{"id":1378,"date":"2018-04-24T06:22:07","date_gmt":"2018-04-24T06:22:07","guid":{"rendered":"https:\/\/projects.techhivetechnologies.com\/lfiold\/?p=1378"},"modified":"2023-12-11T06:25:51","modified_gmt":"2023-12-11T06:25:51","slug":"meniskskade-bor-operere-kneet","status":"publish","type":"post","link":"https:\/\/projects.techhivetechnologies.com\/lfiold\/meniskskade-bor-operere-kneet\/","title":{"rendered":"Meniskskade \u2013 b\u00f8r jeg operere kneet?"},"content":{"rendered":"\t\t
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Meniskskade \u2013 b\u00f8r jeg operere kneet?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"Menisk\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Stakkars meg tenker du sikkert n\u00e5r du har f\u00e5tt p\u00e5vist en meniskskade og det er lange operasjonsk\u00f8er p\u00e5 sykehusene. Frustrasjonen \u00f8ker sikkert ogs\u00e5 n\u00e5r du sitter der med isposen p\u00e5 kneet og Google-s\u00f8ket ditt viser at det er minst 12 ukers ventet tid for \u00e5 f\u00e5 tatt MR.<\/p>

Bruk dette til din fordel- fordi de fleste meniskskade (ne) skal allikevel rehabiliteres med aktive \u00f8velser hos en dyktig fysioterapeut (1). Pengene til haste-MR-bildene burde kanskje ha forblitt i feriekassa di, for disse har ofte lav nytteverdi (med noen unntak).<\/p>

Vi skal ikke mange \u00e5rene tilbake i tid f\u00f8r det var en meget utbredt holdning hos ortopeder og fastleger om at operasjon var den beste l\u00f8sningen n\u00e5r meniskene ble skadet. I dag s\u00e5 har man mer og mer blitt klar over konsekvensene av \u00e5 fjerne menisker, og slitasje-skadene dette medf\u00f8rer (2, 3).<\/p>

LFI Helse & Trening<\/a>\u00a0har liten ventetid, dyktige idrettsfysioterapeuter og fantastiske lokaler for rehabilitering sentralt i Lillestr\u00f8m.<\/p>

Hva er menisker og hvorfor trenger jeg dem?<\/strong><\/h2>

Vi har to halvm\u00e5neformede menisker (indre og ytre), laget av fiberbrusk som danner et fantastisk \u00f8kosystem ved \u00e5 \u00f8ke kontaktflaten (4x) for \u00e5 minske trykket og slitasjen p\u00e5 bruskflatene i kneet. En menisk fungerer som en st\u00f8tdemper og stabilisator, men hvis den skades s\u00e5 endres trykkforholdene dramatisk og slitasje oppst\u00e5r (4).<\/p>

Meniskene er festet til leggbeinet og de m\u00e5 bevege seg under aktivitet. Den indre menisken en st\u00f8rst, best forankret og minst mobil, noe som har f\u00f8rer til at 3 av 4 menisk skader oppst\u00e5r her (3, 5). Den ytre menisken er mest mobil, har l\u00f8sere forankring og er vanskelige \u00e5 rehabilitere (6).<\/p>

Den ytre 1\/3 av menisken (fra sentrum) kalles \u00abr\u00f8d sone\u00bb, fordi den inneholder blod\u00e5rer og har dermed bedre gro-potensiale ved meniskskader.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"Knee\"\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Bilde 2<\/strong>\u00a0<\/em>h\u00f8yre kne sett fra utsiden: Bestanddelene i et kne med ytre menisken mellom l\u00e5r- og legg- beinet.<\/p><\/div>

Ulike typer meniskskader<\/strong><\/h3>

De akutte og dramatiske mensikskade (ne) er ofte forbundet med idrett og oppst\u00e5r ved kraftfulle retningsendringer med vridning p\u00e5 et vektb\u00e6rende kne. De kronisk relaterte skadene kan skje hos middelaldrende pasienter ofte ved minimale vridninger og stress og skyldes alder og slitasje.<\/p>

Meniskskadene klassifiseres etter om de er delvise eller komplekse, ut ifra lokalisasjon (fremme, bake, innside og utside), traumatiske eller degenerative, horisontale, radiale eller vertikale eller etter utformingen til skaden (7).<\/p>

