Progressive wear of the meniscus, mechanical symptoms and management strategies
THE degenerative meniscal lesions correspond to a progressive deterioration of the meniscus linked to natural aging of tissues and to repeated stresses exerted on the kneeUnlike traumatic injuries, they most often occur without a specific triggering event and evolve slowly and insidiously.
These lesions are common in middle-aged or older adults, but can also appear earlier in people exposed to repeated stress on the knee (physical work, high-impact sports, overweight). A medical evaluation is essential to make an accurate diagnosis and tailor the treatment.
The role of the meniscus and its aging
The menisci are two fibrocartilaginous structures located between the femur and the tibia. They perform several essential functions:
- distribution of loads within the joint,
- shock absorption,
- improved knee stability,
- protection of articular cartilage.
Over time, the meniscus undergoes structural modifications Loss of elasticity, decreased shock-absorbing capacity, and progressive weakening. This evolution makes the tissue more vulnerable, promoting the development of degenerative cracks or tears, sometimes without any obvious initial symptoms.
Mechanisms of injury degenerative meniscus
Degenerative meniscal lesions are generally not related to a single trauma, but result from a gradual wear process.
Several factors can contribute to this:
- THE natural aging of the meniscus,
- THE repeated microtrauma,
- activities involving bending, rotating or carrying loads,
- A biomechanical imbalance of the knee,
- the presence of early osteoarthritis.
These injuries often occur during seemingly innocuous everyday activities, such as getting up, squatting, or turning on a support.
Types of degenerative meniscal lesions
Degenerative meniscal lesions have different characteristics than traumatic lesions. They are most often:
- horizontal,
- complexes,
- associated with weakened meniscal tissue.
They frequently concern the medial meniscus, more mechanically stressed. These lesions can develop progressively and be accompanied by cartilage changes.
Symptoms of degenerative meniscal lesionss
The symptoms are usually progressives and can fluctuate over time. The pain is often mechanical in nature, appearing during exertion and decreasing at rest.
The most common signs include:
- a localized pain on the inner or outer side of the knee,
- discomfort during prolonged walking, climbing stairs, or squatting,
- of the episodes of joint swelling,
- sometimes a sensation of being stuck or hanging.
Unlike traumatic injuries, blockages are often intermittent and less abrupt.
Differentiating a degenerative meniscus lesion from other pathologies
There symptomatology of degenerative meniscal lesions It can be misleading, as it shares many similarities with other common knee conditions. Mechanical pain, functional impairment, or episodes of swelling are not specific and can indicate various joint disorders.
The main conditions that can be confused with other conditions include:
- knee osteoarthritis, often associated with morning stiffness and progressive pain,
- THE cartilage lesionsresponsible for diffuse pain and sometimes recurring swelling,
- THE periarticular tendinopathieswhich cause localized pain related to exertion,
- THE lower limb axis disorders, which can lead to asymmetrical mechanical overloads.
A thorough medical evaluationCombining clinical examination and imaging if necessary, is essential to distinguish these different causes, make an accurate diagnosis and avoid inappropriate management that could worsen symptoms or delay functional improvement.
Diagnosis of degenerative meniscal lesions
The diagnosis of degenerative meniscal lesions is based on a clinical and radiological approachIt allows confirmation of meniscal damage and assessment of the overall condition of the knee, often marked by associated degenerative phenomena.
Clinical examination
The clinical examination guides the diagnosis based on the symptoms described by the patient. It specifically analyzes:
- there location and mechanical nature of the pain,
- there knee mobility,
- the possible presence of a joint swelling,
- THE pain triggered by certain movements.
Medical imaging
L'Knee MRI is the gold standard examination. It allows:
- to confirm the degenerative meniscal lesion,
- to specify its morphology,
- to look for associated lesions, particularly cartilage or arthritic lesions.
This assessment is essential for adapting the care provided.
Treatment options
The management of degenerative meniscal lesions is most often conservative first-line treatmentthe aim being to relieve pain, improve knee function and slow down degenerative progression.
Conservative treatment
Conservative treatment forms the basis of management. It is based on:
- L'adaptation of activitiesin order to limit excessive stress on the knee,
- a targeted rehabilitationaiming to restore mobility and stability,
- THE muscle strengthening stabilizing muscles,
- L'improved joint control and the movement pattern.
This approach allows for relieve symptoms in the majority of cases and to avoid surgery.
surgical treatment
Surgery is reserved for specific situations, particularly in cases of:
- persistent pain despite well-conducted treatment,
- repeated and debilitating joint blockages.
When it is considered, the intervention remains cautious and limited, there Maximum preservation of the meniscus being always preferred in order to protect the cartilage and the joint health of the knee.
Evolution and prognosis
THE degenerative lesions of the meniscus most often evolve in a way slow and progressivewith periods of remission and recurrence of symptoms. Their progression depends on several factors, including age, activity level, cartilage condition and quality of care.
Appropriate care allows for:
- of to control pain in the long term,
- of maintain good knee function in daily activities,
- of slow down the degenerative process of the joint.
A regular medical check-ups is recommended in order to assess the evolution of symptoms, adjust treatment if necessary and prevent the worsening of joint damage in the long term.
Resumption of activity and sport
There resumption of physical activity after a degenerative meniscal lesion should be progressive and adapted to the evolution of symptoms. The goal is to maintain activity that is beneficial for the knee while avoiding excessive stress that could reactivate the pain.
Before resuming operations, it is important to ensure:
- of a controlled pain,
- of a satisfactory mobility of the knee,
- of a stability and sufficient muscular strength.
The resumption of sports activities initially prioritizes those involving low impactThis can then be increased depending on the knee's tolerance. Supervision by a healthcare professional allows for adjusting the loads, correcting risky movements, and limiting recurrences.
Conclusion
THE traumatic meniscal lesions These are common knee injuries, often linked to a sudden twisting movement. They can cause pain, locking, and significant functional impairment.
A precise diagnosisassociated with a appropriate and early careThis is essential for preserving knee function and limiting long-term complications. An individualized approach optimizes recovery and promotes a safe return to daily and sporting activities.
