior horn, posterior horn, and in the body of the meniscus. Damage to the meniscus can lead to mechanical obstruction of movement, and cause pain syndromes.

The dangling part of the meniscus provokes the destruction of neighboring cartilage.

With a traumatic rupture of the meniscus, there is swelling of the knee joint and pain. If the rupture occurs in a place where there are vessels, then hemarthrosis occurs. It is manifested by swelling above the kneecap. If the cartilage pad is damaged, the part that has come off and dangles can interfere with free movement in the knee. Small tears can cause painful clicking or a feeling of stiffness. With large ruptures, blockade of the joint may occur due to the fact that the torn fragment of the cartilage lining has moved to the center of the joint and provokes a "jamming" of the joint.

When the posterior horn of the meniscus is torn, the process of flexion is limited, when the body of the meniscus or its anterior horn is torn, pain occurs during the process of extension in the knee joint. Pain syndromes when the posterior horn of the meniscus is torn can be so severe that it is impossible to step on the foot, and sometimes a meniscus rupture is manifested only by pain during certain movements.

With an acute tear of the anterior cruciate ligament, swelling can develop faster and be more pronounced. Damage to the lateral cartilage lining also occurs. Degenerative cartilage tears can occur at the slightest physical exertion, especially when it comes to the older generation. A degenerative tear of the medial meniscus often damages the adjacent cartilage that covers more of the tibia and femur.

General symptoms of cartilage damage:

clicks and crunch;
puffiness;
soreness;
when you stay in one position for a long time, the knees leak;
blockade of the joint with bent knees.

Causes of a meniscus lesion

The structure and anatomical features of the location of the menisci cause a high incidence of pathologies in different age categories. Athletes who are prone to ruptures, injuries and cysts are at risk.

Possible causes of cartilage lining ruptures:

improper formation or sprain of ligaments;
flat feet;
improperly formed knee joint;
the presence of gout, syphilis, tuberculosis, rheumatism and other diseases that can affect the joints;
excess weight.

Forms of the disease

Damage to the external meniscus of the knee joint.

Injury to the lateral meniscus is extremely rare in adults. This happens more often with children and teenagers. As a result of such an injury, blockade rarely occurs.

Symptoms of a lateral meniscus injury include:

pain syndromes in the tissues in the area of the collateral ligament;
pronounced synovitis;
unpleasant sensation of pain in the area of the peroneal ligament;
low tone in the muscles of the front of the thigh.

With a rupture of the external cartilage, the knee joint can be bent at a right angle and the patient himself can unlock it. In general, the signs of this injury are not very pronounced. Diagnosing such an injury is quite problematic due to intermittent pain. A congenital anomaly of development is possible - a continuous (disc-shaped) outer meniscus. It is easily confused with cartilage rupture. With this pathology, the cartilage has the shape of a disk. Signs of a continuous external meniscus may appear during adolescence, and may also be found at an older age.

Damage to the medial meniscus of the knee joint

A common injury to the medial meniscus is a tear. Basically, there is a break in the middle part, while the ends remain intact.

There are three types of damage to the medial meniscus:

rupture of the ligament that fixes the internal organ;
rupture of the cartilage itself;
rupture of cartilage tissue.

Tearing with pinching of the anterior horn of the medial meniscus causes blockage of the knee joint that does not cause knee flexion. This phenomenon is temporary, as unblocking will restore movement in the joint. Damage to the posterior horn of the medial meniscus is a more serious injury. in this case, blocking, jumping out and bending the knee occurs.

Chronic process of degeneration and meniscus injury

The process of damage to the left and right cartilage to the same extent.

Causes of meniscal degeneration include:

sharp extension of the leg;
deposition of mucin in tissues;
severe injury;
rheumatism;
gout.

Diagnosis of the disease

Diagnosis of the disease can be carried out using the following studies:

Magnetic resonance imaging;
CT scan;
radiography;
Diagnostic arthroscopy.

In order to identify the exact diagnosis - a meniscus tear, you should consult a specialist. He needs to tell him under what circumstances you experience pain. Any change in the menisci causes pain. On examination, the hip and knee joint are examined. With effusion, hemarthrosis or synovitis may be suspected.

Researching

Radiography - is performed for any pain in the knee joint. It is carried out in such projections:

Lateral projection;
Direct projection in a standing position, and when bending the knees at 45o;
Axial projection.

MRI - allows you to see the cartilage in several planes, to assess the condition of other periarticular and articular formations, which is important if there are doubts about the diagnosis. MRI in diagnosing problems with the meniscus has an accuracy of up to 95%. In the sagittal plane, the cartilaginous lining takes on the shape of a butterfly. When ruptured, a symptom of a "double posterior cruciate ligament" occurs, when the meniscus is adjacent to the posterior cruciate ligament and is in the intercondylar fossa of the femur.

Treatment

After the diagnosis and confirmation of the diagnosis, the specialist prescribes complex therapeutic methods, including a set of such measures:

puncture from the knee joint;
appointment of physiotherapy: phonophoresis, UHF, iontophoresis, ozocerite;
the appointment of analgesics, drugs containing narcotic substances (Promedol), NSAIDs, chondroprotectors (provide the body with substances that help restore the damaged area of the meniscus).

For 2 weeks, a splint is applied to the straightened leg, which ensures the fixation of the joint in the desired position. With ruptures, chronic dystrophy, joint dysplasia, surgery is performed. In the presence of gout or rheumatism, the treatment of the underlying disease that provoked the process of degenerative changes is also carried out.