Risikofaktorer er ofte forbundet med varig bruk i ugunstige stillinger (for eksempel h\u00e5ndverkere) eller idretter med mye vridning og krefter i dens egenart (fotball, basket, h\u00e5ndball etc) eller tidligere menisk skader.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"Skjermbilde\"\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Er det ingen meniskskader som opereres lenger?<\/strong><\/h3>

Jo, noen meniskskader b\u00f8r opereres, de kan gi l\u00e5singer, smerter eller fordi de har et mindre rehabiliteringspotensiale.<\/p>

En \u00abb\u00f8ttehank\u00bb \u2013 skade (se bilde 3 \u00abBucket handle tear\u00bb), kjennetegnes ved at menisken revner langsg\u00e5ende (vertikalt) n\u00e6rmere yttergrensen, noen rester m\u00e5 fjernes (ektomi) men resten kan ofte sys p\u00e5 plass n\u00e6r den gode gro- sona. Best resultat oppn\u00e5s hos de yngre pasientene i de f\u00f8rste 8 ukene eller hvis pasienten har store problemer med \u00e5 f\u00e5 rettet ut kneet (mer enn 10 grader) innen f\u00e5 dager (10).<\/p>

En ruptur i roten til menisken (ofte over 40 \u00e5rs alderen) oppst\u00e5r gjerne ved mye b\u00f8y i kneet, gir en f\u00f8lelse av ustabilitet, med eller uten smerter (i knehasen) og har somregel en langvarig hevelse (8).<\/p><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"Kne\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Bilde 4 viser:<\/strong><\/em>\u00a0deler av kneleddet sett ovenfra. Meniskene er farget gr\u00f8nne. Meniskr\u00f8ttene er de hvite som forankrer meniskene til beinet. Nr1 og 2 viser den bakre indre meniskroten (9).<\/p><\/div>

Meniskskader hvor aktiv rehabilitering ikke f\u00f8rer frem.<\/p>

Hvis en akutt mekanisk l\u00e5sing av kneet oppst\u00e5r s\u00e5 b\u00f8r en kirurgisk vurdering foretas.<\/p>

Et studie viser at en delvis fjerning (meniskektomi) av den indre menisken s\u00e5 hadde pasientene en 6 ganger st\u00f8rre sannsynlighet for \u00e5 komme tilbake til idrett (fotball) enn de ytre menisk skadene, og de ytre meniskskadene opplevde 7-9 ganger hyppigere komplikasjoner i etterkant (6).<\/p>

Symptomer som kan tyde p\u00e5 en meniskskade<\/strong><\/h3>

Akutt innsettende smerter p\u00e5 innsiden eller utsiden under en kraftfull vridning. Nedsatt evne til \u00e5 strekke kneleddet eller en mekanisk l\u00e5sing. En f\u00f8lelse av ustabilitet under vektb\u00e6ring eller tap av kraft p\u00e5 forsiden av l\u00e5ret (M. quadriceps). Vanlig med hevelse i leddet og evt. leddlyder eller f\u00f8lelsen av at \u00abnoe beveger seg\u00bb i leddet. Andre menisklidelser kan ha langt mindre symptomer.<\/p>

Jeg har f\u00e5tt en kneskade, hva er det beste jeg kan gj\u00f8re for kneet mitt n\u00e5?<\/strong><\/h3>

Du b\u00f8r konsultere en fysioterapeut eller en annen god kliniker som har interesse for kn\u00e6r og har et stort volum av slike pasienter. Under konsultasjonen s\u00e5 vil dere sammen g\u00e5 grundig gjennom sykehistorien og en klinisk unders\u00f8kelse som har til hensikt \u00e5 kartlegge omfanget av kneskaden din. P\u00e5 dette grunnlaget s\u00e5 lages det i felleskap enten en rehabiliteringsplan eller s\u00e5 henviser vi pasienten videre. Noen ganger s\u00e5 kan tilleggsunders\u00f8kelser som MR etc. v\u00e6re p\u00e5 sin plass, men hovedregelen er at dette ikke er n\u00f8dvendig.<\/p>

