What pathologies can the meniscus suffer?
The most common thing that happens in middle-aged people who suffer pain in the internal compartment of the knee can be a meniscal tear. There are always other pathologies that must be ruled out, such as cartilage involvement, the degree of osteoarthritis and, above all, assess the axis of the limb.
But the most frequent in middle-aged people can be a meniscal rupture. In sportsmen the rupture can be traumatic and of a certain type and in older or middle-aged people the rupture generally is degenerative and affects the posterior horn of the internal meniscus, producing a delamination between the superior part and the inferior part that sometimes causes instability and pain in the internal part of the knee.
What is a meniscus tear?
Meniscal tears in middle-aged people are degenerative tears and usually affect the posterior horn of the internal meniscus, and are usually a laceration, a splitting of the meniscus into two parts.
Many times this produces pain and requires an arthroscopy to solve it. In sportsmen the breaks are usually more of radial type or more meniscocapsular disinsertion if the traumatisms in the knee are severe. For it is suitable a correct evaluation by means of resonance and to indicate the most suitable treatment.
What is the diagnosis and treatment in the meniscus tear?
The diagnosis of meniscal tears requires, in the first place, an adequate physical examination by the specialist that allows to orientate the specific pathology and, if necessary and if it is considered necessary, an MRI is indicated, which is the test that indicates the degree of injury that the meniscus has or the type of tear in its case.
As for the treatment, it depends a little bit on the type of patient. In young patients, meniscal tears generally require an arthroscopy because it will allow us, if necessary, to suture the meniscus, which consists of stitching along the disinserted area, especially if it is meniscocapsular, if there is irrigation that allows proper healing, and on the contrary, in middle-aged people, or people of a slightly more advanced age, with meniscal flaps or degenerative tears, the most indicated is to perform a menistectomy, through two mini portals by arthroscopy, which consists of inserting a small camera and a pincer that allow the damaged area or the area of the tear to be resected. Obtaining a free meniscal edge, without fragments, stable and that allows a correct functionality of the knee.
The injuries, on the contrary, in sportsmen, of the anterior cruciate ligament, generally suppose an anterior instability of the knee. And that can be seen in the Lackman maneuver, that the knee, or in this case the tibia is displaced abnormally in excess towards anterior. To treat this type of pathology in athletes, an anterior cruciate ligament ligamentoplasty is indicated, which is normally done with the patient’s own hamstring tendons. Or in other cases it can also be done with bone-tendon-bone. In this case, we have a knee resembling hamstring tendons, with a hamstring repair, and what we do is a tunnel in the tibia and a tunnel in the femur that allows us, through this thread system, to pass the plasty in the anatomical location and that we will subsequently tighten and fix with an interferential screw in the tibia, resorbable. That is the way or the most common practice of this type of ligament constructions and they allow the return to competition in most of the cases.