Meniscus
Meniscus Injury/Tear:
Mechanism:
The most common mechanism of menisci injury is a twisting injury with the foot anchor on the ground, often by another player’s body.
A slow twisting force may also cause the tear.
Damage to the meniscus is due to rotational forces directed to a flexed knee (as may occur with twisting sports) is the usual underlying mechanism of injury .
Types Of Meniscal Tear:
The meniscal tear is of following types:
Longitudinal
Radial
Bucket handle
Flap
Horizontal cleavage
Degenerative
Longitudinal/vertical tear:
This type of tear can be anywhere along the meniscus. If this tear extends it may result in a bucket-handle tear. The ‘handle’ or ‘bucket-handle’ tears run across nearly the entire length of the meniscus. This often causes the formation of a flap that can get caught between the intercondylar space.
Horizontal tear or horizontal slit:
Often forms part of more complex cracks, which consist of more of the above. This tears begin at the inner edge of the meniscus and continue against the capsule.
Flap tear :
There are two types of flap tears, a horizontal and a vertical. The horizontal flap tear is the same as the horizontal tear but with complications. When you have a horizontal flap tear the inferior and superior surface of the meniscus can be uninjured, which is not the case with a vertical flap tear.
Complex tear:
These are patterns that describe tears in different planes and are seen in the degenerative meniscus.
Clinical Presentation:
Medial Meniscus:
The diagnosis of an medial meniscus injury is considered to be fairly certain if three or more of the following findings are present
Tenderness at one point over the medial joint line
Pain in the area of the medial joint line during hyperextension of the knee joint
Pain in the area of the medial joint line during hyperflexion of the knee joint
Pain during external rotation of the foot and the lower leg when the knee is flexed at different angles around 70–90°
Weakened or hypotrophied quadriceps muscle.
Lateral meniscus:
The diagnosis of a lateral meniscus injury is considered to be fairly certain if three or more of the following findings are present:
tenderness at one point over the lateral joint line.
pain in the area of the lateral joint line during hyperextension of the knee joint.
pain in the area of the lateral joint line during hyperflexion of the knee joint.
pain during internal rotation of the foot and the lower leg when the knee is flexed at different angles;
weakened or hypotrophied quadriceps muscle.
Diagnosis:
Special test
X-ray
MRI
Special test are:
The most commonly used special tests are:
McMurry test
Apley’s test
Steinman’s test
Ege’s test
Thessaly test