Knee injury: common causes, symptoms, diagnosis and treatment options, recovery time. What are the types of knee injuries? When an injury occurs, the knee joint is most often damaged

• The knee is the part of the body that is relatively most often injured.
• Among the types of knee injuries are: sprains of the ligaments of the knee joint itself, sprains of the tendons surrounding and attaching to the joint, post-traumatic inflammation of the joint capsule, dislocations, fractures, meniscus cracks, as well as multiple trauma.
• Knee injury typically occurs as a result of twisting or excessive bending, force applied to the knee joint area, or direct impact, such as during sports, a fall from a height, or an accident.
• Risk factors for knee injury include overuse of the joint, improper training and exercise, osteoporosis, and high-impact sports that may involve sudden changes in direction of motion.
• The main signs and symptoms of a knee injury are pain and swelling.
• Knee injury is usually diagnosed based on medical history and physical examination. To clarify the nature of the damage and choose treatment tactics, in most cases, radiography of the knee joint or magnetic resonance imaging (MRI) is used for diagnosis.
• The choice of treatment option for a knee injury depends on the type and severity of the injury, and usually includes a complex of so-called RICE therapy (rest - rest, ice - ice, compression - compression effect, elevation - elevated position), physiotherapy, immobilization or, if necessary, operations.
• The prognosis for recovery from a knee injury depends on the type and severity of the injury, the need for follow-up physical therapy, or the outcome of surgery.
• Knee injury can be prevented through training (such as playing sports), using proper protective equipment or equipment, and following safety rules while playing on the playing field or at home, and preventing falls.

What are the different types of knee injuries?

Since the knee is one of the most mobile, always active and protruding parts of the body, it is logical that if some predisposing factor appears, the likelihood of damage to it is greater than that of other joints. The majority of knee injuries are caused by sports injuries, falls on the knee joint, and injuries from road traffic accidents.

The type of knee injury is always based on the damaging mechanism and the anatomical area of ​​the knee joint.

An injury to the knee joint, such as a sprain, occurs when the ligaments that provide stability to the knee joint and tight contact of the articular surfaces are impacted. There are several such connections. The anterior cruciate ligament and posterior cruciate ligament help stabilize the knee as it moves from front to back and intersect with each other at the middle of the knee joint. The medial (internal) collateral ligament and lateral (external) collateral ligament (LCL) are responsible for the lateral stability of the knee and prevent the bones from moving from side to side.

The severity of a ligament sprain depends on the severity of the sprain or whether the ligament fibers are torn and how much it causes instability of the knee joint. Sprains are classified as follows:

Grade 1 sprain: The ligament or ligaments are stretched, causing pain in the knee, but the fibers do not tear and there are no signs of joint instability.
Grade 2 sprain: When a knee injury occurs, partial rupture of the fibers occurs, which may result in mild instability of the knee joint.
Grade 3 sprain: A complete break/rupture of the fibers of the ligament occurs, as a result of which the knee loses its supporting and articular function.

Fig. 1 Sprain/rupture of collateral (side) ligaments

Knee strains occur when the tendons or muscles surrounding the knee become stretched, usually when the knee is hyperextended or hyperextended. This deformity may cause pain in the tissues surrounding the joint rather than in the joint itself, but may also limit the range of motion of the knee. Often the cause of deformation of the knee joint is damage to the tendons attached to the patella, which is a key anatomical element of the joint. The part of the tendon located between the lower part of the kneecap and the anterior surface of the tibia is especially often injured.

Fig. 2 Mechanism of knee joint deformation

A frequent accompaniment of knee injury is inflammation of the periarticular bursa of the knee joint or bursitis. Bursitis leads to pain, swelling of the knee joint, and as inflammation progresses to infection of the contents of the joint capsule. Functionally, the periarticular bursa with the articular fluid contained in it acts as a shock absorber, limiting friction of the articular surfaces and surrounding tissues of the joint. There are several such bags in the knee joint, of which there are 2 main ones: one is located behind the patella (patella), the other below the knee joint on the front surface of the bones of the lower leg.

