Archief - Meniscus

Legolas02 zei:

Jawel, braces die je kniegewricht fixeren helpen wel degelijk. Met die braces voorkom je dat je dat je knie naar binnen of naar buiten beweegt. Met andere woorden voorkom je dat de (ontbrekende) meniscus contact maakt met je tibia (of toch veel minder).

Maar gemakkelijk is het niet, zeker niet bij karate

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BeeLz zei:

Ben je nadat je gestopt bent omwille van pijn naar de dokter geweest?
Kan evengoed zijn dat het enkel een ontsteking was die de pijn veroorzaakte.

Hoe is je fysiek nu? Ben je volledig gestopt met sporten of ben je enkel gestopt met karate?
Zorg iig dat je spieren volledig in orde zijn voordat je terug begint met karate

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cuda zei:

En die belasting is slecht waarom?
En hoe kun je weefsel belasten wat door de arts is weggenomen?
Contact tibia slecht? een structuur dat zijn oorsprong als insertie op het tibia plateau heeft?

En de richtlijnen omtrent revalidatie na menisectomie zeggen niets over een brace. Daaruit concludeer ik dat er ook geen evidentie is om een brace te dragen?

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Legolas02 zei:

Waar er geen meniscus meer is, is het niet de bedoeling dat je die plaats nog gaat overbelasten. Waarom denk je dat mensen die, net zoals de OP, een stuk meniscus missen niet meer mogen voetballen? Omdat ze zijwaartse bewegingen moeten maken...

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Partial meniscectomy and anterior cruciate ligament rupture in soccer players A study with a minimum 20-year followup zei:

A retrospective review of 77 soccer players with 91 affected knees that had undergone the same operation, a rim-preserving meniscectomy, was made with a minimum followup of 20 years and an average followup of 27 years. The patients were divided into groups based on the presence of an intact (Group 1) or ruptured (Group 2) anterior cruciate ligament.
At 5 years after meniscectomy, 75% of Group 1 and 52% of Group 2 were still playing soccer, and 13% in Group 1 as opposed to 28% in Group 2 had given up sports. The sporting class assessment was good in 80% of the Group 1 knees and 62% in the Group 2 knees.
By followup, 5% of Group 1 and 32% of Group 2 required further meniscectomies, and 2% of Group 1 and 16% of Group 2 required operations for osteo arthritis. Radiologically diagnosed osteoarthritis was present in 24% of Group 1 knees compared with 77% of Group 2. Functionally, 60% of the Group 1 knees were excellent at followup as opposed to 9% in Group 2 knees. In Group 1, 49% were still involved in sports compared with 22% in Group 2. However, 97% of Group 1 were satisfied with their knees compared with 74% of Group 2. All of these differences were statisti cally significant.

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The effect of kinematic and kinetic changes on meniscal strains during gait zei:

The menisci play an important role in load distribution, load bearing, joint stability, lubrication, and proprioception. Partial meniscectomy has been shown to result in changes in the kinematics and kinetics at the knee during gait that can lead to progressive meniscal degeneration. This study examined changes in the strains within the menisci associated with kinematic and kinetic changes during the gait cycle. The gait changes considered were a 5 deg shift toward external rotation of the tibia with respect to the femur and an increased medial-lateral load ratio representing an increased adduction moment. A finite element model of the knee was developed and tested using a cadaveric specimen. The cadaver was placed in positions representing heel-strike and midstance of the normal gait, and magnetic resonance images were taken. Comparisons of the model predictions to boundaries digitized from images acquired in the loaded states were within the errors produced by a 1 pixel shift of either meniscus. The finite element model predicted that an increased adduction moment caused increased strains of both the anterior and posterior horns of the medial meniscus. The lateral meniscus exhibited much lower strains and had minimal changes under the various loading conditions. The external tibial rotational change resulted in a 20% decrease in the strains in the posterior medial horn and increased strains in the anterior medial horn. The results of this study suggest that the shift toward external tibial rotation seen clinically after partial medial meniscectomy is not likely to cause subsequent degenerative medial meniscal damage, but the consequence of this kinematic shift on the pathogenesis of osteoarthritis following meniscectomy requires further consideration.

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