Meniscal Tear

  • January 25, 2020

Meniscal injuries are present in different populaces, and it can be due to traumatic, intense traumatic presentations happen more frequently in younger age during sports competition and practice. A traumatic meniscal tear is seen with the history of sudden onset of the joint line pain which is related with an adequate knee injury. Meniscal tear is common in knee injuries. A torn meniscus happens since of injury caused by intense bending or hyperflexing of the knee joint. These injuries can be seen in all age groups due to several conditions like degeneration and trauma. Most commonly meniscal tears are seen in younger people due to trauma. When a shear force happens between the femur and tibia the typical twisting constrains on a weight loaded flexed knee leads to meniscal damage. Meniscal tear incidence may be as high as 6 per 1000 population with a 2.5 to 4 times male predominance. Injury occurs more at 20-29 years. Over the past decade, meniscal root tears have gotten to be more recognized as a critical source of pain and inability.

The knee menisci are fibrocartilaginous structures that sit within the knee joint, deepening the tibiofermoral articulation. Menisci transfers the axial load from the femur to tibia additionally acts as ashock absorbers, lubricants and stabilizes the knee during flexion, extension and minimal rotation, it plays an important role in keeping up the knee joint stability and congruency, force dissemination and proprioception and decreases the improvement of osteoarthritis. It also play an important role in synovial fluid dynamic circulation menisci are vascularized only via the periphery and the root attachment gets its nutrition through blood vessels; the inner portions are a vascular must rely on the diffusion of synovial fluid the location of a meniscal lesion, along with age and health of the patient influences the options available after injury because of the capacity of the meniscus to heal.

Causes:

  • Older individuals regularly get meniscus tears since their menisci gotten to be fragile and less adaptable with age. But for teenagers as a rule happen since of an damage. This might happen when;
  • Lifting heavy objects
  • Making sudden changes in direction
  • Sports like soccer, tennis, basketball, football, racquetball
  • Taking direct hit to the knee while playing a contact sport such as football, hockey or rugby, where the knee may be forced to twist or turn awkwardly
  • Falling in a way that puts lot of strain on the knee, this can happen in sports like skiing or snowboarding.

Symptoms:

  • Joint line tenderness
  • Pain within the center or side of the knee, particularly when bending the knee or squatting.
  • Swelling& stiffness in the knee that gets worse over the first 2 or 3 days after the injury occurs.
  • Loss of range of motion
  • A feeling of locking and instability
  • Difficulty to move the knee
  • Slipping or popping sensation

 

Meniscal tears are commonly diagnosed clinically using special tests like Thessaly’s test (specificity 97.7%), Mc Murray’s test (specificity 95%), applies test (specificity 90%).

Thessaly’s test has the symptomatic accuracy when it performed at 20 degrees of the knee flexion. A history of locking of knee join, pain with passiveterminal knee extension joint line tenderness and positive special tests when all these signs were present in patients for detections of meniscal tears. Quiet history combined with special tests can create a demonstrative precision of 90%, slightly prevalent to the diagnostic precision of MRI alone exercise has been appeared to progress knee function and diminish pain.

Treatment:

Take anti-inflammatory drugs like acetaminophen, ibuprofen can help to relive pain and swelling in the affected area.

Physiotherapy:

It can helps to strengthen your leg muscles, stabilize the knee and get your knee back to its full ROM & Flexibility.

Short term and long term follow up studies had shown that exercise therapy improves the function and activities in patients with meniscal tear. There’s possibility to cure by conservative treatment if patients get diagnosed prior by different tests done by the clinical practices. In patients meniscal tear showed similar results between orthoscopic meniscectomy and physical treatment be that as it may the physical therapy group had a higher rate of improvement cross over to surgery.

Conservative Treatment for meniscal tears include active exercises that focuses to increases the range of motion and muscle strength, reduce pain, improve balance and flexibility.

Mostly treatment of torn meniscus may include observation and physical therapy with muscle strengthening to stabilize the knee joint.

Reported outcomes of surgery and conservative treatment are similar. Hence there’s a require for extra research into non operative alternate treatment strategies for treating the symptoms of meniscal tears as there’s constrained back that non operative elective treatment are effective. When the conservative measures are ineffective treatments may include surgery to repair or remove the damaged cartilage.

The physical treatment programme included in stages the criteria for progressing from one stage the next, included pain, strength, range motion knee effusion and functional mobility, supervised exercise treatment appeared positive impacts over surgery in progressing thigh muscle strength with in the short term.

Brain mulligan developed mulligan manual techniques used to reduce pain, sensory and motor deficits and restore the movements. It includes the technique of sustained passive accessory glides with an active motion or mobilizations with movement (MWM). The manual therapy of mulligan squeeze technique is used to treat joint line pain and reduced range of motion in meniscal tear. Mulligan mobilization together with exercise convention leads to decrease in pain, functional advancement additionally progresses ROM and muscle strength. Conventional therapy along with mulligan squeeze technique is more effective in patients with meniscal tear

Precautions:

  • Get regular exercise including strength training for your leg muscles. Strong leg muscle offer assistance stabilize and ensure the knee.
  • Always warmup and extend appropriately sometime recently playing sports or engaging in any strenuous activities.
  • Give your muscles plenty of time to rest & recover between activities.
  • Get the correct footwear for sports.
  • Use proper techniques in sport.
  • If you have previously had knee injury, a brace or wrap can give added support to your knee.

© Copyrights Progressive Care 2020. All rights reserved.