M23.2

Clinical Causes: Previous meniscal injury or tear, particularly involving bucket-handle tears that were not properly managed Repetitive stress or strain on the knee joint from activities such as sports, heavy lifting, or kneeling Age-related degeneration weakening the meniscal tissue Trauma or injury during accidents or falls leading to tearing or displacement Underlying knee joint conditions like osteoarthritis which may predispose the meniscus to tearing

Key Symptoms: Knee pain that worsens with activity or prolonged standing Intermittent locking or catching sensations in the knee Swelling and stiffness around the knee joint A feeling of instability or giving way during movement Difficulty flexing or extending the knee fully Reduced range of motion Tenderness along the joint line

Diagnosis Path: Diagnosis of a deranged meniscus due to an old tear involves a combination of clinical evaluation and imaging studies. The healthcare provider will review the patient's medical history, focusing on past knee injuries, and perform physical tests such as McMurray's test, Thessaly test, or Apley's test to assess meniscal damage. Imaging modalities like MRI are crucial to visualize the meniscal tear, identify displacement such as a bucket-handle tear, and evaluate the extent of damage. MRI can clearly show displaced or torn meniscal tissue that contributes to symptoms like locking or catching.

Treatment Protocols: Managing a deranged meniscus due to an old tear depends on the severity of symptoms, the extent of meniscal damage, and the presence of other knee joint issues. Treatment options include: - Conservative approaches: - Rest and activity modification to minimize stress on the knee - Application of ice packs to reduce swelling - Non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief - Physical therapy focused on strengthening the surrounding muscles to provide better knee support - Surgical interventions: - Arthroscopic meniscectomy to remove the damaged portion of the meniscus - Meniscal repair, if the tear is suitable for suturing - Meniscal transplantation in certain cases, especially when large portions are lost Postoperative rehabilitation combines physical therapy to restore strength and flexibility, aiming to prevent future injury and improve knee function.