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Hva er en meniskskade?

Innhold i artikkelen

Skade på meniskene består som regel av rifter eller brudd i menisken. Menisken kan skades på begge sider, men den på innsiden i kneet (mediale menisk, indre menisk) er mye hyppigere skadet enn den ytre (laterale menisk). Forklaringen er at den mediale menisken er festet til andre strukturer i området, og derved blir noe mindre bevegelig sammenlignet med den laterale menisken.

Animasjon av medial meniskskade

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For degenerative meniskskader er målet å unngå tap av meniskvev ved kirurgi, mens strategien for de traumatiske meniskskadene er tidlig kirurgisk reparasjon, slik at man kan redde og bevare menisken i størst mulig grad.

Rifter i meniskene skaper ujevne overflater eller ustabile meniskbiter inne i kneleddet som gjør at leddet hekter seg opp, låser seg, gir smerter eller en kombinasjon av dette - og disponerer for betennelsesreaskjon (inflammasjon) i leddet.

Overrevne menisker tilheler sjelden spontant fordi bare en mindre del av meniskene har blodforsyning.

Vil du vite mer

Dette dokumentet er basert på det profesjonelle dokumentet Meniskskade i kneleddet . Referanselisten for dette dokumentet vises nedenfor

  1. Baker BS. Meniscus Injuries. Medscape, Sports Medicine. Last updated Oct 12, 2018. emedicine.medscape.com
  2. Kise NJ, Heir S. Hvilke meniskskader skal opereres? Tidsskr Nor Legeforen. Publisert 22. mars 2022. doi: 10.4045/tidsskr.21.0540 DOI
  3. Garcia JR, Ayala SG, Allende F, et al. Diagnosis and Treatment Strategies of Meniscus Root Tears: A Scoping Review. Orthop J Sports Med. 2024 Nov 1;12(11):23259671241283962. PMID: 39493310 PubMed
  4. Englund M, Guermazi A, Gale D et al. Incidental meniscal findings on knee MRI in middle-aged and elderly persons. N Engl J Med 2008; 359: 1108-15. New England Journal of Medicine
  5. Lohmander LS, Englund PM, Dahl LL, et al. The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. Am J Sports Med. 2007;35:1756-1769. PubMed
  6. Koo JH, Choi SH, Lee SA, Wang JH. Comparison of Medial and Lateral Meniscus Root Tears. PLoS One. 2015 Oct 21;10(10):e0141021. PMID: 26488288 PubMed
  7. Karpinski K, Forkel P, Häner M, Bierke S, Petersen W. Etiology of posterior meniscus root tears: medial vs. lateral. Arch Orthop Trauma Surg. 2023 Jan;143(1):429-437. PMID: 35076768. PubMed
  8. Stärke C, Kopf S, Petersen W, et al. Meniscal repair. Arthroscopy 2009; 25: 1033-1044. PubMed
  9. Granan LP, Forssblad M, Lind M, et al. The Scandinavian ACL registries 2004-2007: baseline epidemiology. Acta Orthop. 2009;80:563-567. PubMed
  10. Ryzewicz M, Peterson B, Siparsky PN, Bartz RL. The diagnosis of meniscus tears: the role of MRI and clinical examination. Clin Orthop Relat Res. 2007 Feb;455:123-33. PMID: 17279041 PubMed
  11. Smith BE, Thacker D, Crewesmith A, Hall M. Special tests for assessing meniscal tears within the knee: a systematic review and meta-analysis. Evid Based Med 2015; 20 (3); 88-97. ebm.bmj.com
  12. Sagsveen M. Lite samsvar mellom knesmerte og MR-funn. Tidsskriftet . tidsskriftet.no
  13. Cardone DA, Jacobs BC. Meniscal injury of the knee. UpToDate. Literature review current through: Oct 2018. Nettsiden besøkt 19.11.18. www.uptodate.com
  14. O'Donnell K, Freedman KB, Tjoumakaris FP. Rehabilitation Protocols After Isolated Meniscal Repair: A Systematic Review. Send to Am J Sports Med 2017; 7: 1687-97. pmid:28256906 PubMed
  15. Husted H, Winge S. Klinisk kneundersøkelse - hvilke tester kan brukes i diagnostikken av menisk- og ligamentskader?. Tidsskr Nor Lægeforen 2001; 121: 1484-7. Tidsskrift for Den norske legeforening
  16. Eren OT. The accuracy of joint line tenderness by physical examination in the diagnosis of meniscal tears. Arthroscopy. 2003 Oct. 19(8):850-4.
  17. Lee JH, Lim YJ, Kim KB, Kim KH, Song JH. Arthroscopic pullout suture repair of posterior root tear of the medial meniscus: radiographic and clinical results with a 2-year follow-up. Arthroscopy. 2009 Sep. 25(9):951-8.
  18. Blyth M, Anthony I, Francq B, et al. Diagnostic accuracy of the Thessaly test, standardised clinical history and other clinical examination tests (Apley's, McMurray's and joint line tenderness) for meniscal tears in comparison with magnetic resonance imaging diagnosis. Health Technol Assess 2015; 62: 1-62. pmid:26243431 PubMed
