Medial Meniscus

[Yarok]

hi

ultrasound examination should show any damge to menisci.

As i said in the previous post, his ROM is near full (maybe loss of 5 degrees in extension and flexion) ... the passive overpressure however brings some pain in both directions (quite indicative for meniscal lesion). Ultrasound examination also confirmed no MCL or LCL rupture (as i previously diagnosed)

Rotation and extension is combined with Mc'Murray's if that is what you mean? And yes medial Mc'murrays still reproduces deep joint pain, but there is no locking, crepitation.

he is able to perform lateral lunges, nordic hamstring curls, SL deadlifts and normal squats until 45 degrees of flexion (i have also added some weights and he is totally happy about it).... furthermore, his proprioception remains quite solid, he has good control on one leg (excursion exercises), also knee appears stable as he is not shaking nor valgus-collapsing during exercises. And most importantly - no pain at all. Pain is sometimes reproduced on football pitch (kicking the ball) and twisting and cutting.

Just wanted to ask you guys - based on your experience do you think is it anyhow possible for this patient to have a stage III meniscus lesion?
(I am almost 95% that he does not, based on my assessment and his level of fitness)... we would like rule this out and continue with conservative approach as this is desirable for stage I,II lesion anyways.

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hi

ultrasound examination should show any damge to menisci.

As i said in the previous post, his ROM is near full (maybe loss of 5 degrees in extension and flexion) ... the passive overpressure however brings some pain in both directions (quite indicative for meniscal lesion). Ultrasound examination also confirmed no MCL or LCL rupture (as i previously diagnosed)

Rotation and extension is combined with Mc'Murray's if that is what you mean? And yes medial Mc'murrays still reproduces deep joint pain, but there is no locking, crepitation.

he is able to perform lateral lunges, nordic hamstring curls, SL deadlifts and normal squats until 45 degrees of flexion (i have also added some weights and he is totally happy about it).... furthermore, his proprioception remains quite solid, he has good control on one leg (excursion exercises), also knee appears stable as he is not shaking nor valgus-collapsing during exercises. And most importantly - no pain at all. Pain is sometimes reproduced on football pitch (kicking the ball) and twisting and cutting.

Just wanted to ask you guys - based on your experience do you think is it anyhow possible for this patient to have a stage III meniscus lesion?
(I am almost 95% that he does not, based on my assessment and his level of fitness)... we would like rule this out and continue with conservative approach as this is desirable for stage I,II lesion anyways.

[SportRehab]

Unfortunately not my friend. Ultrasound is really poor tool for diagnosing intra-articular lesions (MRI would be much better as it is 90-95 % accurate for torn meniscus). But at least the ligament integrity was double checked with this.

Still would welcome any suggestions,...