The meniscus is a fibro-cartilaginous structure between the femur and tibia that has the function of increasing joint congruence and distributing the loads inside the knee. The two meniscuses, lateral and medial, act as shock absorbers and help maintain joint stability when subjected to intense stress such as a hit, jump or sudden changes of direction.
Sudden traumas or repeated micro-traumas, as well as physiological aging, are the first causes of meniscus rupture – underlines Dr. Luca Usai, specialist in Orthopedics and Traumatology and head, together with Dr. Francesca De Caro, of the Cartilage and Sports Outpatient Clinic of Humanitas Gavazzeni. A trauma is a situation that can cause inflammation of the joints with functional restriction or, in the most serious cases, a real blockage of the knee with the impossibility of walking”.
Preventing meniscus injury
Since meniscus injuries are often caused by sports traumas – the specialist points out – those who perform such an activity must heal their muscular condition: trained muscles help to reduce the possibility of distortion problems. For all others, the first aspect to be treated is the one related to their weight: the excessive load on the knees, resulting from a situation of being overweight or even obesity, can contribute to injury of the meniscus. Anyone who is subject to a deviation of the axis of the lower limbs must use special devices or undergo treatments that can correct these irregularities.
Injured meniscus: remove it or preserve it?
The trend in recent years is the conservative surgical intervention, of suture, when possible – says Dr. Usai. Not all injuries are equal, of course, but today it is believed that the most important thing is to save the meniscus in every way possible, especially if the affected subject is a young person and if he or she continuously carries out sporting activities. In the most severe cases, where the meniscus is irrecoverable, transplantation can also be an option.
It is important to keep the meniscus even when it is ruined because it is still able to perform its function of protecting our cartilage. But not only that, the meniscus is also important from another aspect: the joint surfaces do not fit perfectly together and this tissue helps to overcome this problem, increasing the congruency of the joint and thus maintaining the stability of the knee. Finally, the presence of the meniscus is also important when problems arise with the cross ligament: reconstructions of the latter in the absence of meniscus are in fact more prone to failure because there is a lack of stability in the entire joint “.
The most suitable conservative intervention
There are various techniques, very different from each other – concludes Humanitas Gavazzeni’s orthopedist. Some are arthroscopic, while others include wider cuts at knee level. In general, it can be said that in the presence of large lesions, such as those in which the meniscus is completely detached from its location, we prefer to use open surgical techniques because they offer greater guarantees of tightness over time, which is all the more important in cases with young patients”.