ORTHOPEDICS

Knee meniscus surgery

Meniscus injuries are among the most common causes of knee pain
KNEE PAIN

Meniscusinjuries

One of the leading causes of visiting an orthopedist

Injuries and damage to the meniscus are common in the general population, especially among athletes. We divide them into two large groups, depending on the cause of their occurrence:

      • Traumatic meniscus damage
      • Degenerative damage to the meniscus


Knee anatomy

What is the role of the meniscus?

But what is a meniscus anyway? The menisci are small, fibrocartilaginous formations, located at the top of the tibia. They have the shape of the letter C or crescent and despite their small size, they are a key component in the proper functioning of the knee joint. There are two menisci in the knee joint, one on the inside (medial meniscus) and one on the outside (lateral meniscus). Their role is mostly reflected in the stabilization of the knee joint by increasing what we call the “articulatory surface”, ie the area of ​​communication of the articular bodies, in this case, the femur and tibia (femur and tibia). Since the lower end of the femur is rounded like a roller, and the upper end of the tibia with which it forms the knee joint almost completely flat, like a plate, without the meniscus such a shape of the articular bodies would mean major problems with knee instability and such a joint would be completely dysfunctional. The existence of the meniscus allows the flat articular surface at the top of the tibia to take on the shape of a vessel, which is the key to stability in the knee.



Clinical picture and diagnosis of knee injury


Because of their, so to speak, ungrateful role in the knee, the menisci are extremely susceptible to damage. The knee is the most complex joint in the human body and any imperfection in its structure will lead to disruption of the entire trigger system. Different movements in the knee joint can lead to greater or lesser damage to the meniscus, and once the damage occurs, then arthroscopic surgery to repair it is the only treatment.

In medicine, any illness or injury can be viewed as acute or chronic. The same goes for meniscus injuries. Acute injuries of the meniscus occur on one occasion due to the sudden action of a force on the meniscus, which is greater than the capacity of the force that the meniscus can withstand. If at the same time there is no physiological response of the organism in the form of tightening of muscles and tendons in the immediate vicinity, which is a consequence of unprepared joint for trauma, it will lead to rupture of the meniscus, after which typical symptoms such as pain and knee stiffness position, most often in semi-flexion).

Chronic meniscus damage occurs as the sum of several minor lesions and ultimately results in similar consequences. Surgical treatment of such meniscus damage is the only possible solution. Forcing conservative treatment or improper diagnosis of these disorders can lead to permanent damage and the development of osteoarthritis of the knee.

Suspicion of meniscus damage is made on the basis of anamnesis and a thorough clinical examination. Some clinical signs with a high success rate will indicate this diagnosis, but the final judgment can only be made by magnetic resonance imaging of the knee. In a certain percentage of cases, even that is not enough, and in such cases arthroscopy is used not only as a curative, but also as a diagnostic method. Sometimes it is difficult to distinguish meniscal damage from knee cartilage damage, and arthroscopy is a method that allows us not only to distinguish the two entities, but also to treat it.



KNEE ORTHOPEDICS

From other sources on this topic

How does the anatomy of the knee affect the development of disease and injury?


CONSERVATIVE TREATMENT

Treatmentof meniscus injuries


As we mentioned earlier, meniscus rupture is an indication for arthroscopic surgery. In the case of minor meniscus damage that only to a lesser extent causes discomfort, conservative treatment may be considered. The only effective approach in the conservative treatment of meniscus injuries is adequate physical therapy. In the process of physical therapy, the muscles that stabilize the knee joint are strengthened, primarily the muscles of the anterior thigh (quadriceps), while various methods are used to improve proprioception and thus try to relieve the menisci. In this way, not only the treatment of the injury is carried out, but also the prevention of future injuries.

In a number of cases, if an inflammatory process develops at the site of damage, the use of autologous conditioned plasma (ACP), magnet, laser and ultrasound therapy, and electrotherapy may be helpful. The use of ACP as a derivative of your own blood has proven to be particularly useful, as it has been proven that growth factors, which are extremely rich in blood plasma, have a strong anti-inflammatory and restorative effect.



SURGICAL TREATMENT

Knee arthroscopy

What is knee arthroscopy and am I a candidate for this procedure?


Knee arthroscopy is the absolute gold standard in the surgical treatment of not only meniscus damage, but all knee procedures. The advantages of this method of surgical treatment are reflected in the form of minimal trauma to the operated tissue, extremely shortened recovery time, better treatment and reduced risk of postoperative complications, especially infection of the operated area.

In preparation for the procedure, the anesthesiologist will do a thorough treatment to assess whether you are ready for the procedure. Arthroscopic surgery is performed under local anesthesia, which means you are awake for the entire duration of the procedure. This allows direct interaction between you and the operator, during which you are free to ask all questions related to the answer you are interested in, which are related to the procedure and treatment.



After applying the local anesthetic and sterile washing and covering the operative field, one sparing incision is made on each side of the knee, approximately 5 mm in size. These two incisions represent the entrances to the joint itself. Through one entrance, the surgeon will insert a camera, which provides a view of the knee joint itself, and the other entrance allows the entry of instruments needed to process the structures in the joint. Treatment of structures in the knee joint includes removal of avital parts of the meniscus (non-functional, damaged parts of the meniscus), removal of excess synovium and smoothing of cartilage tissue in the knee.

Candidates for knee arthroscopic toilet are all patients with proven meniscus damage. Depending on the degree of damage to the meniscus, the doctor suggests conservative or operative treatment, and then, in agreement between the patient and the doctor, the best solution for the patient’s health is reached. Arthroscopic surgery, in addition to meniscus injuries and joint toileting, can also treat injuries of the anterior and posterior cruciate ligaments, inflammatory changes of the knee that are not of infectious origin, intra-articular infectious processes that cannot be treated in the classical way, but require rinsing (lavage) and artro.



SURGICAL TREATMENT

Rehabilitation after meniscus injury


The recovery time after the performed arthroscopic repair of the damaged meniscus is shortened compared to the classic open surgery by as much as a few months, and the tissue itself will suffer minimal trauma. A few hours after the procedure, the patient is discharged for home treatment. 24 hours after the operation, the first control, dressing and removal of the drain follows (if it is installed). Our doctors will give you detailed instructions for further behavior and controls.

After the initial recovery, the physical part of the postoperative recovery follows. In cooperation with our physiotherapists and kinesiologists, you go through a rehabilitation plan and program complex and tailored individually to you and your anthropometric measures (age, sex, height, weight), all with the aim of a better and faster return to daily activities. Visit us at our address at Ulica grada Mainza 17 and see for yourself the quality of our service. Our team led by Dr. Milan Milošević is eagerly awaiting you!

Polyclinic Ribnjak. Health and beauty. Together .




In short


Polyclinic Ribnjak is a unique institution in the Republic of Croatia. It unites different branches of medicine, all in order to stay true to its slogan “Health and Beauty. Together”. Orthopedics, advanced sports diagnostics, functional and kinesiological rehabilitation, cosmetic surgery and treatments are the services we provide on a daily basis, professionally and in accordance with the latest professional standards.






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