Knee
Meniscal lesions
by Uperform
The menisci are small cartilaginous structures located between the femur and the tibia. Each knee has two: the medial meniscus and the lateral meniscus. These structures have a role of shock absorbers and stabilizer of the knee. They allow a better distribution of loads and shocks.
1) WHAT IS A MENISCALE DAMAGE, AND WHAT ARE THE DAMAGE MECHANISMS?
Meniscal lesions represent a significant number of knee injuries. They correspond to an alteration of the integrity of the structure.
These lesions can also present themselves in various forms:
– Vertical crack
– Horizontal crack
– Tongue
– Radial or transverse lesion (ME>MI)
– Bucket handle
– Degenerative lesion
– Meniscal cyst (rare in the internal meniscus)
– Malformative lesion (ME) = discoid meniscus
The mechanisms of injury are also varied.
In the event of an acute injury, however, there are certain typical traumas:
– Movement in valgus/internal rotation, most often with foot anchored in the ground
– Sudden extension of the knee
2) IS IT SERIOUS?
Pain and symptoms may vary depending on the severity and type of injury.
It is important to determine whether it is an isolated lesion or not. Indeed, an isolated meniscal lesion has little impact on the stability of the knee, as long as the ligaments are intact.
However, this can lead to a risk of early osteoarthritis, especially if the meniscus has had to be removed.
In case of suspicion of lesion, an MRI or a Scan can be prescribed to confirm the diagnosis. These results are then associated with the clinical examination in order to determine the severity of the injury, and to decide on the strategy to adopt.
3) IS SURGERY MANDATORY?
In the event of meniscal trauma, surgery is generally not offered as first-line treatment.
Conservative physiotherapy treatment proves to be regularly sufficient. However, in some cases (ineffective conservative treatment, excessive pain, locking of the knee, etc.), surgery may prove to be essential.
The intervention is then carried out arthroscopically, and depending on the surgeon’s decision, two acts can be performed:
– Menisectomy, i.e. the resection of the damaged meniscal part
– The meniscal suture
Following this intervention, a physiotherapy treatment can then start.
4) HOW DOES THE REHABILITATION TAKE PLACE?
Conservative and post-operative treatment are similar on many points. The difference will mainly be in the first days following the possible surgery.
Respecting the healing process, work will focus on:
– The recovery of normal articular amplitudes
– Gradual rehabilitation of the joint
– Recovery of a correct gait pattern
– Overall muscle strengthening (strength, neuromuscular control, stability, etc.)
– Re-athletics and getting back into sport
5) CAN I CONTINUE TRAINING?
Initially, stopping sporting activity is most of the time essential in order not to aggravate the lesion. Consulting a health professional then makes it possible to determine the procedure to follow in order to return to your sports practice as quickly as possible in complete safety.
6) WILL I RETURN TO MY PRE-INJURY LEVEL?
Provided you follow the instructions and recommendations given by your surgeon and your therapist, you will more than likely find your level in a few months!
7) WHAT CAN I DO TO SPEED UP THE PROCESS?
In order to speed up the healing process, be sure to follow the recommendations of the health professionals you work with as much as possible. Laziness or, on the contrary, overzealousness, will be your enemies. Conversely, discipline, rigor, perseverance as well as a positive and voluntary state of mind will help you get back in top shape as soon as possible!