Meniscal Injury

 

MENISCAL INJURY

Introduction:-

Each knee joint has two crescent-shaped cartilage menisci. These lie on the medial (inner) and lateral (outer) edges of the upper surface of the tibia (shin) bone. The menisci are made of tough cartilage and conform to the surfaces of the bones upon which they rest.

Functions:-

They are essential components, acting as shock absorbers for the knee as well as allowing for the proper interaction and weight distribution between the tibia and the femur (thigh bone). This uneven weight distribution would cause excessive forces in specific areas of bone leading to early arthritis of the knee joint. As a result, injuries to either meniscus can lead to critical impairment of the knee itself.

Mechanism of Injury:- 

The medial meniscus is more prone to injury than the lateral meniscus as it is connected to the medial collateral ligament and the joint capsule and so is less mobile. Hence, any forces impacting from the outer surface of the knee, such as a rugby tackle, can severly damage the medial meniscus. In addition, medial meniscal injuries are often also associted with injuries to the anterior cruciate ligament. Other mechanisms of injury may be twisting of the knee or degenerative changes that are associated with age. Any of these circumstances may lead to tearing of the medial meniscus, which in serious cases may require surgical intervention.

Symptoms:-

· A history of trauma or twisting of the knee

·Pain on the inner surface of the knee joint

·Tenderness when pressing on the meniscus

· Swelling of the knee within 24-48 hours of injury

· Inability to bend knee fully- this may be associated with pain or a clicking noise

·  A positive sign (pain and/or clicking noise) during a “McMurrays test”

· Pain when rotating and pressing down on the knee in prone position

·  “Locking” of the knee

· Inability to bear weight on the affected side

Diagnosis:-

Medical history-doctor will ask about the mechanism of injury Specific tests like mc Murray’s test can be performed to detect meniscal tear .

X-rays and MRIs are the two tests commonly used in patients who have meniscus tears. An x-ray can be used to determine if there is evidence of degenerative or arthritic changes to the knee joint. The MRI is helpful at actually visualizing the meniscus.

Types of Meniscal Injury:-

– Degenerative changes – This may lead to edges of the menisci becoming frayed and jagged

–  Longitudinal Tears- this occurs along the length of the menisci

–  Bucket handle Tears- this is an exaggerated form of longitudinal tear where a portion of menisci becomes detached from the tibia forming a flap that looks like a bucket handle.

Treatment:-

– Apply RICE to the injured knee.

– Wear a heat retainer or support.

– Gentle exercises to maintain quadriceps strength, although care should be taken not to aggravate the symptoms.

– Take a glucosamine / joint healing supplement.

PHYSIOLINE’S SPECIALIZED PHYSIOTHERAPY HAS VITAL ROLE TO PLAY

 At Physioline, all the members of the rehabilitation team work together so as to provide proper care and the therapy in order to: -Reduce pain-Reduce Inflammation-Strengthening of exercises.

Physioline Treatment
This may be indicated in the case of a small tear or a degenerative meniscus and may involve:

Ice

compression

Electrotherapy

Manual therapy

Once pain has subsided, exercises to increase range of movement, balance and maintain quadriceps strength may be prescribed. These may include: squatting, single calf raises and wobble-board techniques.

Visit Physioline for further treatment and rehabilitation