Musculo-skeletal   [back to the Category]

Meniscal Injuries   [read the french version]

Author :   Docteur Anne Thiescé

These lesions have little specificity consistent with ballet.
Isolated medial meniscal injuries
Pain is acute in certain attitudes and positions such as the turn out, "grands pliés", "fondus", crouching and jump landings. An articular effusion can occur after intensive exercising.

The diagnosis is confirmed by jamming in flexion.
Contrary to the results found in sport pathology, this affection is common amongst female ballet dancers. It is linked to ballet technique: repetitive jumps, "pliés" and twisting movements and ligament hyper-mobility which results in an abnormally mobile posterior meniscal segment.

Treatment is carried out using arthroscopy in cases of considerable or recurring functional difficulty. Re-education is carried out very early and it is possible to resume dancing after about 1 month.

Lateral meniscal Injuries

Pain appears progressively, consequently dancers put up with it for a long time. It can be medial or lateral, mechanical and nebulous. Meniscal compression indications are negative. Importance must be attached to meniscal clicking during extension, pain revealed by palpation of the lateral joint or the existence of a meniscal cyst. Arthrography is not always very clear and the diagnosis is confirmed by M.R.I.

Treatment by meniscectomy under arthroscopy, must be followed by prolonged rest. Recovery takes longer after this operation than for medial meniscectomies.
Post-operative, recurring effusions or the observation of chondral lesions during arthroscopy must delay a return to ballet. This can only be envisaged if the punctures do not result in any cartilaginous fragments.
The lateral meniscectomy can change the delicate balance of a knee (genou valgum). It is not always possible to resume an optimal activity.

Ligamentous stabilisation is questionable in the event of meniscal lesions being associated with a lesion of the anterior cruciate ligament.

Bibliography:

Reid D.C.: Prevention of Hip and Knee Injuries in Ballet Dancers. Sports Medicine, 1988, 6, p295-307.

Sabourin F.: Le genou du danseur. Pré-actes du 4° Congrès international sur la recherche en Danse, 25-29.09.1989.

Sabourin F.: Traumatologie et microtraumatologie au cours de la pratique de la danse. Colloque "Médecine de la Danse" Cannes 25/3/1995.

Sabourin F.: Les lésions méniscales externes: diagnostic et pronostic chez le danseur. Médecine des Arts,1993, 5, p32-35.