Fig.3 Bursitis (inflammation) of the periarticular bursa

Damage to the meniscus can occur with trauma to the inner surface of the knee or with submaximal load on the joint during a dislocation. The meniscus is a semicircular cartilaginous spacer placed between the large bones of the knee joint and serves as a kind of airbag for the bones. Menisci can be damaged by severe trauma or even minor stress if they become anatomically dysfunctional due to aging or chronic overuse.

Fig.4 Meniscus injury

A knee dislocation can only occur as a result of severe mechanical trauma to the knee, such as a sports injury or a traffic accident. This is one of the rarest types of knee injury, but it leads to serious damage to all the anatomical elements of the knee joint, often compromising the integrity of blood vessels and nerves. This type of knee injury usually requires emergency intervention or surgery.

The patella or kneecap is a sesamoid (accessory articular) bone, which under normal conditions is quite mobile and moves well relative to the plane of the joint when moving. Patellar luxation injuries can be very painful, but in most cases do not cause life-threatening complications and respond well to reduction, immobilization (eg, splinting), and physical therapy.

Knee fractures occur as a result of a direct blow to the bone. A fracture or crack of the patella occurs when a person falls on the knee joint. One of the most common types of bone fractures in knee injuries is a fracture of the base of the tibia, which occurs due to a compression mechanism, especially in patients with such a predisposing factor as osteoporosis. Fractures of other bones of the knee joint occur rarely and are often isolated.
One type of knee injury is the so-called patellofemoral pain syndrome or “runner's knee,” in which degeneration of the cartilage tissue (chondromalacia) of the articular surfaces of the knee joint occurs as a result of constant trauma while running. Often this can be a congenital problem or result from improper knee mechanics.

Fig. 5 Options for a tibia fracture in a knee injury

What are the causes of knee injury?

In most cases, knee injury is associated with an external force, which is based on a twisting or bending mechanism. The knee joint is anatomically not adapted to this type of movement. The vast majority of these injuries occur as a result of falls, sports or accidents. An injury involving a twisting mechanism can result in both ligament damage and cartilage destruction.

When the traumatic force is extreme, such as during sports injuries and road traffic accidents, damage to several anatomical elements of the knee joint can occur at once, resulting in several types of injury at once.

What are the risk factors for knee injury?

Perhaps the most common risk factor for knee injury is participation in team sports or sports that place significant physical stress on the knee joints, such as running, basketball, football, hockey, soccer, cycling, etc. . Very often, a knee joint injury occurs during athletics, when submaximal loads are placed on the tissues of the knee joint and sudden changes in the direction of movement are possible.

The risk is especially high when running using spikes, which transfer most of the load to the knee joint as a result of fixing the ankle joint.

Elderly people have a different problem; a knee injury can occur as a result of a fall or weak bone tissue due to osteoporosis.

For women, injuries involving damage to the anterior cruciate ligament and kneecap are more common. This is largely due to the special anatomy of the woman’s hips and femur, as well as the angle of the knee joint. This results in progressive chondromalacia patella, an inflammation or irritation of the underside of the kneecap.

Fig. 7 X-ray and MRI for cruciate ligament rupture (green arrow) and tibia fracture (red arrow)

The traumatologist, taking into account the mechanism of the injury, will conduct special tests using bending and twisting of the knee, with the help of which he will clarify the stability of the ligamentous apparatus and identify hidden damage to the menisci and cartilage tissue of the joint. These tests are also necessary for the correct selection of the knee joint immobilization required in the future.

Instrumental diagnostics in the form of radiography, (CT) or MRI may be required to determine the tactics and the need for surgical treatment. Since knee damage is often accompanied by inflammation of the joint capsule (bursitis) or even hemorrhage into the joint (in medical terminology this condition is called hemarthrosis), ultrasound examination (ultrasound of the joint) can be quite informative, especially in cases where puncture treatment of complications of injury may be required.

X-rays and CT scans are usually used to detect injuries such as fractures of bone structures, and magnetic resonance imaging is used to assess damage to soft tissues (ligaments and cartilage).

What are the commonly used treatment options for a knee injury?

Treatment for a knee injury usually depends on the part of the knee injured and the extent of the damage.

