Sport with a torn meniscus
Sport can be connected with a meniscus tear in different ways. On the one hand, the injury can be caused by certain types of sports and thus be an expression of a sports injury. On the other hand, many patients with a torn meniscus have the question of when sport can be recommended again.
The individual healing time after a meniscus tear can vary greatly depending on the type and location of the injury and the chosen therapy. Thus, a recommendation as to when and from which type of sport is appropriate should always be made individually. Depending on how quickly the cartilage heals, sports activities can usually be recommended again after a few weeks.
Generally speaking, knee-friendly sports such as swimming or cycling are better than running at the beginning, which can only be recommended much later. It is also decisive whether there is chronic cartilage damage in the knee or whether the meniscus tear has been caused by an injury. Injury-related cartilage damage, for example, usually occurs in younger, athletic persons, and the healing time is correspondingly shorter than in the case of a meniscus tear, which occurs due to osteoarthritis of the knee joint.
The type of therapy chosen has a major influence on the moment at which the knee can and should be partially or fully loaded again. For example, loading is usually possible again shortly after partial removal of the cartilage, whereas the knee should be treated and protected for a much longer period of time after cartilage transplantation. Special exercises during post-operative treatment can be useful and should be performed according to the recommendations of the physician and physiotherapist.
A general ban on sports can therefore not be imposed, as such lack of movement tends to be detrimental to the healing process and mobility in the knee joint. In addition to the question of when the knee can be loaded again, depending on the prevailing disease, adjustments to the type of sport performed may be necessary. Sports that are generally associated with a very high knee joint load should be avoided if possible, even after a successful therapy.
This is especially true for patients suffering from osteoarthritis of the knee joint, since the strain can also cause the destruction of existing cartilage tissue and cause further complaints. The meniscus consists of two crescent-shaped fibrocartilage discs, which are positioned between the upper and lower leg in order to compensate for the incongruity (inequality) of the articulating bones, as mentioned above, and thus transfer impacts evenly to the cartilage of the lower leg. In addition, the meniscus distributes the synovial fluid, which is particularly responsible for protecting the cartilage tissue, since it causes cartilage discs to slide over each other without friction.
It also supplies the cartilage tissue with nutrients and is responsible for the removal of waste products from the joint space. The diagram on the right shows the anatomical structure of both menisci. In the middle, the two menisci are separated by the cruciate ligaments.
To the left of the cruciate ligament is the outer meniscus (light blue coloring), to the right of the cruciate ligaments is the inner meniscus (grayish coloring). and the posterior cruciate ligament. As you can easily see in the diagram, the volume of the outer meniscus is much larger than the volume of the inner meniscus.At this point, the meniscus is to be described in more detail in its structure in order to better understand the function and possible impairments due to injuries in the meniscus area beyond the description of the fixation: The inner as well as the outer meniscus consists of three parts.
The anterior part is called the The two menisci are mounted as C- or crescent-shaped structures between the femoral condyles (= femoral joint rolls) and the tibial head joint surface (lower leg sliding surface). They are fixed in place by the joint capsule within the framework of adhesions and are supplied via their vessels. It is noticeable that the inner meniscus is connected to the capsule over almost its entire length.
This finding explains the fact that an inner meniscus is much less mobile than the more curved outer meniscus. In addition to the outer wall adhesions, both the inner and the outer meniscus are additionally fixed at the end points. These end points of a meniscus are called anterior or posterior horn, depending on their position.
Both “horns” have numerous sensory nerve endings. Fiber connections also exist between the inner meniscus and the medial collateral ligament.
- Front horn (1) marked
- The middle part as pars intermedia (2)
- And the rear part as the back horn (3).
In the last section, the supply of the menisci via the joint capsule was briefly discussed.
At this point this will be presented in more detail. Morphologically (= concerning the cellular structure), a distinction is made between the base of the meniscus, which is more directly connected to the joint capsule (red zone), the middle meniscus area (light red zone) and the white border zone. Vessels penetrate through the red zone to the middle third of the meniscus (marked light red).
The white border, on the other hand, has no vessels. It is supplied by the synovial fluid (= synovial fluid). These findings have a great impact on the chances of healing various meniscus injuries.
While the red and light red areas have good chances of healing because of the supply through the vessels, a meniscus tear in the area of the white edge is much more difficult to treat. A healing in the actual sense (restoration of an uninjured meniscus) is not possible in this zone. Since the cartilage is an important component of the knee joint, which can be damaged especially by torn menisci, the function of the cartilage will be discussed here: The cartilage is a supporting tissue consisting of water-rich cartilage cells (= chondrocytes) and so-called intercellular substances (basic substance, fibers).
Depending on the nature of the intercellular substance, a distinction is made between
- Hyaline cartilage
- Elastic cartilage
- Fibrous or connective tissue cartilage
In the area of the knee joint, the meniscus contributes in a special way to the protection of the cartilage. The meniscus absorbs shocks, but also stabilizes the knee in a special way in cooperation with the cruciate ligaments. In MRI video sequences, it could be shown that the ligament connections of the menisci in particular are required for the shock absorbing function.
Thus, loosened torn ligament connections can also be held responsible for meniscus tears, which under certain circumstances can develop from superficial meniscus tears. The yellow arrow points to a healthy meniscus. Torn or torn menisci destroy the cartilage tissue by not being able to exercise the shock absorber function to the full extent.
Arthrosis of the knee joint as a serious consequence can and will occur sooner or later. Studies have shown that meniscus injuries, regardless of their cause, occur more frequently in the area of the medial meniscus. The area of the posterior horn is particularly susceptible to injuries (about 75% of all injuries of the medial meniscus affect the area of the posterior horn).