The main method of treatment of pathologies of the knee cartilage is surgical intervention. Arthroscopy is performed, the operation is carried out through two incisions one centimeter long. The torn part of the meniscus is removed, and its inner edge is aligned. After such an operation, the recovery period depends on the condition of the patient, but on average it ranges from 2 days to several weeks.

The pair of pads of cartilaginous tissue present in the human knee joint are called menisci. Like the cartilaginous discs of the spine, the menisci perform both shock-absorbing and stabilizing functions, protecting the joint from excessive movement and excessive stress.

To increase functionality in the human knee, there are as many as two types of elastic formations:

External (lateral).

Internal (medial).

And although pathological changes in the menisci do not pose a mortal threat, the quality of life of a patient with any pathologies, including meniscus rupture, invariably falls.

Degenerative changes in the menisci - what is the danger

Degenerative changes are called acquired anomalies of the anatomy of the organ, the cause of which is mechanical damage or any, perhaps even unconscious, injury to the joint. Unlike the outer, more mobile and mobile meniscus, the inner one is rigidly connected to the lateral knee ligament, which often leads to injuries accompanied by severe pain.

The most common degenerative cartilage changes are:

Violation of the integrity of the ligament at the attachment points of both horns or the body in the paracapsular region.

Transchondral ruptures of the body and horns of the meniscus.

Meniscopathies of various etiologies, which lead to complications after infectious and a number of autoimmune diseases.

Rupture of intermeniscal ligaments, leading to pronounced degenerative changes in the joint.

Clinical picture

The manifestations of the disease are quite diverse and directly depend on the nature of the damage. The following signs of degenerative changes can be considered common:

Pronounced pain syndrome.

A distinctly audible crunch and single clicking sounds in the knee joint.

Inability to fully extend the leg.

The illusion of the presence of a foreign body in the knee.

puffiness

Morning stiffness of movement, disappearing after attempts to disperse.

Causes of pathology

Most often, degenerative changes are observed among people who lead an active lifestyle and sufficiently load the knee joint.

In addition, anatomical damage can be caused by dysplasia, heterogeneous and infectious diseases of the internal organs, injuries of the lower extremities, and pathological changes in the shape of the foot.

Excess body weight and excessive physical activity can also provoke violations of the integrity of the meniscus.

Diagnostics

In the absence of pronounced symptoms that clearly indicate the degenerative-dystrophic nature of the damage, the doctor prescribes a number of non-invasive research methods designed to clarify the diagnosis:

MRI, thanks to which the doctor can see the affected area in different planes.

Arthroscopy, which allows you to examine damage from the inside, using an endoscope inserted into the joint.

Therapy

Depending on the nature of the damage, the doctor chooses a type of therapeutic measures, the task of which is to combat the manifestations of pathology.

If the symptoms of the disease are acute, conservative therapy is recommended. After the puncture, the doctor prescribes potent painkillers designed to reduce the manifestations of acute pain.

The next treatment stage includes the use of chondroprotectors, anti-inflammatory drugs and physiotherapy. Two weeks later, after the limb has partially regained its mobility, a splint is placed on it to fix the joint.

If the damage to the joint is in the nature of an injury, as well as in the case of a chronic manifestation of the disease, the best treatment would be surgery.

In order to keep the knee joint healthy, it is recommended to get a qualified consultation from a Koleno21 specialist at the first signs of degenerative changes. This is the only way you can stop the attack and prevent its further spread.

Degenerative changes in the menisci of the knee joint are common injuries in any age group. Damage is typical for athletes, but ordinary people are also quite common.

The occurrence of dystrophic changes leads to the fact that the motor system is disturbed. Accordingly, it is very important to undergo a course of treatment in a timely manner in order to prevent the consequences. That is why, when the first symptomatology occurs, you need to go for a consultation with doctors without wasting time. The course of treatment takes a long time.

To fully understand the severity of the damage, you need to know what the meniscus is for. This is a cartilage tissue that plays the role of a shock absorber in the joint, as well as stabilizing the knee. The meniscus affects the improvement of rotational movements of the entire joint.

Background of the disease

There are two menisci in the knee:

internal, or lateral;
external or medial

Anatomy of the menisci in the joint

Due to structural features of the joint or genetic predisposition degenerative changes in the medial meniscus occur much more frequently, especially in the posterior horn. There are no arteries in the meniscus; accordingly, a complex course of treatment is prescribed. With the onset of the disease on the knee, swelling immediately forms, pain begins to disturb.

The main causes of meniscus degeneration.

Gradually happening joint wear, accordingly, it is simply impossible to avoid the problem with the full-fledged work of the knee in the older age category.
Changes in the knee occur due to sudden stress on the joint when stretched. Moreover, a break is possible.
The risk group includes people who perform every day physical exercise.
The cause may be anatomical or genetic predisposition.
Previously transferred inflammation of the knee joint. In cases of damage to the medial meniscus, the formation of a hollow cyst, filled with fluid, is observed.

Symptoms of the degenerative process

There are two types of damage:

The main symptomatology of the change in the posterior horn of the medial meniscus;

An acute type of degenerative injury to the knee meniscus can proceed for a long time. The chronic appearance can occur after 2 weeks after the rupture has occurred. Pain becomes stronger and is permanent. The feeling of pain may not leave even in the process of movement. Experts strongly recommend to observe bed rest, so as not to injure the leg even more. When the patient begins to walk, a crunch or click may appear - this signals a disease of the joint. When probing the diseased part of the body, it is possible to feel the articular roller.