Some types of injury, such as a simple sprain or subluxation, respond quite well to treatment using RICE therapy (defined above). During the period of this therapy, restrictions from physical activity and sports are sufficient. It is imperative to use over-the-counter forms of anti-inflammatory drugs, such as ibuprofen (Advil, Motrin) or naproxen (Aleve), which will relieve pain and inflammation of the knee joint.

Immobilizing or splinting the knee will provide rest and restriction of movement, thereby reducing the likelihood of further damage. This will stabilize the injured knee in case of instability of the joint, for example due to a torn ligament.

Fig.8 Immobilization of the knee

Chronic knee injury accompanied by inflammation and bursitis usually responds well to anti-inflammatory medications. Often, with severe inflammation and/or pain, intra-articular administration of cortisone (a glucocorticosteroid - a steroid with powerful anti-inflammatory effects) may be required.

Extensive injuries associated with ligament rupture, instability of the knee joint, severe swelling, limited range of motion or fracture always require consultation with an orthopedic traumatologist. In case of acute injuries, during the period of transporting the patient to the emergency room or trauma hospital, immediate compliance with the conditions of RICE therapy (rest - rest, ice, compression, elevation - elevated position) is considered optimal. The use of support devices, such as crutches or a wheelchair, is also encouraged to provide additional rest.

Fig.9 RICE therapy

Surgery may be indicated for ligament tears or extensive meniscal damage. Surgery may also be required to treat fractures or dislocations of the knee joint. Some acute injuries that involve severe damage to the joint due to intense force or involving multiple parts of the knee usually require emergency surgery.

Nowadays, most knee surgeries can be done using arthroscopic techniques. This is due to the fairly large size of the joint itself and the possibility of using endoscopy equipment. Such operations are performed through small punctures of the skin in the projection of the joint capsule, through which endoscopic instruments are inserted. The operation itself is carried out under visual control using a small camera connected to one of the instruments. All this allows the intervention to be performed in full and without the use of a large incision. In case of acute injury, most operations are performed in a delayed manner, after the inflammation has subsided.

Fig. 10 Arthroscopic technique for knee surgery (meniscus resection)

Immediately after surgery, or if there is no need for surgery, physical therapy aimed at strengthening the muscles and ligaments of the knee joint can be used as an alternative treatment option. In addition, physical therapy can help ensure optimal ankle and knee mechanics to prevent future re-injuries.

What exercises are recommended and what exercises should be avoided during knee injury rehabilitation?

When performing physical therapy for the rehabilitation of a knee injury, depending on the type of injury received, individual specific exercises will be developed for the patient to strengthen and stabilize the knee joint. These exercises typically include exercises to strengthen the anterior thigh muscles (quadriceps), posterior thigh muscles (hamstrings), and other muscles in the lower leg and thigh.

It is very important to understand that at the beginning of therapy you cannot use exercises independently and uncontrollably, since with this approach you can only harm and slow down the recovery of the joint. Inexperienced athletes try to “pump up” the damage they have received on their own, which is absolutely not the right thing to do. During the rehabilitation period, the joint usually requires rest and minimal loads, taking into account the anatomy of the injury. And to develop the correct exercise program, a mandatory consultation with a traumatologist or physiotherapist is required, who know exactly the mechanics of joint movement and are able to select the optimal exercises and practice them until the patient can use them independently.

If you experience pain or discomfort in your joint or surrounding tissues during exercise, be sure to tell your doctor or physical therapist.

• Low-amplitude extension of the knee joint in a sitting position (with a roller under the knee)
• Straight leg raises: lying on your stomach and/or back
• Bringing the tibia to the thigh under load
• Toe raises
• “Bridge” without breaking the blades
• Light squats with alternating legs

The American Academy of Orthopedic Surgeons (AAOS) has developed a special guide for these purposes, which describes each exercise with detailed analysis and pictures. However, before using these exercises on your own, you must obtain the approval and consultation of a traumatologist.

Here are some of the exercises that will help you avoid future knee injuries:

• Full knee extension while sitting on a chair
• Forward lunges with leading knee bend
• Deep squats (can be used with a weightlifting bar)
• Stretch in a sitting position with the leg pulled up and out to the side, and the stretched leg extended (hurdleman stretch)

With the help of these exercises, a slight additional load is created on already damaged knee joints, resulting in the so-called “pumping” of the joint.

