آسیب مینیسک زانو؛ When a small blow becomes a big pain

Knee Meniscus is one of the most important components of the knee joint, which plays a key role in absorbing pressure, joint stability and uniform distribution of body weight. Meniscus injury or tear is one of the most common knee problems, especially in athletes and people who engage in heavy physical activities. Understanding the structure and function of this part of the knee can be very helpful in its prevention and effective treatment.

What is the meniscus of the knee and what is its role?

There are two menisci in each knee: inner (medial) and outer (lateral) meniscus. These structures are composed of fibrous cartilage and are placed between the thigh bone (femur) and the leg bone (tibia). Their shape is crescent and they act like a natural cushion to absorb the pressure on the knee.

The main roles of the meniscus are:

• absorption and distribution of forces on the knee when walking or running
• Increasing the stability of the knee joint and preventing the bones from slipping
• reducing friction between bones during movement
• helping to nourish joint cartilage by distributing synovial fluid

How does a meniscus injury or tear occur?

Meniscus tears usually occur as a result of sudden rotational movements, twisting of the knee, or excessive pressure on the joint. This injury is very common in sports such as football, basketball, skiing and martial arts. In elderly people, due to gradual erosion of cartilage and degenerative changes, even simple movements may lead to meniscus tear.

The most important causes of meniscus damage include:

• Rapid rotation of the knee while the foot is fixed on the ground
• Lifting heavy objects or long squats
• direct blow to the knee during exercise or accident
• Degenerative changes due to aging

Types of meniscus tear

Meniscus tears are divided into several types in terms of shape and location:

• Longitudinal tear (longitudinal): occurs along the axis of the meniscus, and sometimes a part of the meniscus may detach and get stuck in the joint.
• Radial tear: proceeds from the inner edge of the meniscus towards the center.
• Flap tear: A small part of the meniscus detaches and may cause the knee to lock.
• Complex tear: It is a combination of several types of tears in different parts of the meniscus.

Symptoms of knee meniscus damage

Symptoms of a meniscus tear may not appear immediately after the injury, and in some cases, pain and swelling appear with a delay of several hours. Among the common symptoms:

• Pain in the inner or outer part of the knee depending on the type of meniscus damaged
• Feeling of "locking" or "stuck" knee when moving
• Swelling and inflammation around the knee joint
• Decreased range of motion and difficulty in bending or straightening the knee
• Clicking sensation or sound in the knee when moving

Diagnosis of meniscus damage

The accurate diagnosis of meniscus damage is the responsibility of an orthopedic doctor who uses a combination of physical examination and imaging methods. Tests such as McMurray Test and Apley Test are performed to check the condition of the meniscus.

If needed, MRI (Magnetic Resonance Imaging) is the best way to see the type, location and severity of a meniscus tear. In certain cases, the doctor may also use diagnostic arthroscopy.

Treatment of knee meniscus injury

Treatment varies depending on the type, size and location of the tear. Sometimes minor injuries can be treated without surgery and with rest and physiotherapy, but in severe cases, surgery may be necessary.

1. Non-surgical treatment

• Resting and avoiding pressure on the knee: Using a cane to reduce the weight on the joint.
• Cold compress: Reduce swelling and pain by placing ice on the knee for 20 minutes every hour.
• Pressure bandage: Using a special knee brace to stabilize the joint.
• Keeping the leg elevated: Help reduce swelling by placing the leg at a higher level than the heart.
• Physiotherapy: Special exercises to strengthen the muscles around the knee and restore range of motion.

2. Surgical treatment (arthroscopic)

If the tear is extensive or in areas with poor blood supply, the doctor suggests arthroscopic surgery. In this method, with small incisions and the use of a fine camera, the surgeon can repair or remove the damaged part. This operation is usually outpatient and has a short recovery period.

Types of surgery include:

• Meniscus repair (Meniscus repair): In cases where there is a tear in areas with blood supply.
• Meniscectomy (removal of part of the meniscus): in case of severe damage or irreparable tear.

Care after surgery

After surgery, the patient usually faces a strict program of physical therapy. The purpose of rehabilitation is to restore the strength of thigh muscles, knee stability and prevent joint dryness. The patient should avoid sudden movements and squatting and, according to the doctor's opinion, gradually start daily activities.

Possible side effects if meniscus is not treated

• Gradual destruction of knee joint cartilage and the occurrence of early arthritis
• Decreasing joint stability and the feeling of looseness of the knee
• Chronic pain and permanent limitation of movement
• Frequent knee swelling in simple activities

Prevention of knee meniscus injury

Prevention is always easier than cure. By following a few simple tips, you can minimize the possibility of damage to the meniscus:

• Warming up the body before starting exercise and proper stretching movements
• Avoid sudden turns or quick stops during exercise
• Using suitable shoes with shock absorption
• Strengthening the quadriceps and hamstring muscles to support the knee joint
• Reducing excess weight to prevent excessive pressure on the knee

Final summary

Knee meniscus is one of the vital components in the normal function of the joint and damage to it can cause pain, swelling and limited movement. Timely diagnosis and basic treatment will prevent the progression of damage and premature arthritis. If you experience knee pain, locking or sudden swelling while walking or exercising, it is better to see an orthopedic specialist as soon as possible. Correct treatment can restore your knee to smooth, stable and pain-free movement.