Meniscal ganglion

definition

Under a Meniscal ganglion one understands one connective tissue cyst filled with Synovial fluid or a gelatinous mass. It can arise at the base of the inner meniscus or, more often, the outer meniscus and usually has no connection to the joint cavity or the body surface.

Since often Signs of wear of the Meniscus are the cause of a ganglion, the meniscus ganglion increasingly joins over 50 years Patient. Men are more often affected by the disease than women.

Emergence

Every knee joint has one inner (medial) and one outer (lateral) meniscus (Greek for "moon-shaped body"). The menisci consist of cartilage and are disc-shaped. They take on important tasks in the knee joint by increasing the contact area between the joint partners (thigh bones and lower leg bones), bumps (Incongruences) and buffer the pressure on the joint surface and redistribute it.

Because of their location in the joint, the menisci are within the scope of trauma prone to injury. A meniscus tear occurs far more often in the inner than in the outer meniscus. In addition to traumatic injuries, the menisci can wear out over the years, one then speaks of a degenerative change, the so-called Meniscopathy. At first, tiny cracks can form in the cartilage, which expand over time with continued stress.

Both a traumatic meniscus tear and wear and tear over the years can occur Cause of a meniscal ganglion be. A meniscus ganglion is often the first symptom of previously unnoticed wear and tear on the meniscus. Each meniscal ganglion arises at the bottom of a tear in the meniscus Accumulation of synovial fluid comes at the base of the meniscus. Often a small cyst initially forms on the edge of the meniscus, which then expands over the edge of the damaged meniscus.

Medial meniscal ganglion

Of the The inner meniscus tears far more often in injuries than the outer meniscus. As described, a meniscus ganglion can form on the floor of this tear. A medial meniscus gangion is therefore common traumatic conditional and can arise, for example, from tears in the meniscus such as sports injuries.

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The knee joint is one of the joints with the greatest stress.

Therefore, the treatment of the knee joint (e.g. meniscus tear, cartilage damage, cruciate ligament damage, runner's knee, etc.) requires a lot of experience.
I treat a wide variety of knee diseases in a conservative way.
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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External meniscus ganglion

Of the External meniscus tears far less often than the medial meniscus in knee injuries. A meniscal ganglion on the outer meniscus is true more often than an inner meniscus ganglion, but the cause of the outer meniscus is more often one degenerative wear and tear and far less often a traumatic tear, as is more often the case with the medial meniscus ganglion.

Symptoms of a meniscal ganglion

Often they are similar Symptoms of a meniscal ganglion that of a meniscus tear or wear and tear of the same. Depending on whether the inner meniscus or the outer meniscus is affected, it can become one Swelling on the inside or outside of the knee joint.

Since the Filling state of the ganglion fluctuates, the cyst can be fuller and tender, but sometimes also empty. There is pain over the internal or external joint space when the patient does this Stretch leg, bends or burdened.

Larger meniscal ganglia appear than externally visible cysts at the inner or outer joint space of the knee joint.

Diagnosis of a meniscal ganglion

The Examination by the specialist starts with the Inspection of the knee joint, with already a swelling on the inner or outer knee joint. At the Scan the ganglion arises firm and elastic and pressure sensitive represent.

The doctor can various clinical tests to detect meniscus damage (such as the Steinmann test, Apley grinding test and similar, which can be found under Meniscal tear), which are often positive for a meniscal ganglion.

Various come to confirm the diagnosis imaging procedures for use. in the Ultrasonic a meniscus ganglion can first be visualized, more detailed information about Size or location However, the doctor does not receive this examination alone.
For a more precise representation, a MRI image of the knee jointwhich shows the full extent of the meniscus ganglion and is crucial for therapy planning. Furthermore, the cause of the ganglion such as a degenerative change can be revealed in the MRI.

On one X-ray image the meniscal ganglion cannot be shown as a soft tissue lesion, but can bony damage or Injuries excluded in case of doubt.

Treatment and surgery

Basically, a Meniscal ganglion conservative or by one surgical intervention be treated.

The conservative therapy is only promising for smaller meniscal gangliathat have only existed for a relatively short time. The therapy is limited to that Symptom relief and consists of taking Painkillers like diclofenac or ibuprofen, as well as the application of Anoint with the same ingredients. In many cases the ganglion then forms back by itself, especially if the knee is spared and relieved and an operation is not necessary.

The manual compression used in which the ganglion is to be crushed. This procedure is because of the frequent damage to blood vessels or bony structures Recommended only to a limited extent. One is less risky Pressure massage, in which the filling of the ganglion is to be transported back into the joint, which, however, by a high rate of recurrence the cyst is accompanied.

Another option is to treat the ganglion with a Puncture needle and so relieve the strain with the removed liquid. However, even with this type of therapy, the ganglion comes back in more than half of the cases.

Also the injection (Bringing in) from Cortisone by injection can be beneficial.

If the mentioned therapy options have failed, functional limitations in the knee joint, or severe pain and cosmetic impairments or recurrences occur, then this is recommended surgical removal of the meniscal ganglion. The operation usually takes the form of a knee arthroscopy (Knee arthroscopy). Here is a small cut (Incision) a Probe with a camera introduced into the joint. The surgeon receives an overview of the entire inside of the knee joint on a screen. Small tools are introduced through further small incisions. The result is now the meniscus ganglion completely removed and also the Cause of the ganglion, So a Meniscal tear or a wear, can fixed at the same time become.

The procedure can usually be performed depending on the patient's condition outpatient and take place under general or spinal anesthesia. Due to the low invasiveness, the procedure is low risk and the Recovery time short. In rare cases, however, it can Complications like the formation of a blood clot (Thrombosis, embolism), or accumulation of pus and inflammation in the knee joint (knee empyema). Wound healing disorders and bleeding are also conceivable, but rather rare. In rare cases, when the meniscus ganglion is very large or the situation does not allow otherwise, a open surgery be necessary to lead to sustainable success.

prophylaxis

Prevent One can predict the occurrence of a meniscus ganglion to the extent that the underlying wear and tear of the menisci is due excessive stress (such as leg misalignments or excess weight) can be corrected.

Furthermore, one should already have suffered a trauma or degenerative changes pre-damaged meniscus adequate treated by a specialist to prevent the formation of a ganglion.

forecast

In many cases a meniscal ganglion disappears on its own under merely symptomatic therapy to combat pain. Often it is conservative therapy here sufficient.

Does it come to Recurrence of the ganglion or no visible success by conservative therapy, the operation promises one very good prospect of recovery. However, that is important here Extent of damage of the meniscus. If this shows severe signs of wear and tear, the ganglion can be removed, but in the future the degenerative changes will continue to show increasing symptoms, so meniscus wear is often part of osteoarthritis of the knee.

If a meniscus ganglion is the first sign of a previously symptom-free meniscus wear, then not only the ganglion as the first sign, but the cause should be treated to identify a Progression of wear on the knee joint to prevent.