With chronic degenerative damage to the medial meniscus, thinning of cartilage tissue often occurs. The general clinical manifestations of the change look like this:

redness on the knee;
severe pain, which in the process of walking only intensifies;
crunchy feeling during movement.

Reasons for the development of changes

Degenerative-dystrophic changes in the meniscus can be diagnosed in a person at any age. The risk group includes people involved in sports professionally. The gap occurs due to an incorrect sharp movement.

Among other reasons, the presence of flat feet, a previously obtained sprain or incorrect formation of the knee joint, problems directly related to the destruction of the joints (syphilis, gout, tuberculosis, rheumatism, and others) are also distinguished. The main role is played by the mass of the human body. With excessive weight, the likelihood of pathology formation increases significantly.

Characteristics of traumatic and degenerative meniscus rupture

Degenerative rupture of the posterior horn of the medial meniscus is characterized by periodic pain. This injury occurs more often in older people. The patient has swelling of the injured knee. Given the severity of the change, the course of treatment lasts quite a long time. The patient is prescribed a comprehensive treatment, taking into account all individual characteristics, the degree of damage. It is strictly forbidden to self-medicate or resort to folk methods, this will not show the desired result, time will be lost, and complications may arise accordingly.

The rupture of the lateral meniscus of the knee joint is mainly traumatic. The patient immediately begins to be disturbed by severe pain, redness occurs, due to the fact that blood accumulates in the damaged area, and swelling of the knee also occurs. Accordingly, the patient must immediately seek medical help.

Diagnostics and methods of treatment of the damaged knee joint

In cases where the patient has experienced a degenerative-dystrophic rupture of the meniscus of the knee joint in an acute form, confirm the diagnosis quickly enough, due to the fact that in this period of time the symptoms of the pathology are pronounced. There are certain difficulties in the chronic form of pathology. In this situation, the patient is given passing a certain test.

The course of treatment is directly related to the severity of the damage. Degenerative changes in the medial meniscus are treated with conservative ways. In cases where the patient has an accumulation of blood in a part of the affected joint, he is prescribed strict bed rest, the complete exclusion of stress on the injured knee. As a rule, the course of treatment lasts from 1 to a month. The patient is prescribed special physiotherapy procedures, as well as physiotherapy exercises, all exercises are performed under the supervision of specialists.

It must be remembered that all procedures and exercises begin to be performed only when the elimination of the inflammatory process. In situations where conservative treatment did not show the desired result, or the patient had a rupture of the internal meniscus, it is prescribed surgical intervention because surgery is the only way to help.

A few words about the meniscus

Degenerative processes of the meniscus are divided into 5 types:

Rupture of meniscus ligaments. In this case, the knee becomes unnaturally mobile in all directions. This can cause a dislocation, fracture, or other injury. The very integrity of the joint when the ligaments are ruptured is not broken.
Meniscopathy. This is the most classic case, when the cartilage gradually becomes thinner and ceases to perform its functions. The root cause may be arthrosis, gout and other diagnoses of the patient.
Meniscus tear. The cartilage is displaced from its anatomically correct position. The person becomes limited in movement.
Cystosis. With this disease, formations are formed in the cartilage cavity that interfere with the normal functioning of the meniscus. Over time, they deform and all surrounding tissues.
Degenerative rupture of part of the meniscus. This can be either the cartilage body itself or its horns.

The most common degenerative changes occur in the posterior horn of the medial meniscus. They are based on long-term microtraumas and chronic diseases, that is, these are physiological damages.

Causes

More often they talk about provoking factors that contribute to the appearance of degenerative processes in the menisci.

Elderly age

Athletes

flat feet

Inflammatory diseases

Other reasons

The list continues:

Persons who squat or stand for long periods of time. In the squatting position, all vessels and nerve endings are pinched. In a standing position, stagnation also occurs in this joint, which negatively affects its condition.
congenital anomalies. So, even ordinary walking with knee dysplasia, that is, the wrong position of the bones in the joint, provokes the initiation and progression of degenerative changes.
Metabolic diseases. This is not only gout, familiar to everyone, in which the deposition of uric acid salts completely disrupts the nutrition of the joint, but also hypothyroidism, cirrhosis of the liver and many other diagnoses.
Injuries. The specialist will ask about them first of all. If there is a history of damage to the articular parts of the knee, then the likelihood of developing degenerative processes is very high.

Injuries to the meniscus can sometimes be combined with injuries to other joints, such as the anterior cruciate ligament. Traumatologists see this combination regularly.

Degrees of damage

In total, 4 types of joint condition are noted:

Zero degree. If a person sees these words in his card, then he can calm down. Zero degree is an absolutely healthy meniscus without any changes. All its structures work without deviations.
First degree. Changes are only inside the meniscus, but they do not reach the outer shell. For this reason, such injuries are very poorly diagnosed by traditional methods - x-rays and even ultrasound. X-ray will be informative in cases where the damage has already affected the bone structure. The most informative for degenerative changes of the 1st degree is magnetic resonance imaging, which will very clearly indicate the difference in the density of the joint structure. Degenerative signs on MRI are enough to initiate appropriate treatment.
Second degree. There is a more extensive meniscus lesion, but it still does not reach the outer shell. These changes in some cases can be seen on ultrasound. Sometimes a specialist doubts what kind of severity to determine the disease in a particular patient, and he writes "1-2 degrees according to stoller." The second degree according to stoller is a rupture of the meniscus, but in this case, a violation of the integrity of the meniscus has not yet been recorded.
Third degree. This is the 2nd degree in stoller. The rupture at the 3rd degree of joint damage can be complete or partial, which determines the tactics of therapy by the doctor.