How long does it usually take to recover from a knee injury?

The recovery time for the knee after an injury usually depends on the type and severity of the injury. If the injury is serious, requiring surgery and/or long-term physical therapy, the recovery time will be extended.

Recovery from simple sprains or sprains can take one to two weeks. More massive injuries that require arthroscopic surgery may require one to three months of rehabilitation.
Sometimes a complete program of rehabilitation and restoration of knee joint function after an injury may require about 1 year, and in most cases the timing of this recovery is highly individual.

When carrying out a rehabilitation program, it is important to listen to the advice of a practicing traumatologist, follow a rest regime, carry out proper immobilization and avoid exercises that can provoke re-injury.

Physiotherapeutic treatment plays an important role in rehabilitation. Typically, various physiotherapeutic influences and procedures can be used, such as massage, magnetic therapy, therapeutic baths and Jacuzzis, warming up the joint, etc. Of course, physiotherapeutic procedures should be performed under the close supervision of a specialist.

Chronic knee injuries will occasionally disturb the patient and manifest themselves with the recurrence of pain in the joint, but, as a rule, in such conditions, physiotherapy, anti-inflammatory and analgesic treatment, and intra-articular administration of hormonal drugs are sufficient.

What is the prognosis for a knee injury?

The prognosis for a knee injury, as well as the results of treatment, completely depend on the type, severity of the injury and the timing of its occurrence.

A knee injury is rarely life-threatening, although severe injuries may be accompanied by severe pain and shock with symptoms of collapse. Severe deforming trauma with disruption of bone integrity can lead to neurovascular injury and severe disability.

Most minor knee injuries (sprains, minor dislocations) heal on their own with conservative treatment. The prognosis for this type of injury is generally good.

Involvement of the ligamentous apparatus of the joint is fraught with dysfunction or instability of the knee joint, which may require surgical treatment. Such injuries are well treated surgically, especially using an arthroscopic technique, and the patient returns to full or nearly full range of motion as before the injury.

Some knee injuries result in chronic and irreversible damage to the knee and subsequent long-term dysfunction. That is why it is advisable for the patient to seek the help of a traumatologist within the first few hours or days (depending on the nature) after the injury, so that he can understand the clinical situation and provide timely assistance.

Can knee injuries be prevented?

The following are the main activities or exercises that will significantly reduce the likelihood of injury and reduce the severity of its symptoms:

• It is necessary to constantly exercise and maintain physical fitness, especially the lower parts of the body
• It is necessary to monitor your weight and correct it in a timely manner
• When exercising, use specialized sports shoes
• The nature of the training exercises should be appropriate to the sport and it is recommended to avoid overexertion
• Preparing and maintaining the playing surface for sports in optimal condition
• Avoid contact with slippery or uneven surfaces
• Avoid contact with loose turf or gravel
• Be sure to wear knee pads and pads if they are needed for protection when playing sports
• Be sure to perform all recommended rehabilitation exercises for a previous injury.
• It is necessary to be examined for osteoporosis and treated for it.

Consisting of the tibia, fibula, femur and patella. The articular surfaces of the listed elements are covered with cartilage tissue, fixed by muscle tendons, intra-articular and lateral cruciate ligaments. Mobility in the joint is ensured by synovial fluid, meniscus and articular bursa. The knee is subject to heavy loads and performs important functions for the body. Therefore, knee joint injury is a common injury to the osteoarticular system.

Damage to the knee can be the result of a bruise, blow, twisting or sharp bending in the joint area. Most often, such injuries occur in the elderly, children, athletes, and people engaged in heavy physical labor are also vulnerable. The greatest likelihood of injury is observed in patients suffering from arthrosis, osteoporosis, arthritis, and other joint diseases.

Minor injuries include contusion, or bruise, of the knee area. The kneecap is more susceptible to dislocation. Dangerous injuries include loss of integrity, sprains, etc. Less common are cracks and intra-articular fractures. Such injuries are usually accompanied by rupture of blood vessels, muscle tissue, damage to nerve trunks, and destruction of cartilage.

Knee bruise

This type of injury to the lower extremities can occur to a person of any age group and profession. Contusion may not be clearly expressed externally, however, in the intra-articular cavity, trauma can provoke pathological changes. Therefore, a bruise cannot be considered a completely harmless and unworthy injury.

