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MENISCUS

What is a meniscus?

 

The menisci are two crescent-shaped cartilage discs that sit between the femur and lower leg. One meniscus on the inside of the knee and one on the outside of the knee. Its task in the knee is to be shock-absorbing, to equalize the load and contribute to the stability of the knee.

 

Why do you get an injury to the meniscus?

 

This is a common injury. More than 30,000 meniscus operations are performed in Sweden annually. Injury to the inner meniscus is clearly more common than damage to the outer meniscus.

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Treatment of meniscus in Alta Vita

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There are two types of meniscus injuries. One type occurs acutely in connection with an accident, which often involves strain in combination with a twist in the knee, for example in football, floorball or running. The damage can be limited to the meniscus only. But it can also be a combination of damage to the meniscus, lateral ligament (collateral ligament) and anterior cruciate ligament, an "unhappy triad".

The second and most common type of meniscus injury occurs through a gradual wear and tear of the meniscus. Over the years, the meniscus becomes more and more fragile, can crack and break more and more easily. The pain then often comes gradually, or because the knee begins to ache after a seemingly light load that causes the worn meniscus to eventually break, for example when squatting or sitting in a tailor position.

Symptoms of meniscus injury?

 

Symptoms of acute meniscus injury are often sudden load pain on the outside or inside of the knee. The knee can "lock in", hook up, often in combination with pain, which then releases. Restricted movement and pain when trying to squat is common. Some swelling may occur on the side of the injury. If it is a triad of injuries to the knee, then the swelling may have been more extensive.

Symptoms of gradual wear and tear are often not as acute, but come more gradually. However, the type of symptoms is the same as in an acute injury.

A meniscus injury can advantageously be diagnosed via tests and  ultrasound diagnostics . With ultrasound diagnostics, we can in many cases see the extent of the damage to the knee.

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Treatment of acute meniscus injury?

 

If the injury occurs acutely, it is good to wrap the knee for compression, with the aim of holding down any swelling. Relief of the leg with a high position, ie the knee above heart level. Cooling can be used for pain relief, if needed.

Most menisci have no blood supply, but they get their nutrition from the synovial fluid in the joint. This means that a broken meniscus in most cases does not heal. However, the injury can be such that when the emergency situation has subsided, the knee works well.

Treatment of meniscus injury?

 

Physiotherapy can with manual treatments, mobilizations and  shock wave therapy  soften the joint capsule that sits around the knee. In this way, there is an opportunity to make the meniscus able to slide in a more advantageous way, for some the pain then disappears completely.

An step is also important  rehabilitation training  to optimize knee load tolerance, mobility, strength and coordination. Here, our physiotherapists can help so that the rehabilitation starts at the right level and increases, to optimize the possibility that you can return to the activity you want to perform.

If the injury is extensive, with recurring locks and increased pain during exercise, despite treatment and rehabilitation attempts, we refer them to a doctor for a decision on possible arthroscopy (peephole surgery). To optimize the outcome of an operation for acute meniscus injury, it should be performed within 3 months after the time of injury. In such an operation, the broken part is removed and the remaining part is leveled. After this, it is again important that an increased rehabilitation training is carried out to optimize the knee's mobility, strength and coordination.

Prognosis in case of damaged meniscus

 

The prognosis is very dependent on where the damage is and how big the damage is. If the pain is not too severe and if you do not have locks in the knee, then the prognosis is good. In surgery when a part of the meniscus is removed, the prognosis is good. Nowadays, the meniscus is removed as little as possible. This is because a clearly increased risk of osteoarthritis has been seen if the entire meniscus is removed.

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Differential diagnoses

Pain on the inside of the knee can also be due to a medial collateral ligament injury (lateral ligament on the inside of the knee) that runs just above the meniscus on the inside of the knee. An injury to the pes hellerinus (ankle foot, muscle tendons) that runs behind the medial collateral ligament can also cause pain on the inside of the knee.

Pain on the outside of the knee may be due to damage to the lateral collateral ligament (lateral ligament on the outside of the knee). On the outside of the knee also runs a tendon called the iliotibial tract. An injury to it gives rise to running knees , where pain on the outside of the knee is a symptom.

Physiotherapy at Alta Vita Physiotherapy

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