Symptoms

The most striking symptoms appear as a result of a meniscus injury:

sharp, severe pain that does not go away even at rest;
the appearance of swelling in the knee area;
hemorrhage into the joint cavity (hemarthrosis);
pathological movement of the joint (too active, in all directions, or, conversely, restriction if you want to bend the knee).

Treatment

Unfortunately, conservative methods are not always effective, and relapses often occur.

The knee joint is the most frequently operated on, which is understandable. The knees, along with the elbows, a person uses much more than the rest of the joints of the skeleton.

Article publication date: 03/24/2014

Article last updated: 03/29/2019

What are degenerative meniscus changes?

Degenerative changes can be different:

detachment from the place of attachment;
rupture of the horns and body of the meniscus;
excessive mobility as a result of rupture of intermeniscal ligaments;
cyst - the formation of cavities filled with fluid inside the cartilage;
meniscopathy - dystrophic changes that develop under the influence of minor injuries, as well as a complication of gout, osteoarthritis, rheumatism, tuberculosis and a number of other diseases.

Characteristic symptoms

If you are pursued by aching, which then disappears, then appears with renewed vigor - it can already be assumed that there are changes in the meniscus. About 90% of pathologies of the knee joint are due to damage to the "shock absorber".

Symptoms largely depend on the nature of the pathology. Tears are accompanied by severe pain, blockade of the leg in a bent state and swelling. With a serious one, hemorrhage often occurs in the articular cavity -. Significant swelling and severe pain are also characterized by meniscal cysts.

Tears, detachments from the place of attachment are often chronic and are manifested by the periodic appearance of pain and a feeling of interference in movement.

There is such a diagnostic test: go up and down a ladder or slope. With pathology of the meniscus, when moving down, the pain in the knee increases.

The chronic course is also characterized by secondary degenerative-dystrophic transformations in the medial meniscus, that is, those that have arisen due to other pathologies of the body or diseases. Often in such cases there are clicks and rolls * of the joint in motion after a long rest, sometimes there is pain in the knees. The increase in symptoms occurs gradually as the cartilage layer thins and salts or uric acid crystals accumulate in it (the latter - with gout). In the absence of adequate treatment, the final stage of meniscopathy becomes - a stable violation (limitation) of joint mobility.

* Rentals - sensations of pathological mobility, instability and displacement of the articular surfaces of the bones.

Common to all types of meniscus degeneration are the following symptoms:

pain,
swelling,
blockage of the joint in a bent position or sensation of a foreign body in the knee,
clicks and crunches,
swelling of the knees with a long absence of movement.

Causes of degeneration

More possible reasons:

dysplasia - abnormal formation of the knee joint;
gout, syphilis, tuberculosis, rheumatism and other diseases that can affect the joints;
sprains, as well as their incorrect formation;
flat feet (low depreciation of the foot is compensated by an increased load on the knee);
high physical activity;
excess weight.

Diagnostics

MRI allows you to get a three-dimensional image of all tissues of the knee: the articular surfaces of the bones, the ligamentous apparatus and the joint itself.
During arthroscopy, an endoscope is inserted into the joint cavity through a miniature incision, with the help of which the state of tissues and synovial fluid is monitored (on the monitor).

Treatment Methods

Therapy for degenerative changes in the menisci depends entirely on the nature of the damage. Acute injuries serve as a direct indication for the use of conservative methods of treatment:

First of all, the joint is punctured, eliminating its swelling and restoring mobility. Sometimes several procedures are required, since active exudation (release of inflammatory fluid) in the joint lasts up to three to four days.
Analgesics are prescribed, preference is given to narcotic drugs (Promedol and its derivatives), because other drugs in this case, as a rule, are not able to relieve the patient of pain.
Chondroprotectors provide the body with the necessary substances to restore the damaged area of the meniscus.
Anti-inflammatory drugs.
At the stage of rehabilitation, physiotherapeutic methods serve as an auxiliary means - ozocerite, UHF, iontophoresis, shock wave therapy.
For 14 days, a splint is applied to the straightened leg, which ensures fixation of the joint in the required position.

Chronic dystrophies, joint dysplasia and abnormal development of the ligamentous apparatus require exclusively surgical treatment.

If the cause of degeneration is chronic diseases such as rheumatism and gout, along with surgical methods, the underlying disease is also treated (diets, immunocorrectors and other methods).

Owner and responsible for the site and content: Afinogenov Alexey.

Your comments and questions to the doctor:

Julia | 03.10.2019 at 08:19

Good afternoon. I really want to know your opinion. My daughter, 13 years old, had an injury 2 years ago, on alpine skiing, an unsuccessful knee rotation led to Chondromalacia of the patella of the 2nd degree, a degenerative change in the posterior horn of the medial meniscus of the knee joint, synovitis. We have been given this diagnosis. The doctor prescribed a course of treatment with chondroprotectors (dona, structum500, piaskledin300). Tell me, please, these drugs will not harm a child of 13 years old (in the instructions, the restrictions are up to 18 years). And what treatment would you recommend. Thank you very much in advance.

Olga | 09/14/2019 at 16:13

Good evening. What is the relationship between gout and menisci? Or rather, why menisci can hurt because of gout, as written in your article. And what to do to stop meniscus degeneration. I was diagnosed with this 2 years ago.