Causes

You can get a bruise in the knee area from a fall or from a blow to the lower limb. This area is very vulnerable when you lose balance. Children often get this injury during outdoor games. Athletes, especially track and field athletes and football players, suffer no less often from such injuries.

Symptoms

The main symptom is a sharp pain syndrome that occurs immediately after injury. In addition, swelling of the knee increases rapidly. The skin over the injured knee turns red and becomes hot to the touch. There is limited mobility in the affected lower limb.

Diagnostics

A bruise can be diagnosed by comparing the injured knee with a healthy limb. In addition, the affected joint will have smoothed contours due to the development of hemarthrosis. Mobility in the knee is examined with the patient in a horizontal position. If there is blood in the intra-articular cavity, movements become difficult and their volume is limited. In addition, the doctor checks whether the patient can keep the lower limb straight. It is often difficult for the injured person to perform this test.

Treatment

Treatment of this type of injury involves the following measures:

1. Anesthesia. This can be achieved by taking non-steroidal anti-inflammatory drugs or analgesics.
2. Applying cold to the affected area. This leads to a reduction in swelling and pain.
3. Bandage. It is a mandatory measure for a knee injury. A pressure bandage helps reduce bleeding and swelling. After its application, the patient must remain in bed. In this case, the affected lower limb should be elevated.
4. Puncture. It is carried out if there is a large amount of blood in the joint cavity or in soft periarticular tissues. This procedure reduces swelling and pain.
5. Local treatment - ointments, creams and gels that help relieve inflammation and relieve pain.
6. Physiotherapy. To cure the pathology in question, UHF therapy and diadynamic currents are often prescribed.

You cannot treat a knee injury on your own. To avoid complications, consultation with a specialist is necessary.

Ligament damage

This pathology is observed among young people and people leading an active lifestyle. The cruciate and collateral ligaments of the knee can be damaged. There is either a violation of the integrity of the fibers or their separation from the place of attachment. Damage to a specific ligament manifests itself with specific symptoms.

Causes

The integrity of the ligaments can be compromised by excessive extension and twisting of the lower limb. Athletes often receive such injuries during competitions. However, a person can damage ligaments in everyday life.

1. The cruciate ligaments are injured when there is impact on the lower leg, which is in a state of flexion.
2. The anterior cruciate ligament is injured together with other ligaments and the meniscus. In addition, rupture of the knee joint capsule often occurs.
3. Violation of the integrity of the posterior sections of the cruciate ligament occurs when there is a blow to the shin with a bent limb, but is often observed when the knee is in extension.
4. The lateral ligaments are affected when the foot rolls. This type of injury can occur if you trip while walking in high heels.

Symptoms

If all ligaments are damaged, the following signs appear:

1. Severe pain syndrome occurs.
2. Swelling forms in the knee area.
3. Pathological mobility of the patella is noted.
4. A hematoma grows in the area of ​​soft periarticular tissue.
5. The supporting function of the limb is lost.
6. A cracking or clicking sound is heard at the time of injury.
7. Movements in this area are sharply limited.

The more significant the degree of ligament damage, the more pronounced the listed signs are.

If the integrity of the ligaments is completely broken, pathological mobility of the joint occurs.

In addition to general symptoms, there are signs characteristic of a particular type of ligament:

1. Violation of the integrity of the lateral collateral ligament leads to pain, which intensifies when the tibia is rotated inward. In addition, swelling is visualized. When a joint is punctured, a bloody fluid is obtained. More often than not, such damage is complete.
2. If the external collateral ligaments are torn, the injured person experiences intense pain, swelling develops, and the lower leg deviates outward.
3. When the cruciate ligaments are injured, a “drawer” symptom is detected (excessive mobility in the knee and lower leg).

Diagnostics

It will help to make a diagnosis. Indications for it are the following pathological points:

1. Severe hemarthrosis (blood in the joint cavity).
2. The presence of effusion of unknown etiology in the joint cavity.
3. Severe pain syndrome.
4. Suspicion of intra-articular injuries.

