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Blog / Doctor Christopher Zarembinski

Monday, 7 January 2013 at 00:42

Christopher Zarembinski

Treatment of a partial tear or stretch injury is usually conservative. Physical Therapy should be a first choice option for treatment and diagnosis of injuries to this structure. This includes measures to control inflammation as well as bracing. Kannus has shown good clinical results with conservative care of grade II sprains, but poor results in grade III sprains. As a result, more severe grade III and IV injuries to the MCL that lead to ongoing instability may require arthroscopic surgery. However, the medical literature considers surgery for most MCL injuries to be controversial. Since isolated MCL injuries are uncommon, surgery is often focused on ACL replacement or repair with combined surgical approaches being common.

Dr Zarembinski:The fibers of the posterior part of the ligament are short and incline backward as they descend; they are inserted into the tibia above the groove for the semimembranosus muscle.
The anterior part of the ligament is a flattened band, about 10 centimeters long, which inclines forward as it descends.
It is inserted into the medial surface of the body of the tibia about 2.5 centimeters below the level of the condyle.
Doctor Christopher Zarembinski

The lateral meniscus is less likely to be injured or torn than the medial meniscus. Diagnosis of lateral meniscus tear is done with McMurray's test. If a tear is detected, treatment depends on the type and size of the tear. Small tears can be treated conservatively, with rest, ice, and pain medications until the pain is under control, then exercise may be started with gradually increasing intensity, to improve range of motion and decrease swelling. More severe tears of the lateral meniscus require surgical repair or removal, which can often be done arthroscopically. Swelling and stiffness of the knee can occur when you have a torn lateral meniscus.

Dr Christopher Zarembinski:

The medial collateral ligament (MCL or tibial collateral ligament) is one of the four major ligaments of the knee. It is on the medial (inner) side of the knee joint in humans and other primates.
Christopher Zarembinski
Acute injury to the medial meniscus fairly often accompanies an injury to the ACL (anterior cruciate ligament) or MCL (medial collateral ligament). A person occasionally injures the medial meniscus without harming the ligaments. Healing of the medial meniscus is generally slow. Damage to the outer third of the meniscus will often fully heal, but the inner two thirds of the medial meniscus has a limited blood supply and thus limited healing ability. Large tears to the meniscus may require surgical repair or removal. If the meniscus has to be removed (menisectomy) because of injury (either because it cannot heal or because the damage is too severe), the patient has an increased risk of developing osteoarthritis in the knee later in life.
More chronic injury occurs with osteoarthritis, made worse by obesity and high-impact activity. The medial meniscus and the medial compartment are more commonly affected than the lateral compartment.

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