Sergei Lopukhov | 08/27/2019 at 07:34

I play football. The result of an MRI of the knee joint: MRI signs of degenerative changes in the anterior cruciate
ligaments.
MRI signs of injury to the posterior horn of the medial meniscus, grade II according to Stoller. MR-
signs of degenerative changes in the lateral meniscus.

Svetlana | 07/21/2019 at 10:50

Hello.
MRI of the right knee joint in standard projections received T2 WI and RDFSaT.
Joint congruence is preserved. The joint space is moderately narrowed. The contours of the bones are even. The structure of the bones is homogeneous. Articular cartilage without visible defects. In the joint cavity, suprapatellar and deep ifrapatellar bags, a large effusion is determined. The patellar ligaments are preserved, the displacement of the patella is not determined. The tendon of the four head muscles of the thigh and the own ligament of the patella is not interrupted, their structure is homogeneous.
The height of the medial meniscus is reduced, a slightly hyperintense signal is detected in the structure of the posterior horn, which does not pass to the articular surfaces. The height of the lateral meniscus is somewhat reduced, the structure is homogeneous. The anterior cruciate ligament is preserved. The posterior cruciate ligament showed no signs of injury. The course of the medial collateral ligament is preserved, the structure is homogeneous. The course of the lateral collateral ligament is not interrupted, the structure is not changed. The hamstring tendon is not interrupted.
Conclusion: MRI picture of medial meniscus degeneration. Synovitis
Do I need an operation?
Sincerely, S.

Svetlana | 07/01/2019 at 12:10

good afternoon, doctor. Girl, 12 years old, has been doing judo for 2 years.
X-shaped. Apparently there was an injury, but she didn’t feel it. And then she began to notice that her knee hurts when she sits for a long time. MRI: tendonitis of the patellar tendon. degenerative and post-traumatic changes, meniscite) Initial manifestations of degenerative changes in the joint. I would like to know how to treat it, what are the consequences, whether it is possible to continue playing sports (after all, when she moves, nothing hurts).

Alla | 03/29/2019 at 16:41

Hello. On a series of MR-tomograms weighted by T1 and T2 in three projections, T2-tirm and PD-FS (fat suppression), bone-traumatic changes are not determined.
The structure of the bone tissue is not changed, uniform. The cortical layer of bones at the level of the study is even and clear.
In the cavity of the joint, its bags, inversions, a slightly increased amount of fluid is determined, somewhat more pronounced in the patella inversion and in the posterior parts of the joint.
The joint space is not narrowed, the congruence of the articular surfaces of the bones that make up the joint is preserved.
There is some unevenness of the articular cartilage of the patella in the central sections, without signs of a decrease in its height. Articular cartilage in other departments is not reduced in height, uniform.
The lateral meniscus is of regular shape, not reduced in height, its boundaries are clear, even, the MR signal is homogeneous.
The medial meniscus is of regular shape, not reduced in height, its boundaries are even, clear, the MR signal is heterogeneous, mainly in the region of the posterior horn, due to the presence of an area of increased MR signal that does not interrupt the boundaries of the meniscus.
The anterior cruciate ligament can be traced throughout, without features.
The posterior cruciate ligament can be traced throughout, without features.
The integrity of the collateral ligaments is preserved, their contours are even, clear, the signal is not changed.
Own ligament of the patella without features.
Goff intensity without singularities.
Visible soft tissues without pronounced changes.

CONCLUSION: MR-signs of degenerative changes in the medial meniscus (grade 2), mild synovitis. Indirect MRI - signs of initial manifestations of chondromalacia of the patella (grade 1).
Thanks in advance.

Zinaida | 03/17/2019 at 08:15

Good day! I am 51 years old. In 2015, the uterus and ovaries were removed. And after the operation, my weight reached 93 kg, before the operation it was 80. My height is 162. I drink femoston 1/5. I am struggling with weight, but so far there are no special results .. until I let it increase any more. But this is a small digression from my problem.
A year ago, my knees started hurting. Previously, they didn’t bother me much, they crunched a little, but I didn’t feel much pain. Did an MRI. And this is the result I got. I would very much like to know your opinion. Please tell me if you need surgery (knee arthroscopy) or you can get by with a conservative method. Thanks in advance for your reply!
MRI EXAMINATION OF THE KNEE JOINTS № 0191
(MagFinder 0.32Tl)

Left knee joint. On the obtained images in the joint cavity, the upper inversion is determined by an additional significant amount of effusion. Subchondral sclerosis of the articular surfaces that form the knee joint. The joint space is narrowed. The intercondylar eminences, the upper and lower poles of the patella are pointed. MRI signal from the bone marrow of the femur, tibia and patella is not changed. Hyaline cartilage is preserved.
In the posterior horn of the internal meniscus, with the transition to the body of the meniscus, an irregularly shaped hyperintense area is determined, which communicates with the tibial plateau.
In the posterior horn of the external meniscus, a linear, slightly hyperintense area is defined, which runs along the plateau of the tibia and does not emerge on its surface.
The anterior cruciate ligament can be traced in fragments, at the site of its attachment to the tibia, a limited accumulation of fluid is visualized, at the site of its attachment to the femur, an area of inhomogeneous MR signal.
The external lateral ligament is deformed, heterogeneous, with hyperintense inclusions.
The posterior cruciate and internal lateral ligaments are intact.

