Meniscus

Meniscus injuries are among the most common injuries in sport. They account for around seven percent of sports injuries every year. This is because the meniscus acts as a shock absorber and stabilizer, thereby reducing the load on the cartilage. However, by protecting the cartilage from damage and premature wear and tear, the meniscus itself is often affected.

Meniscus tears are divided into horizontal, vertical and radial tears according to their shape. In addition to complex damage, the base of the meniscus can also be torn off. In some types of tear, parts of the meniscus can become detached and move within the joint. A typical special form is the basket joint lesion. This can lead to the meniscus tissue becoming trapped and the knee joint becoming blocked.

Causes of meniscus injuries

Age plays a key role in meniscus injuries. While in patients over the age of 40, the cause is often wear and tear, in younger patients it is often triggered by a sports injury, particularly in soccer, handball or skiing. The affected person often twists the knee joint while standing or bending. It is not uncommon for a meniscus tear to occur in conjunction with a torn anterior cruciate ligament and obesity is also a risk factor.

Symptoms of a meniscus tear

Typical symptoms of a meniscus tear are pain at the level of the inner, outer or posterior knee joint area. As the meniscus itself does not contain any nerve fibers, the pain is triggered by irritation of the nerves in the joint capsule.

This can be accompanied by swelling or joint effusion. This fluid is in turn formed by irritation of the joint mucosa.

Diagnosis of meniscus injury

The diagnosis of a meniscus injury begins with a medical history. The attending physician takes into account the origin of the symptoms, whether an injury or an accident has preceded them and the duration, type and localization of the symptoms.

During the clinical examination, the patient usually reports pressure pain over the inner or outer knee joint space. The doctor checks whether there is a joint effusion or a joint snap or whether the knee joint is locked. Magnetic resonance imaging (MRI) is also frequently used for diagnosis. This examination procedure can detect a meniscus tear with a high degree of certainty.

Treatment: How is a meniscus injury treated?

As a general rule, increased strain should be avoided after the injury, such as deep bending positions in a squatting position or twisting movements under strain. Conservative treatment measures are varied. Depending on the extent of the symptoms, temporary immobilization and the use of non-steroidal anti-inflammatory drugs (NSAIDs) may be necessary. Cushioned footwear can also alleviate pain. Custom-made insoles, a raised shoe edge, supports or an orthosis can provide relief. Physiotherapy or chiropractic treatment with accompanying physical measures such as electrotherapy or ultrasound treatment are also possible. Other conservative measures include injecting hyaluronic acid into the knee joint and acupuncture.

Surgery for meniscus tears

For surgical treatment, the attending physician first examines the shape of the tissue quality and the shape of the meniscus tear using arthroscopy of the knee joint. The primary aim is to preserve the meniscus as far as possible and suture the tear. Minimally invasive arthroscopic surgery is used. If suturing the meniscus no longer makes sense, only as much of the damaged part as necessary and as little as possible is removed. If a larger portion has to be removed, meniscus replacement surgery with the insertion of an artificial meniscus implant or, in rare cases, a donor meniscus can be considered.

After the operation

After the operation, the knee joint should only be loaded in accordance with the recommended rehabilitation program until it has healed. Rotational sports should even be avoided for up to three to four months until the injury has healed completely. This increases the chance of being able to return to full sporting activity afterwards.

The motto "save the meniscus" applies in order to maintain knee joint function under all circumstances.