What Is the Treatment for a Knee Cyst?

The age of meniscus cysts is mainly young, and it is more common in athletes, most of which occur in the outer meniscus, with a ratio of 5: 1 to 10: 1. Its formation is mostly related to trauma. Common intrameniscus cysts and perimenopausal cysts.

Meniscus cyst

Overview of meniscus cysts

The meniscus of the knee joint is fibrous cartilage tissue with a thick peripheral edge and a thin inner edge. It is a meniscus from the plane and is called a meniscus. It is filled between the femoral condyle and the tibial condyle to enhance the stability of the knee . The characteristics of the structure and function of the meniscus determine that it is one of the easily damaged tissues in the knee joint. Men who are engaged in strenuous exercise and special occupations are more likely to have a meniscus injury.

Meniscus injury

Pathogenesis of meniscus cyst

Knee joint meniscus injury is often caused by knee flexion and flexion accompanied by internal and external rotation of the calf or varus, which causes contradictory movement of the meniscus. Meniscal cysts can cause the femoral condyles to slide on the meniscus, push the meniscus forward when it extends, and backward when flexed. When the knee joint is rotated, the meniscus moves in concert with the femoral medial and lateral condyles. The rotation occurs between the meniscus and the tibial plateau, with one side of the meniscus forward and the other side of the meniscus backward. When the knee joint is in a semi-flexed position and the calf is in or out of rotation, the meniscus is squeezed and cannot move. When it is suddenly straightened or further rotated, the tensile force of the fibrous cartilage of the meniscus itself or its surrounding fibrous tissue exceeds its own endurance, tearing will occur.

1. When the knee joint flexes, the tibia is fixed, and the femur is strongly externally rotated, it can cause damage to the anterior horn of the lateral meniscus or the posterior horn of the medial meniscus.

Meniscal cyst ^[1]

2. Strong internal rotation of the femur (or external rotation of the lower leg) in the state of knee flexion, which may easily cause damage to the posterior angle of the lateral meniscus or the front of the medial meniscus. Long-term compression and wear can cause degeneration and easily cause tearing. Meniscus abnormal looseness, joint ligament instability after injury, or obesity, excessive weight and other reasons are all factors that make meniscus vulnerable.

According to foreign literature, meniscus injuries are mostly medial, while domestic reports are more common laterally. Meniscus injuries include edge tears, vertical tears, horizontal tears, horizontal tears, and front and back corner tears. Because the meniscus itself has no blood flow, there is blood circulation only in the periphery. Therefore, only edge tears are likely to heal.

Causes of meniscus cysts

1. Trauma: Can cause contusion and hemostasis in meniscus tissue, resulting in mucus-like degeneration.

2. Degeneration with age: can cause local necrosis and mucus degeneration into cysts.

3 Synovial cell inclusions or tissue metaplastic cells formed in the meniscus tissue secrete mucus to cause cyst formation.

4 Synovial cells are displaced into the meniscus by a small tear in the fibrocartilage, resulting in the secretion of acidic mucopolysaccharide protein, forming the contents of the meniscus cyst. Smaller cysts first appeared in the avascular zone. Later, due to the pumping action of the synovial fluid suction of the joints, the small cysts migrated around the knee joint, and more fluid entered the cysts to increase the volume.

Meniscal cyst symptoms

1. Most patients have no history of trauma, gradually swell after injury, and the injured side is more significant.

2. Pain often occurs in a certain position during exercise, and the pain may disappear after the position is changed. The pain is in the joint space on both sides.

3. Walking is OK, but fatigue, especially when going up and down stairs, and accompanied by pain or discomfort. In the elderly, the quadriceps will gradually shrink.

4. Interlocking symptoms. When in motion, the femoral condyle protrudes into the rupture of the meniscus and cannot be lifted off, which can suddenly cause knee flexion and extension disorders and form an interlock. After relaxing your muscles, changing your position, and rotating or flexing your muscles autonomously or passively, interlocking can be relieved.

Meniscus cyst injury types

1. Marginal type: The rupture is located in the front, middle and rear positions of the edge of the medial meniscus. A severe marginal rupture is a complete perimeter rupture, connected only by the front and rear corners, and the ruptured waist slides toward the center of the knee. And lead to joint lock. Symptoms are significant when the knee is extended. It is believed that this type may heal on its own. Some also healed by sutures.