  19. Enger M. Meniskruptur. Oslo skadelegevakt metodebok i skadebehandling. Sist oppdatert 15.08.2017. skadelegevakten.no
  20. Phelan N, Rowland P, Galvin R. A systematic review and meta-analysis of the diagnostic accuracy of MRI for suspected ACL and meniscal tears of the knee. Knee Surg Sports Traumatol Arthrosc 2016; 24(5): 1525-39. pmid:26614425 PubMed
  21. Bernthal NM, Seeger LL, Motamedi K, et al. Can the reparability of meniscal tears be predicted with magnetic resonance imaging? Am J Sports Med 2011; 39: 506-10. PubMed
  22. Shetty AA, Tindall AJ, James KD, Relwani J, Fernando KW. Accuracy of hand-held ultrasound scanning in detecting meniscal tears. J Bone Joint Surg Br 2008; 90-B: 1045-8.
  23. Siemieniuk RAC, Harris IA, Agoritsas T, et al. Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline. BMJ. 2017;357:j1982. Published 2017 May 10. PMID: 28490431 PubMed
  24. Khan M, Evaniew N, Bedi A et al. Arthroscopic surgery for degenerative tears of the meniscus: a systematic review and meta-analysis. CMAJ 2014; 186: 1057–64. PMID: 25157057 PubMed
  25. Swart NM, van Oudenaarde K, Reijnierse M et al. Effectiveness of exercise therapy for meniscal lesions in adults: A systematic review and meta-analysis. J Sci Med Sport 2016; 19: 990–8. PMID: 27129638 PubMed
  26. Thorlund JB, Juhl CB, Roos EM et al. Arthroscopic surgery for degenerative knee: systematic review and meta-analysis of benefits and harms. Br J Sports Med 2015; 49: 1229–35. PMID: 26383759 PubMed
  27. Beaufils P, Becker R, Kopf S et al. The knee meniscus: management of traumatic tears and degenerative lesions. EFORT Open Rev 2017; 2: 195–203. PMID: 28698804 PubMed
  28. Kise NJ, Aga C, Engebretsen L et al. Complex Tears, Extrusion, and Larger Excision Are Prognostic Factors for Worse Outcomes 1 and 2 Years After Arthroscopic Partial Meniscectomy for Degenerative Meniscal Tears: A Secondary Explorative Study of the Surgically Treated Group From the Odense-Oslo Meniscectomy Versus Exercise (OMEX) Trial. Am J Sports Med 2019; 47: 2402–11. PMID: 31298923 PubMed
  29. Skou ST, Hölmich P, Lind M, et al. Early Surgery or Exercise and Education for Meniscal Tears in Young Adults. N Engl J Med 2022. doi:10.1056/EVIDoa2100038 DOI
  30. Bergenstock M, Min W, Simon AM, et al. A comparison between the effects of acetaminophen and celecoxib on bone fracture healing in rats. J Orthop Trauma 2005; 19: 717-723. PubMed
  31. O'Connor JP, Lysz T. Celecoxib, NSAIDs and the skeleton. Drugs Today (Barc) 2008; 44: 693-709. PubMed
  32. Gjør kloke valg. Norsk forening for allmennmedisin. Unngå å forskrive NSAID uten at det foreligger spesifikk grunn og risiko for bivirkninger er vurdert. Publisert 4. juli 2018. www.legeforeningen.no
  33. Cinque ME, Chahla J, Moatshe G, et al.. Meniscal root tears: a silent epidemic. Br J Sports Med. 2018 Jul;52(13):872-876. pmid:29574455 PubMed
  34. Persson F, Turkiewicz A, Bergkvist D, et al. The risk of symptomatic knee osteoarthritis after arthroscopic meniscus repair vs partial meniscectomy vs the general population. Osteoarthritis Cartilage 2018; 26(2): 195-201. pmid:29146386 PubMed
  35. Mutsaerts EL, van Eck CF, van de Graaf VA, et al. Surgical interventions for meniscal tears: a closer look at the evidence. Arch Orthop Trauma Surg. 2016 Mar;136(3):361-70. pmid: 26497982 PubMed
  36. Beaufils P, Becker R, Kopf S, et al. Surgical Management of Degenerative Meniscus Lesions: The 2016 ESSKA Meniscus Consensus. Send to Knee Surg Sports Traumatol Arthrosc 2017; 25: 335-346. pmid:28210788 PubMed
  37. Sihvonen R, Paavola M, Malmivaara A, et al. Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear. N Engl J Med. 2013: 26; 369: 2515-24. doi: 10.1056/NEJMoa1305189 DOI
  38. Kise NJ, Risberg MA, Stensrud S, et al. Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up. BMJ 2016; 354: i3470. doi:10.1136/bmj.i3740 DOI
  39. Nepple JJ, Dunn WR, Wright RW. Meniscal repair outcomes at greater than five years: a systematic literature review and meta-analysis. J Bone Joint Surg Am 2012; 94: 2222–7. PMID: 23318612 PubMed
  40. LaPrade RF, Matheny LM, Moulton SG et al. Posterior Meniscal Root Repairs: Outcomes of an Anatomic Transtibial Pull-Out Technique. Am J Sports Med 2017; 45: 884–91. PMID: 27919916 PubMed
  41. Weber J, Koch M, Angele P et al. The role of meniscal repair for prevention of early onset of osteoarthritis. J Exp Orthop 2018; 5: 10. PMID: 29607459 PubMed
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