© ACIBADEM HEALTHCARE SERVICES 2021
DO NOT BE SURPRISED, THEY CAN EVEN HAPPEN IN CHILDREN! THIS CONDITION, WHICH IS RATHER KNOWN AS AN ADULT DISEASE, CAN ALSO BE ENCOUNTERED IN CHILDREN AFTER AGE 10.
Meniscus tears, which we all have referred to as an “athlete’s disease” for many years, are also misconceived by many. While most people think that meniscusis a disease that develops in some people, the real condition is actually a tear that occurs in the structure referred to as the meniscus. Professor ÖzgürÇetik, an orthopedist and traumatologistat AcıbademBakırköy Hospital, states that the meniscus is a crescent-shaped piece of natural cartilage of which there are two in each knee joint, and says, “Each knee of person has two menisci, an inner one and an outer one. It is possible for tears to develop in these due to various reasons. When there is a tear in these cartilages, it is accompanied with many problems. In recent years, the number of meniscus tear cases has started to increase in children as well. The public generally recognizes meniscus tear as a condition that occurs in athletes because those who appear in the media with this condition are always athletes”.
The menisci are shaped in the womb Meniscus tears can occur in anyone, particularly housewives. However, as more and more members of the public get involved in sports, meniscus tears have become common occurrences in children over the age of 10 as well.
The meniscus cannot be torn so easily while running in a straight line. However, when the knee is sprained or twisted or when there ispatellar dislocation of the kneecap due to movements such as sudden turns while running, it is very possible for the meniscus to get torn.
Meniscus tears in children occur in two forms. The first occurs when the meniscus develops an abnormal shape while the child is still in the womb. Such abnormal menisci, which are referred to as “discoid menisci”, are in the shape of discs instead of crescents. It is possible for crescent-shaped menisci to resist tears but disc-shaped ones can be torn easily. In cases where the menisci fail to become crescent-shaped in the womb and remain as discoid menisci, it is very common for tears to occur at age five or six. Although tearing possibility is high due to abnormal structure, there are rare cases in which the child becomes an adult without occurrence of a tear.Informed exercising has critical importance in prevention of meniscus tears under normal circumstances.
Awareness of families is being raised Meniscus tears are accompanied with certain problems. Some of these are knee pain, stiffness and locking. The diagnosis can be made after the child is examined physically and certain imaging techniques are applied. Professor Çetik states that the whole condition is explained to the families from the start since they tend to have the thought that meniscus tears occur only in adults or athletes, and says, “In cases of discoid meniscus, for instance, we tell families that the meniscus has failed to assume its normal form and can be torn with the slightest of traumas. If the tear has already occurred and the patient is experiencing problems due to it, the patient is operated on. However, if the patient is diagnosed with discoid meniscus during MRI due to other reasons and there are no tears, treatment is not necessary. The surgery is nor performed because of the shape of the meniscus, but for the problems the shape leads to”.
Treatment method does not vary according to age Meniscus operations are performed through the closed surgery method. Images of the meniscus are produced with help from camera-bearing tubes that are introduced into the body through two points. The intervention involves giving the meniscus the shape that it was supposed to have in the first place. During surgery, both the tear is repaired and the meniscus is shaped into a crescent to avoid further tears in the future. This eliminates the problems of the patient. The meniscus tears in children older than 10, especially those who actively exercise, are referred to as “adult-type tears”. In such cases, the meniscus tears of children who are 11 or 12 are treated with the same method as those of adults.
It is important for the meniscus to be repaired! Meniscus, which is not just a random structure in the knee joint, has certain functions. For instance, it ensures for the joint cartilages of the knees to be protected. If the entire meniscus is removed through surgery, it is possible for joint degeneration to start in 5 to 10 years. Professor Çetik states that because of this occurrence, which is colloquially referred to as “calcification”, specialists try to repair meniscus tears as much as possible and says, “Since blood circulation is better in children and young patients when compared to older ones, the possibility of recovery for the meniscus of such patients is much higher once the meniscus is repaired with sutures. However, such recovery requires for patients to avoid subjecting the area to loads. It is important for such patients to walk with a stick for an average of 1,5 months, without forcing the knee to bear the weight of the body. It is possible for patients to continue exercising after this period. On the other hand, in cases where it is not suitable to repair the meniscus and there is no chance for recovery even if the tear is sutured, the torn section is removed. It is possible for patients to continue exercising in 20 days after this operation”.
While preventing meniscus tears is not possible in every case, the risks can be reduced. It is necessary for children who are professionally involved in sports to be guided by trainers because good trainers are able to direct children to exercises that provide protection from injuries instead of instructing them to start running directly. Underlining the importance of teaching children how to protect themselves from injuries, Professor ÖzgürÇetik says, “Avoiding injuries is essential to continue sports activities for long years. Children who are disciplined into protecting themselves are able to avoid injuries. However, it should not be forgotten that even this does not reduce the risk of tears down to zero”.
© ACIBADEM HEALTHCARE SERVICES 2021