2. Anterior angle type: The rupture is located at the anterior corner, which can be just the nick, or it can be rolled backward and thickened as the rupture, and the anterior horn connection is also broken. The pain is located in front of the knee, but it may be indistinguishable between patients inside and outside.

3. Posterior horn type: The rupture is located in the posterior corner, which can be a crevice, the crevice shrinks and the posterior horn connecting fiber breaks. Pain is noticeable when knee flexes excessively. Pain can be pointed to the back and inside, but there are a few that can't indicate the side.

4 Horizontal type: The medial meniscus waist ruptures laterally, and the number and depth of ruptures vary. Pain in the medial knee can be indicated, with occasional joint interlocking.

5. Bucket handle type: It is a longitudinal rupture of the inner meniscus. The slits can be of different sizes and have transverse cracks. The rupture opening was thickened significantly, and the femoral condyle synovium was extensively damaged. The affected knee often has "locking", which is laborious and time consuming.

6. Inner edge type: There is one or more injuries on the inner edge of the meniscus, and it can show comminuted damage. Occasionally, free pieces enter the joint cavity. This type often affects flexion and extension of the knee, showing pain over the years, obvious damage to the femoral condylar joint surface, and sometimes joint interlocking. X-ray film is rare. Free bone pieces.

7. Horizontal split type: The tibiofemoral joint rotates so strongly that the two layers of the medial meniscus are separated horizontally. If diagnosed early and well braked, repair may be possible. The affected knee may show dull pain, instability, or a feeling of slipping.

8. Longitudinal fissure type: The inner meniscus ruptures vertically. It can break at the front or back corner, and the free part enters the knee, becoming the main factor of knee pain and blocking of extension and flexion.

9. Relaxed type: The medial meniscus is relaxed at the joint capsule attachment. Every time the knee is stretched and flexed, the rotation has an unstable slipping feeling. When the tibiofemoral joint is squeezed toward the center of the knee, the medial joint capsule (and skin) can sink into the joint space. This type can be caused by a trauma or a congenital structural defect. ^[2]

Meniscus cyst harm

Joint pain

Pain occurs when the knee joint is in a certain position. When the position is changed, the pain can disappear.

Muscle atrophy

The quadriceps is the main component. Due to the meniscus injury, the knee joint is restricted, and the long-term muscles have atrophic atrophy. The more severe the muscle atrophy, the more obvious the weakness of the lower limbs.

3. Inconvenient walking

After the meniscus is ruptured due to long-term wear or acute injury, it has partially or completely lost its original function, and even formed interference in the joints, resulting in joint interlocking and springing, affecting the normal movement of the knee joint, causing inconvenience to walking Troubled.

Meniscal cyst examination

Between the patellar ligament and the collateral ligament, there is a fixed and limited tenderness along the joint space. Mycosis is positive. The grinding test was positive. X-ray examination can help exclude bone lesions or other conditions. The diagnosis rate of knee arthroscopy is over 90%.

Self-diagnosis of meniscus cyst

1. Most patients have a history of knee sprain.

2. When the knee joint is stretched and flexed, there is a popping sound in the knee.

3. There was a tear and noise in the knee joint at the time of the injury, that is, severe pain, swelling of the joints, and dysfunction of flexion and extension. Knee joint pain is obvious when walking and going up and down stairs. Some patients may suffer from soft legs and twists in the knee.

4. Quadriceps atrophy and tenderness in the knee joint space can be found during inspection. The knee joint cannot be overextended or flexed.

5. Meniscus bounce test: The patient is lying on his back, fully flexing his hips and knees. The examiner holds the foot in one hand and puts the other in the knee. Spread, then adduct and straighten, positive if there is pain or popping. Most patients are positive.

6. Grinding test: The patient is in the prone position, suffering from knee flexion of 90 °. The examiner presses down on the foot and ankle and rotates it. It is positive when there is pain in a certain position, and some cases can be positive.

Meniscus Cyst Treatment

There are limited indications for non-surgical treatment. Non-surgical treatments include bed rest, which must be treated with traditional Chinese medicine, and then suction fluid in the joints, elastic bandages and pressure bandaging, etc., and cast-type fixation and strengthening of the quadriceps exercise. For patients with mild symptoms or obvious degeneration.

Minimally invasive meniscus cyst therapy

Arthroscopy minimally invasive technology ^[3] is a rod-shaped optical device with a diameter of about 5mm for observing the internal structure of joints. It is an endoscope used to diagnose and treat joint diseases. The internal structure of the joint will be displayed on the monitor, which can dynamically observe the degree of influence of abnormal tissue on joint stability and function. Under the monitor of the monitor, various lesions can be accurately resected, trimmed, sutured, fixed, and reconstructed to achieve the goal of radical cure. It has a significant effect on the treatment of meniscus cysts.