The procedure is performed under anesthesia. An arthroscope equipped with a video camera is inserted into the joint cavity. The image is transferred to the monitor. The specialist evaluates the condition of the cartilage tissue, menisci, patella, tibia and femur.

Treatment

After diagnosis, the following activities are carried out:

1. Applying cold compresses to the lesion. This manipulation is carried out within the first two hours after injury.
2. Immobilization of the lower limb.
3. Fixation of the knee with bandages or splints. You can also use an elastic bandage for these purposes.
4. Relief of pain syndrome. Nonsteroidal anti-inflammatory drugs and analgesics will help with this.
5. A few days after the injury, warming ointments or compresses can be used.
6. Exercise therapy, massage.
7. Physiotherapy.

If the above methods do not produce a positive effect, there is a high probability of complete rupture of the ligaments. In this case, surgical treatment is necessary. The operation is gentle and is performed by making two small incisions using endoscopic technology. The ligaments can be completely replaced with an autograft from the patient’s own tendons.

Meniscus injury

Menisci (internal and external) are cartilaginous formations in the shape of crescents. They perform an important function, being a protector of intra-articular cartilage tissue and participating in shock absorption.

The menisci are the most injured elements of the knee joint. Often their damage is observed in skiers, figure skaters and football players.

Damage to the menisci entails a violation of the integrity of the ligaments and can lead to fractures of intra-articular structures.

Meniscus injuries are divided into avulsion, pinching and tear. In most cases, the last two types of damage are recorded.

Causes

The cause of this type of injury may be a twisting of the lower limb or a direct mechanical impact on the knee with any object. The injury is typical for those who squat for a long time, do a lot of squats, and actively engage in sports.

Patients suffering from arthritis, gout, or congenital abnormalities of the musculoskeletal system can easily suffer such damage. Often the menisci are damaged due to severe spasm of the muscles of the anterior surface of the thigh with simultaneous tension of the iliopsoas and rectus muscles.

Symptoms

Manifestations of meniscus damage include the following:

1. Sharp pain on the outer or inner part of the knee, which increases sharply even with light loads.
2. Effusion in the joint cavity.
3. Pathological increase in range of motion in the knee.
4. Difficulty going up and down stairs.
5. Clicking sound in the joint area when bending.
6. Local increase in temperature.
7. Atrophic changes in the muscles attached to the joint.

Diagnostics

The diagnosis can be made based on complaints and analysis of the circumstances of the injury, according to examination. In addition, the following examination methods will help in diagnosis:

1. MRI allows you to accurately diagnose what exactly happened - separation, pinching, tear.
2. Arthroscopy – allows you to visualize the structural elements of the knee.

If a significant amount of time has passed since the injury, examination may reveal a cyst.

Treatment

How specialists will treat a meniscus injury depends on the type of injury. The tear and pinching can be eliminated conservatively. The avulsion can only be treated with surgery.

Therapy for meniscus injuries includes the following types of treatment: conservative and surgical.

If surgery is not necessary, then conservative treatment is resorted to. It includes the following activities:

1. Drug treatment - NSAIDs, vascular drugs, chondroprotectors.
2. The patient's knee must be fixed and cooling bandages applied.
3. Physiotherapeutic procedures.

In case of severe damage and ineffectiveness of conservative measures, surgical methods are used. During this intervention, suturing, removal or resection of the meniscus is performed.

Rehabilitation consists of restoring movement in the damaged knee and normalizing its functions. During this period, muscles and ligaments should be strengthened and the joint should be developed. Physical therapy, massage courses, and acupuncture are prescribed. The duration of the recovery period is from a week to three months.

Knee fractures

This type of injury is always difficult. A knee fracture can be partial or complete, depending on the number of damaged bones that make up the joint.

Fracture of the femur and tibia is associated with sudden muscle contraction. The consequence is damage to the condyles. Injury to the patella, that is, injury to the cap of the knee joint, is common.

According to the classification, there are extra-articular (injury to bones) and intra-articular (injury to bone areas located inside the synovial bursa of the joint) fractures.

Causes

A knee fracture is associated with a direct mechanical impact on it or with a fall with a bent limb.

The patella is injured quite often. A direct blow may not damage it. However, injury can occur without force due to excessive tension or overstrain of the tendons. Often, injuries to the patella result in its complete rupture.