Conclusion: Rupture of the anterior cruciate ligament. Chronic damage to the posterior horn and the body of the internal meniscus against the background of degenerative changes. Deforming osteoarthritis of the left knee joint 1 tbsp. Degenerative changes in the posterior horn of the outer meniscus. signs of synovitis. Tenosynovitis of the anterior cruciate ligament. Tendonitis of the external lateral ligament.

Right knee joint. An additional significant amount of effusion is determined on the obtained images in the joint cavity, upper inversion, crow's foot pouch. A limited accumulation of fluid is visualized in the popliteal region measuring 18.2x73.6 mm.
Subchondral sclerosis of the articular surfaces that form the knee joint, marginal bone growths. The joint space is narrowed. Intercondylar eminences are pointed. The MRI signal from the bone marrow of the femur is heterogeneous. Hyaline cartilage is preserved.
In the posterior horn of the internal meniscus, an irregularly shaped hyperintense area is determined, communicating with the tibial plateau.
In the posterior horn of the external meniscus, a linear, slightly hyperintense area is defined, which runs along the plateau of the tibia and does not emerge on its surface.
In the projection of the anterior horn of the outer meniscus, a limited accumulation of fluid measuring 5.2x8.4 mm is determined. In the projection of the posterior horn of the outer meniscus, there is a similar accumulation of fluid measuring 5.1x8.1x12 mm.
The anterior cruciate ligament can be traced along its entire length, deformed, heterogeneous, torn, in the place of its attachment to the tibia, a limited accumulation of fluid is visualized, in the place of its attachment to the femur, a patch of inhomogeneous MR signal.
The external lateral ligament is deformed, heterogeneous, with hyperintense inclusions.
The posterior cruciate and internal lateral ligaments are intact.

Conclusion: Chronic damage to the posterior horn of the internal meniscus against the background of degenerative changes. PCC damage. Deforming osteoarthritis of the right knee joint 2 tbsp. Degenerative changes in the posterior horn of the outer meniscus. signs of synovitis. Parameniscal cysts of the external meniscus. Tenosynovitis of the anterior cruciate ligament. Tendonitis of the external lateral ligament. Baker's cyst.

Olga | 03/06/2019 at 07:01

Good afternoon. My daughter in 2012. I had an injury to my right knee joint and was in the hospital with a gibs. During these years, if he turns around uncomfortably or stumbles with his right foot, then his knee hurts. They made an MRI conclusion: at the time of the study, the MRI picture of the gap
anterior cruciate ligament of the right knee. Intra-articular vypod. Vypod in the suprapatellar suture. Degenerative changes in articular cartilage with areas of chondromalacia. Damage. posterior horn of the medial meniscus (Stoller class III). I would like to hear a professional opinion, do you need surgery? daughters 39 years old Inv. childhood 2 gr.

Natalya | 02/19/2019 at 09:35

Good afternoon.
Started to disturb the right knee 3 years ago. There were no injuries. Previously, once every 3-4 months, then more and more often, now maybe once or twice a week. When turning the right leg outward (while the body remains stationary), the knee is blocked and I cannot move my leg. There is no pain, only stiffness and fear. After about a minute, through force I move my leg and there is a click in the place of the knee and everything falls into place. There is no pain.
A month ago, I started running on a treadmill to maintain my figure.
I went to an orthopedist and ordered an MRI. The result of MRI is a picture of degenerative damage to the lateral and medial menisci of the II degree. Degenerative damage to the anterior cruciate and lateral collateral ligaments. Gonarthrosis I st.
The doctor forbade running more expensive, only light physical activity. He ordered Don to drink for 6 weeks, and if changes do not occur, he is offered to do the blockade.
I want to hear your opinion on my diagnosis and treatment options. And is it really impossible to use a treadmill, maybe you can leave walking on it?
I will be grateful for the answer

Faith | 04.02.2019 at 12:08

Good afternoon! I have gonarthrosis of the knee joint. Degenerative damage to the menisci. They suggested doing an operation. But they said it wouldn't help much. Tell me what to do?

Maria | 02/03/2019 at 10:27

Hello. My son is 13 years old, fell ill in May 2018. Pain and lameness of the left knee appeared, the knee swells when walking for a long time. Larsen-Johanson syndrome, arthritis of the left knee joint. Act.1.fn 1. Examination: MRI picture of osteochondropathy of the patella, dystrophic changes in the tendon of the patella (Larsen-Johanson syndrome,) moderate degenerative changes in the medial meniscus; effusion in the joint cavity. X-ray images are signs of bilateral Larsen-Johanson syndrome, bilateral insertional tendinopathy of the patella ligament (changes are more pronounced on the left.) The treatment of rheumatologists and orthopedists contradict each other. Treated: nemisulide 50 mg 1 time per day for a month, physiotherapy, folk remedies horseradish leaf wrap. Wearing a corset. The child also has combined flat feet.

Enter your name | 01/30/2019 at 11:44

Hello, I have echo signs of degenerative-dystrophic changes in the right knee joint of the 2nd degree. chondromallations of the 2nd degree. I am a full 57 years old. I got up on a chair and got this injury. Please tell me how can I cure this without orerative intervention? Thanks in advance!))