Traditional Chinese medicine therapy for meniscus cysts

^[4] Meniscus injury is difficult to heal, because its slow blood supply is only the blood supply on the outer side close to the joint capsule side, so it must be topically applied with traditional Chinese medicine Wulakun cream to improve and increase blood circulation and increase local cartilage tissue permeability The damaged soft tissue is repaired through local penetration, and meniscus cysts are completely and fundamentally treated, which has been widely recognized by the medical community. Individual patients with severe effusions need to withdraw effusions and apply pressure bandaging. ^[4] Angelica, Chuanchuan, Safflower, Yanhusuo, Poria, Sanling, Cork, Sichuan achyranthes, continuum, Atractylodes, Duhuo, Qianjin rattan, red peony, etc. can strengthen muscles and strengthen bones and enhance the load capacity of meniscus To make the knee joint more firm and stable.

Meniscal cyst technique

1. The patient is in a supine position. The doctor first applies a kneading method between the patellar ligament and the lateral ligament at the lower edge of the sacrum, with acid swelling as the degree.

2. Roll the knee joint and its surroundings, mainly at the upper and lower edges of the sacrum and the quadriceps, for about 5 minutes, then shake the knee joint (flexion and extension first, then internal and external rotation).

3. Press the two knee eyes, knee Yangguan, Ququan and Heding points to the degree of acid swelling.

4. Rub the affected part with the degree of heat penetration, and apply hot and humid compresses.

Meniscal cyst western medicine

1. The hospital treats meniscus cyst

Orthopaedic hospitals can only treat patients with ordinary painkillers, anti-inflammatory injections or effusions. Blocking (sodium hyaluronate) can be done once or twice. Once the joint cavity is infected for a long time, it will make the treatment of the disease more difficult.

2. Oral drugs for meniscus cysts

Oral medicine is the preferred treatment method for most patients after the disease, but oral medicine is not effective in treating meniscus damage, mainly because oral medicine reaches the lesion site through blood circulation, and the meniscal cartilage in the joint cavity is avascular. Organization, so the effect is minimal.

Physical treatment of meniscus cyst

Acupuncture cupping, acupuncture, massage and other physical therapy methods play the role of promoting blood circulation, removing stasis, and channeling collaterals, but only as an adjuvant treatment. Meniscal cysts are mainly caused by aseptic inflammation of the joints, and it is impossible to completely eliminate aseptic inflammation.

Meniscus cyst massage

(1) Loose tendon method: The surgeon uses a tap to release the soft tissue around the knee joint, and straightens the tendons for 3 to 5 minutes (the prone position of the back of the knee joint can be used).

(2) Manipulation method: The surgeon first rubs the patellar body (knead the thumb on the patellar bone, then scrapes around the patellar bone).

(3) Knee expansion method: The operator moves the knee joint several times, placing one forearm on the back side of the knee joint as a fulcrum, flexing the knee joint as much as possible, and then removing the arm serving as the fulcrum, and then directly flexing the knee joint 2 to 3 times.

Precautions for meniscus cysts

1. Be prepared when doing physical exercise, wait for the joints to warm up, and respond flexibly before starting exercise;

2. Don't exercise under fatigue, so it's easy to coordinate movements, which can cause knee meniscus injury and meniscus injury;

3. Strengthen muscle strength exercises to ensure the stability and flexibility of the joints; avoid excessive movements during exercises to avoid accidents.

Daily Meniscus Cyst Care

I. In daily life, we must foresee the possibility of accidents in all things, and make full use of the tools around us to help reduce the risk of meniscus damage caused by accidents. For example, when getting on or off the bus or going up and down stairs, don't be too rushed. You can use the handrail to help stabilize your body and take another step. People with professional habits should change their working position and take a break every so often.

Second, you must pay full attention when you are going up and down the stairs. After the two feet are stable, take the second step to avoid trauma. To prevent knee trauma, you can usually wear knee pads. Strengthen the functional exercise of the quadriceps, such as freehand exercises and weight-bearing exercises, to improve the stability of joints.

3. Reasonably arrange rest and work time, get enough sleep, pay attention to safety, do not walk in wet and slippery places, keep warm and keep warm, and take appropriate exercise, such as walking, to maintain a comfortable mood.