Cartilage Damage in the Joint

It is important to emphasize that meniscal injuries frequently coincide with tears of the anterior cruciate ligament (ACL). Such trauma typically results from the application of substantial mechanical force, yet it often occurs in contexts where the meniscal structure has been previously compromised by cumulative microtraumas—ultimately leading to the formation of a distinctive longitudinal tear within the horizontal plane. Subsequent therapeutic interventions for meniscal damage are primarily dictated by the precise location of the lesion: whether it affects the vascularized region (the so-called "red zone") or the avascular portion (the "white" or "red-white" zone).

Among the most frequent manifestations of this type of injury—beyond the expected pain—are sudden, sharp "catching" sensations within the knee joint, coupled with a markedly reduced capacity for full flexion of the limb. Patient histories commonly reveal a rotational trauma mechanism occurring alongside slight knee flexion. It is not uncommon for the knee to become completely locked in a flexed position, with restoration of full extension often requiring deliberate manual manipulation. A distinguishing feature is the restricted range of extension accompanied by a springy, soft resistance sensation during the terminal phase of movement. Additionally, periarticular swelling and an inability to bear weight on the affected limb during ambulation or standing may also present.

Immediately following an incurred injury, therapeutic management adheres to the **P**rotection, **R**est, **I**ce, **C**ompression, and **E**levation (P. R. I. C. E.) protocol, supplemented by anti-inflammatory pharmacological interventions—such as topical ointment applications. Comprehensive post-injury care integrates manual therapy techniques (including transverse friction massage), proprioceptive stability training, progressive resistance exercises, and targeted stretching regimens. During the initial four-week phase post-trauma, significant reduction of knee joint loading is advised, alongside restriction of flexion to a maximum of 60 degrees to mitigate the risk of secondary damage to healing tissues. Biomechanical evidence demonstrates that knee motion below 60 degrees induces minimal meniscal displacement, whereas flexion exceeding this threshold triggers posterior translocation, potentially generating deleterious tensile forces on the injured structure. In severe cases where conservative measures prove ineffective, radical surgical excision of the meniscus—termed meniscectomy—becomes necessary. Under these circumstances, the rehabilitation process may proceed at an accelerated pace, as concerns regarding meniscal re-injury are eliminated. Primary therapeutic objectives post-meniscectomy focus on rapid alleviation of pain and edema, immediate full weight-bearing on the operated limb, restoration of complete range of motion, and quadriceps muscle strength rehabilitation. The menisci play a pivotal role in knee joint biomechanics: in full extension, they transmit approximately 50% of compressive forces acting on the knee, with this proportion increasing to 85% at 90 degrees of flexion. Published data indicate that total meniscectomy may reduce the joint’s shock-absorbing capacity by up to 20%, thereby predisposing to accelerated degenerative joint disease progression.