Nina | 01/24/2019 at 20:52

Good afternoon! I am 31 years old. I have been doing it myself in the gym 3 times a week for 2 years with interruptions during pregnancy, before pregnancy I was engaged in dancing. For the first time in my life, I decided to start running and immediately ran 5 km at the end of October (it was already cool and it was pouring light rain). Not immediately, but after a couple of days, the right knee on the outer right side ached (when descending the stairs or when you sit for a long time or in the evening after activity). I have been on treatment for three months now, but the pain does not go away. Alflutop injections for 10 days, Mexidol injections for 10 days, chondroprotectors chondroguard for 10 days, ointment and vitamins, physiotherapy, massage, exercise therapy, aertal for 7 days. X-ray protocol: Rg- signs of osteoarthritis of the right knee joint of 1-2 degrees. OS. Fabella along the posterior-lateral surface of the lateral condyle of the femur. MRI protocol: visible pathological changes were not revealed. Moderately pronounced degenerative changes in the posterior horn of the medial meniscus. Which study to believe: X-ray or MRI? What exactly is knee pain? The orthopedist offers prp-therapy to the joint. But I did not find positive reviews about it. The rheumatologist says in no case any injections into the joint, I think this is not the case. Whom to listen to? What other treatment will help in my case?

Love | 01/22/2019 at 05:43

Hello. Three years ago I slipped, there was pain and swelling of the knee, and it hurt from time to time. I took diclofenac and the pain stopped. Didn't go to the hospital. But recently it started to hurt a lot, I did an MRI, Conclusion: partial damage to the anterior cruciate ligament. Partial rupture of the posterior horn of the medial meniscus of the 3rd degree. Dystrophic changes in the anterior horn of the lateral meniscus of the 2nd degree. Solitary parameniscal cysts of the medial meniscus. Minor synovitis. Gonarthrosis 1 degree. Baker's cyst. Please tell me what to do with this diagnosis. Thanks!

Tatyana | 12/19/2018 at 07:36

Question to Alex admin on 12/17/2018 at 11:51 am (previously posted by Tatyana on 12/15/2018 at 8:28 pm)
Thank you very much for your answer. Swimming is contraindicated for degenerative changes in the menisci?
Is it better to start swimming now or wait? A sudden aggravation occurred in mid-November of that year, on both knees. Now I walk normally, I am engaged in exercises. Are injections highly desirable? After all, concomitant diseases are unlikely to be allowed, for example: hypertension of the 1st degree, all sorts of other things, ... nodular goiter (postoperative hypothyroidism), mastopathy ...

Tatyana | 12/15/2018 at 20:28

Dear doctors!
I am 59 years old, now I walk, it hurts a little, as I slept, I forget about the illness. Stiffness in the morning.
Conclusion of the ultrasound of the knee joints.:
Anterior access
Suprapatellar bag of the right joint - 3.0x0.7cm, left joint 7.0x 1.5cm
Synovial membrane of the right joint -2mm, left joint -3-4mm
The effusion in the torsion of the right knee joint is visualized in a moderate amount,
left - largely, inhomogeneous
The articular surfaces of the femur and tibia are uneven: with sharpened edges of the condyles on the right and with osteophytes on the left
Hyaline cartilage of the articular surface of the medial and lateral condyles
of the femur of a heterogeneous structure, with an uneven clear contour, thickness:
on the right - 1.6 mm on the lateral condyle, 1.3 mm on the medial condyle; (N= 2.6mm and
more)
on the left - 1.4mm on the lateral condyle, 1.1mm on the medial condyle (N= 2.6mm and
more)
Own ligaments of the patella of a homogeneous structure, uniform thickness. Tendons of the quadriceps femoris with a fibrous component
Medial/lateral access
Lateral ligaments with fibrous component (more in left IJ)
Menisci with hypo- and hyperechoic component, the greatest changes (stratification) -
in the posterior horn of the medial meniscus of the left joint
The iliac-tibial tract at the site of attachment to the tibia and tendon of the popliteal muscle and biceps femoris without structural changes.
Posterior access
Popliteal cyst on the right: 1.7x0.3cm. left-3.0x0.7cm and 2.9x0.5cm
CONCLUSION: US signs of bilateral sipovit (more on the left), Baker's cysts (on the right, an unfilled cyst) and gonarthrosis. Degenerative changes in the medial meniscus on the left-2-3st, menisci on the right and lateral meniscus on the left-2st, as well as lateral ligaments. Tendinosis of the tendons of the quadriceps femoris.
There was an exacerbation due to the brush, now it has subsided. There is no way to bend your knees less than 90 degrees, a month has already passed. In conclusion, why not a word about the condition of the menisci...?? The recommendation is this: to undergo magnetotherapy (I go), NVSP ointment, I chose ibuprofen + Dimexide. If magnetic therapy does not help, I will be offered injections for three months with Hyaluronic Acid. I wanted Piascledin, I took a course a long time ago, and I liked that I forgot about the crunch. And now I almost do not feel the crunch. Or is it already like a placebo with such destruction? Only synovitis does not allow to bend completely. What should I do next? The left knee suffered more, the right one began to hurt a week later. Both are so sudden. Yes, I fell this year, the last time in September, but on one knee. And also arthrosis of the wrist joint on both sides, but tolerable.
Can you exercise on an exercise bike? Thank you in advance. I'm desperate.