Symptoms

Common symptoms include the following:

1. Loss of the ability to flex and extend in the joint area in question.
2. When palpating and attempting to move the lesion, severe pain is felt.
3. Swelling of the periarticular area.
4. Bruising in the knee area.

Diagnostics

In addition to the characteristic clinical picture, radiography and arthroscopy will help make a correct diagnosis.

An x-ray image reveals displacement of bone fragments and a fracture line.

With arthroscopy, you can determine whether there is a crack in the cartilage tissue, and also examine the location of the fracture in detail.

Treatment

The first step in helping a patient with a knee fracture is to immobilize the injured limb. Analgesics are used to relieve pain. Next, the traumatologist compares the bone fragments and fixes the limb in a certain position.

Reposition can be performed in an open or closed manner. Closed reduction involves manual comparison of fragments, while surgical reduction involves open intervention on the limbs. Then the affected leg is cast.

If the cartilage is damaged, chondroprotectors are used to accelerate its regeneration.

Damage to the condyles requires the administration of non-steroidal anti-inflammatory drugs intramuscularly or orally.

At the rehabilitation stage, the affected knee is restored with the help of physiotherapy, massage and exercise therapy.

Conclusion

Injuries to the knee joint always lead to disruption of its functioning. If even a simple bruise is not treated in time, serious complications may develop, including long-term immobility in the knee.

A knee injury is an unpleasant occurrence because a person needs joints to move.

The knee joint is subject to greater stress than the rest. After all, the entire weight of the body falls on him. Loads often lead to.

Find the answer

1. The most common and easiest injury to the knee is a bruise. It occurs when there is a slight blow or as a result of a fall.
2. Sometimes a large load (with torque) on the joint leads to dislocation of the knee (patella).
3. Tears or sprains of ligaments and tendons are caused by lifting a load when bending, or unsuccessful jumps. The lateral ligaments can be injured when the leg is straightened. Slipping can cause a sprain if there is a torque present.
4. Meniscus injuries are very dangerous. If a rupture occurs, surgery may be required. This is an intra-articular injury in which a person feels a sharp pain impulse in the joint. In addition, limited movement appears; in some cases, this injury leads to joint blockade. Sometimes a meniscus tear occurs simultaneously with a cruciate ligament tear. A meniscus injury can be isolated or accompany other injuries. A torn meniscus occurs in those who have previously injured the anterior cruciate ligament. Meniscus damage does not only occur as a result of injury. It can be caused by degenerative processes (due to illness or senile changes in the body). If the meniscus is destroyed by disease, then improper lifting of the leg on the stairs or a slight load is enough to cause a rupture of the meniscal tissue.
5. Cartilage damage. Typically, a dislocation or fracture leads to changes in the cartilage tissue and pinching.
6. Fractures are a common injury among athletes. Elderly people experience this injury due to the fragility of bone tissue.
7. Cracks can occur in the patella or in the joint bones.

• sitting on a chair, flex and extend the damaged joint (10-15 times);
• you can do a “bicycle” with your feet (moderate pace);
• small squats (with support);
• to restore stretch to the tendons, sit on the floor (legs extended forward) and try to bend your torso as low as possible.

All exercises are carried out daily.

There should be no pain during the warm-up.

At first, 5-10 minutes of exercise is enough.
A visit to the sanatorium allows you to undergo a rehabilitation course and restore mobility.

Possible consequences

1. Fluid accumulation. If immobilization and fixation do not produce results, the fluid rises and has to be pumped out.
2. A torn meniscus can cause disability.
3. Ligament rupture impairs motor activity.
4. A fracture of the kneecap leads to loss of support function of the leg.
5. Infection of a wound during an injury can cause purulent bursitis. And its treatment requires surgery.
6. Stiffness of movements.
7. It is impossible to bend the knee.

More attention should be paid to a set of rehabilitation exercises.

The human body is very complex. Therefore, any injury can lead to unexpected and very serious consequences. When playing sports, do not put excessive strain on your joints. After all, an injury can put even the most avid athlete out of action for a long time; the worse option is that you can forget about sports forever.