Det er flere av idrettsfysioterapeutene ved\u00a0LFI Helse & Trening<\/a>\u00a0i Lillestr\u00f8m som har lang erfaring med \u00e5 rehabilitere meniskskader. I de tilfellene hvor vi m\u00e5 henvise videre s\u00e5 har vi et stort kontaktnett \u00e5 spille p\u00e5 slik at vi p\u00e5 best mulig m\u00e5te ivaretar pasientene.<\/p>

LFI Helse & Trening<\/a>\u00a0\u00f8nsker og legge til rette for pasientene og vi har nettopp re-lansert klinikken v\u00e5r i en rykende fersk utgave med fantastiske muligheter for et aktivt rehabiliteringsforl\u00f8p. Du er i gode hender her hos oss!<\/p>

Velkommen.<\/p>

Mvh<\/p>

Johann Lundin-Knutsen<\/a><\/p>

Fysioterapeut<\/p>

Daglig Leder<\/p>

johann@projects.techhivetechnologies.com<\/p>

  1. Raine Sihvonen, et al 2013: Arthroscopic Partial Meniscectomy versus Sham Surgery for a Degenerative Meniscal Tear<\/li>
  2. Intervju med bl a Lars Engebretsen gjengitt i Dagens Medisin, 10.01.14<\/li>
  3. Store Norske Leksikon (https:\/\/sml.snl.no\/menisk)<\/li>
  4. Anderson BC. Office Orthopedics for Primary Care: Diagnosis and Treatment, 2nd ed, WB Saunders, Philadelphia 1999.<\/li>
  5. Retningslinjer og behandlingsrutiner, Ortopedisk avdeling, Aker Universitetssykehus HF, 2002.<\/li>
  6. Nawabi, D H, AJSM Vol 42, Issue 9, 2014 \u00abReturn to Play After Lateral Meniscectomy Compared With Medial Meniscectomy in Elite Professional Soccer Players\u00bb<\/li>
  7. Binfield PM, Maffulli N, King JB\u00a0 Patterns of meniscal tears associated with anterior cruciate ligament lesions in athletes, 1993;24(8):557.<\/li>
  8. Bhatia, S, AJSM Vol 42, Issue 12, 2014 \u00abMeniscal root tears. Significance, Diagnosis and Treatment\u00bb<\/li>
  9. https:\/\/mo-journal.com\/posts\/medial-meniscus-posterior-root-tears-730<\/a><\/li>
  10. Kompendium \u00abe-l\u00e6ring medisinske fakultetet UIO\u00bb<\/li><\/ol><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

    Meniskskade \u2013 b\u00f8r jeg operere kneet? Stakkars meg tenker du sikkert n\u00e5r du har f\u00e5tt p\u00e5vist en meniskskade og det er lange operasjonsk\u00f8er p\u00e5 sykehusene. Frustrasjonen \u00f8ker sikkert ogs\u00e5 n\u00e5r du sitter der med isposen p\u00e5 kneet og Google-s\u00f8ket ditt viser at det er minst 12 ukers ventet tid for \u00e5 f\u00e5 tatt MR. Bruk […]<\/p>\n","protected":false},"author":1,"featured_media":1379,"comment_status":"open","ping_status":"open","sticky":false,"template":"elementor_header_footer","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[],"class_list":["post-1378","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blogs"],"yoast_head":"\nMeniskskade \u2013 b\u00f8r jeg operere kneet? - LFI<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/projects.techhivetechnologies.com\/lfiold\/meniskskade-bor-operere-kneet\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Meniskskade \u2013 b\u00f8r jeg operere kneet?\" \/>\n<meta property=\"og:description\" content=\"Meniskskade \u2013 b\u00f8r jeg operere kneet? 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Stakkars meg tenker du sikkert n\u00e5r du har f\u00e5tt p\u00e5vist en meniskskade og det er lange operasjonsk\u00f8er p\u00e5 sykehusene. Frustrasjonen \u00f8ker sikkert ogs\u00e5 n\u00e5r du sitter der med isposen p\u00e5 kneet og Google-s\u00f8ket ditt viser at det er minst 12 ukers ventet tid for \u00e5 f\u00e5 tatt MR. 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