| Abstrakt: |
Objective: Meniscus injuries are a serious cause of knee pain and disability in athletes and the general population. Using manipulative techniques traditionally employed for meniscus injury, we prospectively followed 5 patients with clinically diagnosed meniscus injuries with valid and reliable outcome measures, 4 of whom had MRI imaging. Methods (Case Series): Five successive patients with a clinical diagnosis of meniscus tear or injury based on history of knee pain and in which a majority of these signs and symptoms were present: buckling (giving way), marked antalgic gait, locking, joint-line pain, swelling, and orthopedic tests, were included in this report. Diagnosis of meniscal injury was confirmed by MRI on 3 patients for tears, and in 1 for meniscal degeneration. Patients received = 6 treatments consisting of Genu-Circumduction Extension Mobilization technique, HVLA axial elongation, and a simple knee exercise protocol. Outcome measures included the VAS, the Lower Extremity Functional Scale (LEFS), and Goniometry (ROM). Results: Patient 1's VAS decreased 4.6 cm, ROM remained unchanged, and LEFS increased 31 points. Patient 2's VAS decreased 8.7 cm, ROM increased 10°, and LEFS increased 17 points. Patient 3's VAS decreased 6.5 cm, ROM increased 6°, and LEFS increased 15 points. Patient 4's VAS decreased 1.2 cm, ROM increased 3°, and LEFS increased 6 points. Patient 5 reported worsening of symptoms after 1 treatment. The study treatment protocol was discontinued for Patient 5, palliative care initiated, with orthopedic consultation recommended but not obtained by patient choice. Conclusion: This case series reports on chiropractic treatment of meniscal injury using traditional diversified manipulative therapy and rehabilitative exercise. Chiropractic care appeared helpful in 4 out of 5 patients, but these findings should not be extrapolated beyond these particular patients. The results highlight the need for research on chiropractic care for meniscal injury. Improvements in VAS, ROM, and the LEFS suggest the possibility of benefit of chiropractic care; nevertheless, additional research, randomized controlled trials, and careful monitoring of risks and benefits are needed to fully determine the efficacy, safety, and effectiveness of this approach. [ABSTRACT FROM AUTHOR] |
