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- What is a meniscus, and what does it do?
- Can meniscus injury be treated conservatively? In which case requires surgery?
- What happens without timely surgery for a grade 3 injury? A grade 3 meniscus injury is a bit like a hangnail.
- Treatment of meniscal injuries
Meniscal injury is a very common knee injury. Many people ask whether their meniscus injury is serious or not and whether they need surgery. Knee trauma often damages the meniscus, so how should a meniscus injury be treated?
What is a meniscus, and what does it do?
We walk, run, and jump every day, and there will be repeated friction and impact between the femur and tibia. Therefore, if there is no shock-absorbing buffer structure in the middle, one can’t imagine how terrible it will be. Yes, the meniscus is actually the two “soft pads” in the knee joint between the femur and tibia. There is one on the inner side and one on the outer side. These two pads usually play a role in shock absorption, cushioning and maintaining stability for the knee.
For young people, meniscus injuries are mainly acute injuries caused by various sports, especially sports that require weight bearing (such as weightlifting) or running and stopping suddenly (football, basketball, fighting, etc.). For older people, meniscus damage is mostly a chronic degenerative change. After an acute meniscus injury, patients may experience swelling, pain, and limited mobility of the knee joint. After the acute phase, the knee joint generally still has pain and even feels like snapping, being stuck and unable to move.
Can meniscus injury be treated conservatively? In which case requires surgery?
Simply put, the severity of the meniscal injury dictates the treatment path. A non-severe injury may be treated conservatively, while a severe one often requires surgical intervention.
The severity of a meniscus injury can be determined by its MRI-based classification into grades 1-3:
Grade 1:the slightest lesion of the meniscus, only a little problem in the “cushion”. The cushion is still completely normal in appearance, and the surface is smooth and undamaged.
Grade 2: the moderate meniscus lesions; the extent of damage is larger than grade 1, but the damage is all internal, does not involve the surface of the meniscus, does not pass through the joint, and the surface of the meniscus is still smooth and complete.
Grade 3: It is a relatively serious injury of the meniscus, which refers to the tear-like injury of the meniscus, which has already involved the surface, and the surface of the meniscus is not smooth and is torn apart.
Generally, conservative treatment (rest, physiotherapy, medication, intra-articular injection) is the first choice for grade 1 and 2 injuries. In contrast, grade 3 injuries, particularly acute injuries in young individuals, typically require prompt surgical intervention.
What happens without timely surgery for a grade 3 injury? A grade 3 meniscus injury is a bit like a hangnail.
In the beginning, the hangnail was just raised up a little. If the hangnail were trimmed off in time at this time, it would be fine. If you don’t care about it, with the friction and extrusion, the barb is likely to be torn and bigger, exacerbating the injury and increasing the pain.
The meniscus functions in a similar manner. That is, the tearing gap goes all the way to the surface of the meniscus, and the surface of the meniscus is uneven. At this time, arthroscopic surgery should be performed in time to rest the tear, and it will be fine.
If the operation is not performed in time, then as we walk, run and jump, the meniscus will be repeatedly squeezed and rubbed by the thigh and calf bones. It will definitely rub the tear of the meniscus even more, making the damage to the meniscus more serious.
It is very likely that the meniscus that could still be sutured can only be partially removed, or a large part of the meniscus must be cut.
Treatment of meniscal injuries
In the acute phase of meniscal injury, a long-leg plaster cast can be used for 4 weeks of immobilization. Those with hemorrhage can be bandaged under local anesthesia after pumping out the hemorrhage. After the acute phase, the pain is relieved, and quadriceps exercises can be started to avoid muscle atrophy. If the symptoms cannot be eliminated, surgical treatment should be considered.
For meniscus surgery, arthroscopic surgery is currently advocated. The meniscus with separated edges can be sutured, and the torn meniscus flap that is easy to lock can be partially excised, and it can also be repaired if possible. The broken meniscus can also be completely removed under the microscope.
Arthroscopic surgery results in less physical trauma, minimal interference with the joints, and quicker postoperative recovery, allowing patients to get up and move around soon after the procedure. As such, it has become a standard treatment approach.
In this context, Canwell has developed a dedicated solution for meniscus repair-CanFast™. Designed for simplicity and quick operation, CanFast™ is suitable for fully internal, vertical fixation meniscus suture techniques.
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