Understanding the mechanisms, recognizing the symptoms, and acting early to protect the knee
THE traumatic meniscal lesions These represent a common cause of pain and functional impairment of the knee, particularly in active individuals and athletes. They most often occur following a sudden twisting movement, from a wrong movement or a fall, when the knee is subjected to significant stress in rotation or flexion.
Depending on the nature of the trauma and the condition of the knee, the meniscus may be crack, se deform or se ripcausing symptoms that are sometimes immediate, sometimes delayed. Prompt medical attention is essential to confirm the diagnosis, tailor the treatment, and limit the risk of worsening or long-term complications.
The essential role of the menisci
The knee contains two menisci:
- THE medial meniscus (internal),
- THE lateral meniscus (external).
These fibrocartilaginous structures play a fundamental role in the proper functioning of the joint. They ensure:
- a harmonious distribution of the burdens between the femur and the tibia,
- a stability improvement of the knee,
- a protection of articular cartilage,
- a contribution to the proprioception.
When a meniscus is damaged, the mechanical balance of the knee is disrupted, exposing the joint to abnormal stresses.
How do these meniscus lesions occur?
Traumatic meniscal tears usually occur on a healthy knee, following a well-identified event. They are frequent during activities involving rapid or poorly controlled movements.
The most common situations include:
- A twisting motion knee with foot fixed to the ground
- A sudden change of direction,
- a unbalanced jump landing,
- A faux pas or a fall with a bent knee.
These mechanisms are particularly found in so-called "pivot" sports (football, rugby, skiing, handball), but also during everyday activities.
Types of traumatic meniscus injuries
Depending on the mechanism and intensity of the trauma, several types of injuries may be observed:
- meniscal tear : partial involvement, sometimes with few symptoms at the beginning
- longitudinal or radial tear,
- bucket-handle lesionwhich can lead to joint blockage,
- complex lesion, combining several tear planes.
The type of lesion directly influences the symptoms, treatment, and prognosis.
What are the symptoms?
Symptoms may appear immediately after the trauma or in a way progressive in the following daysTheir intensity varies according to the severity of the injury.
The most frequently reported signs are:
- a localized pain, often on the inner or outer side of the knee,
- A joint swellingimmediate or delayed,
- a walking difficulty, especially when going up stairs or squatting,
- a sensation of being stuck or caught,
- sometimes an impression ofinstability.
Joint locking, when present, is a suggestive sign of a displaced meniscal lesion.
Differentiating between meniscal tears and other knee pathologies
Knee pain following trauma does not always indicate a meniscal tear. Other structures may be affected, sometimes in combination.
The differential diagnosis includes, in particular:
- ligament injuries (anterior cruciate ligament, lateral ligaments),
- bone contusions,
- cartilage lesions,
- simple knee sprains.
A medical evaluation is therefore essential to precisely identify the origin of the symptoms.
Diagnosis of traumatic meniscal lesions
The diagnosis of traumatic meniscal lesions relies on a complementary clinical and radiological approachIt allows confirmation of meniscus damage, assessment of its severity, and identification of any associated injuries.
Clinical examination
The clinical examination guides the diagnosis based on the patient's history and the analysis of symptoms. The practitioner specifically assesses:
- there location of the pain,
- there presence of joint swelling,
- L'amplitude of movements of the knee,
- the existence of a joint locking or mechanical pain.
Of the specific clinical tests tests can be performed to reinforce the suspicion of a meniscal tear.
Medical imaging
L'Knee MRI is the gold standard examination. It allows you to:
- confirm the meniscal tear,
- specify its type and extent,
- look for any associated injuries.
This assessment is essential to adapt the treatment and prevent the injury from worsening.
Treatment options
The treatment of traumatic meniscal lesions must be individualized and adapted to each clinical situation.
The therapeutic decision depends in particular on:
- of the patient's age and its overall joint condition,
- of his activity level and its functional or sporting objectives,
- of type of meniscal lesion, its location and extent,
- of the presence of associated lesions, particularly ligamentous or cartilaginous.
The main objective of the treatment is to relieve the symptoms, of to restore satisfactory joint function and prevent degenerative complications.
Conservative treatment
In certain situations, treatment non-surgical This approach may be recommended, particularly when the lesion is stable, small, and causes moderate symptoms. It is often preferred in patients with good knee stability and no joint locking.
Conservative treatment is based on:
- A relative resthelping to reduce inflammation and pain,
- a adapted rehabilitationaiming to restore knee mobility and control,
- A targeted muscle strengthening, including the quadriceps, hamstrings and stabilizing muscles,
- a gradual resumption of activities, while respecting the functional capabilities of the knee.
Regular clinical monitoring is essential to assess the evolution of symptoms and to adapt treatment if necessary.
surgical treatment
There surgery may be indicated when conservative treatment is insufficient or from the outset in cases of lesions causing significant symptoms. It is particularly considered in the presence of:
- persistent pain despite well-managed care,
- joint lockingindicating a displaced meniscal tear,
- unstable or complex lesioncompromising knee function.
The surgical procedure may consist of:
- a meniscus repairwhich aims to preserve the meniscal tissue and maintain its protective role,
- a partial meniscectomy, carried out when repair is not possible, by removing only the damaged part.
Resumption of activities and return to sport
The return to activity must be progressive and structuredIt depends on:
- the type of treatment,
- of the healing process,
- of muscle and functional recovery.
Resuming activity too early exposes one to a risk of recurrence or aggravated injury.
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.