Gulnara | 05.12.2018 at 18:40

Good afternoon doctor! I am 48 years old. I have never been involved in sports, 4 months ago I hit my knee on a stone. MRI results: - articular surfaces are congruent.
- In the posterior horn of the medial meniscus, the damage zone is of the type of delamination with its dislocation to the outside by 1/3; manifestations of degenerative changes in the lateral meniscus;
- cartilaginous surfaces of articular bones are minimally unevenly thinned;
- cruciate ligaments are not changed, the usual signal;
- the medial collateral ligament is edematous; another joint-forming ligamentous apparatus without visible changes;
- medial tibial epiphysis and medial femoral condyle with areas of bone marrow edema; epiphyses with minimal osteophytes, visible sections of the metaphyses of articular bones are not changed;
- the shape of Goff's fat body is not changed, signs of edema in the tibiofibular portion;
- moderate overproduction in torsion and joint cavity;
- there are no zones of potological intensity in the patella, its contours are clear, even, the cartilage is not changed;
- there are no zones of pathological signal intensity in the popliteal fossa;
-periarticular soft tissues are swollen from the anterior and lateral surfaces.
CONCLUSION: MR- signs of osteoarthritis of the left knee joint 1 tbsp according to Zecker; condition after puncture; damage to the posterior horn of the medial meniscus with its dislocation to the outside by 1/3 (Stollor III) degenerative changes in the lateral meniscus; contusion bone marrow edema in the medial femoral condyle and medial tibial epiphysis; signs of distortion of the medial collateral ligament; moderate suprapatellar bursitis, synovitis.
The doctor said that he needed to have an operation. But the surgeon with whom I wanted to do the operation will be able to perform it only in a month and a half. Is it worth it to rush and do it with another surgeon, just because of the urgency. I remind you that 4 months have already passed since the injury. I wore a tutor for almost a month. Now my knee continues to hurt and I can’t fully walk and bend my knee. And with such an MRI conclusion, is it possible to stitch the meniscus or will it be necessary to remove the damaged part of the meniscus? What would be better in my case - to sew or remove the damaged part of the meniscus? Can I take Glucosamines before surgery? Really looking forward to the answer! Thanks in advance!

Sergei | 29.11.2018 at 11:52

Hello! Sometimes when straightening the left knee, a sharp pain was felt, which immediately passed. After the MRI, they wrote in the conclusion: Dystrophic changes in the horn of the medial meniscus, arthrosis of the 0th degree. Periodically I drink a course of chondroprotectors and pierced the course of Alfuton. The pain went away for a while, but now it's back. Please tell me what to do in my case? Is it possible to cure a joint with conservative methods?

Elena | 11/20/2018 at 05:22

Good afternoon. I suffer from pain in my right knee after a fall (I went skiing).
MRI showed: degenerative changes in the meniscus I st according to Stoller. Infringement of the posterior sections of Goff's fat body. Mediopatellar fold syndrome. Minimal articular protrusion.
A consultation with an orthopedic traumatologist was scheduled.
The pain in the rut is aching, especially in the evening and at night, especially after exercise.

Valentine | 11/14/2018 at 10:27 am

Hello. I had an MRI of my left knee.
Conclusion: Osteoarthritis grade 2, Degenerative changes in the medial meniscus grade 3, lateral meniscus grade 2, Synovitis, Bone marrow edema of the medial condyle of the tibia.
Can you advise something?
Thanks!

Claudia | 29.10.2018 at 20:19

HELLO! My knee hurts a lot, I have been suffering for a whole month, painkillers do not help, Fermatron plus pumped, does not help. got an mri. Conclusion MR picture of degenerative changes in the internal meniscus of the 2nd degree according to stoller. degenerative changes in the lateral meniscus of the 1st degree. moderate degenerative changes in the anterior cruciate ligament. suggest surgery. Please tell me what to do?

Anna | 10/15/2018 at 08:57

Hello, if you answer I will be very grateful to you.
The right knee is very disturbing, as a result, two MRI scans were performed with a difference of a year:
1 MRI conclusion: MRI - picture of partial traumatic damage to the ACL and internal lateral articular ligaments, damage / degeneration of the medial meniscus (Stoller .2 class), gonarthrosis (grade 1), causing contusion changes in adjacent bones, lateralization of the kneecap, edema of the paraarticular tissue.
2MRI was compared by a radiologist with 1: MO-picture of lateral subluxation of the patella against the background of moderate hyperplasia of the femoral condyles, moderate degenerative changes in the ACL at the site of rupture of the posterior cruciate ligament in the upper third of the initial degenerative changes in the menisci. When compared with the previous MRI - no significant changes.
The doctor in the city hospital in my city says that you just need to smear the knee. The doctor from MONIKI wrote in the conclusion that arthroscopic resection of the lateral meniscus and ACL plasty is needed. Tell me what to do? Is an operation required? Thanks!!

Geser | 10.10.2018 at 03:08

Hello! at the summer Olympics, he injured his knee joint, had an MRI. The results are - MRI signs of degeneration 2 tbsp. anterior horn of the lateral meniscus. synovitis. Mediopatellar synovial fold. Small focus of enostosis of the tibia. Please tell me what to do in my case

Fania | 09.10.2018 at 03:29

Conclusion mri. Degenerative changes in the posterior horn of the medial meniscus, cysts in the popliteal fossa. What treatment do I need. I don't remember any major injuries.

Alex admin | 08.10.2018 at 11:10

Hello Kundyz. Degenerative changes are not completely cured, they can and should be slowed down. Treatment must be comprehensive. Prescribes treatment orthopedist or traumatologist. What is needed for effective treatment is described in this article.

Alex admin | 08.10.2018 at 11:07

Hello Ruslan. You don't need an operation. Contact your local doctor (orthopaedist or traumatologist) to prescribe treatment: anti-inflammatory pills and / or injections, physiotherapy (laser, magnet), applications, therapeutic massage, etc. Give the joints temporary rest and no stress or weight lifting.