Sports injuries

A significant percentage of patients in modern clinics are athletes with these injuries. Professional sports leaves its mark on the performance and proper functioning of the joint. Due to excessive stress on the lower body, a variety of ligament tears, meniscus tears, fractures and dislocations occur.

After this, many people are forever deprived of their sports career, the ability to fully move, and undergo very long treatment and subsequent rehabilitation. Among the most common injuries: meniscus damage, cruciate ligament rupture, and less commonly, bone fractures.

Hemorrhage or hemarthrosis

In modern medicine there is a special term - hemarthrosis. So, hemarthrosis is an accumulation of blood in the joints. With a small amount of blood (up to 10 ml), the body suppresses the problem on its own.

When the amount of fluid in the joints increases, a number of serious complications arise, which can lead to subsequent operations and long-term rehabilitation. The main causes of hemorrhage are injuries. Due to its unique structure and properties, the accumulation of blood in this area can lead to consequences.

Main symptoms:

• slight pain in the knee area, while normal stability and clarity of movement may be maintained;
• slight increase in knee volume (with a small amount of blood);
• swelling and change in skin color;
• loss of skin elasticity and significant enlargement of the knee (more than 100 ml of blood);
• the formation of blood clots that can be felt under the skin with your fingers;

Overuse injury

Every knee injury occurs as an acute condition as a result of physical impact on the joint. But some of them can also be a consequence of prolonged stress or repetitive actions. For example, cycling, climbing stairs, jumping and running can cause irritation or inflammation.

In medicine, there are several injuries of this type:

• bursitis - inflammation of the synovial bursae that soften friction between the heads of bones;
• tendonitis (inflammation) or tendinosis (ruptures) of tendons;
• Plick's syndrome - twisting or thickening of the ligaments in the knee;
• patellofemoral pain syndrome - occurs after excessive stress, excess weight, injury or congenital defects of the kneecap.

Diagnostic methods

No treatment will be prescribed without tests, examination and diagnosis, therefore, the traumatologist uses various diagnostic methods:

• questions are asked about what happened and when, what treatment was taken before the consultation, what worries you (general symptoms);
• an examination is carried out, during which the doctor will palpate to determine whether there is internal bleeding, a lump, swelling and redness;

Knee injury from a fall - treatment, what to do

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Date of: 2016-10-17 Views: 32 655 Grade: 5.0 Probably every person has been bothered by pain in the knee joint at least once in their life. The reason for this may be both acute damage due to trauma and age-related degenerative changes in joint tissue. This is due to complex anatomy, as well as increased loads experienced by the knee. In the statistics of sports injuries, knee injuries occupy a leading position. Quite often, it is the knee that causes the end of the career of professional athletes. As I already said, the structure of the knee joint is very specific and has a number of features. 1. In fact, the knee joint consists of two joints: the femorotibial joint and the patellofemoral joint. Very often, after a trauma, patello-femoral conflict syndrome develops. This occurs due to traumatization of the articular surface of the patella, which becomes uneven, as if rough. The patella can no longer slide normally along the surface of the thigh, which causes pain when flexing and extending the leg. 2. In the cavity of the knee joint there are menisci, cartilaginous formations that play the role of a kind of gaskets. These structures can be damaged even with minor traumatic effects. 3. Complex ligamentous apparatus of the joint. In addition to the external, extra-articular ligaments, there are two cruciate ligaments in the knee cavity: anterior and posterior. These structures are also quite often subject to trauma.

II. Sprain

III. Meniscal damage

IV. Knee ligament rupture

VI. Fractures of the bones forming the knee joint

Injuries to the knee joint are a common pathology that can occur due to careless movements, falls, impacts, or playing sports. The knee is the most mobile joint in the human musculoskeletal system. The joint consists of the corresponding surfaces of the bones of the lower limb, ligaments, menisci and other structures. All of them form a complex complex that provides the basic functions of the lower limb.

Read more about knee injuries

As a result of injury, the integrity of soft tissue, bone and tendon structures may be compromised. Since they are a single connection, any violation affects the function of the entire joint. Knee injuries are quite common, since the lower limb bears a lot of stress with both movement and weight. The knee joint is the most common target of such injuries.

Depending on the mechanism of injury and the strength of the damaging factor, mild and more severe degrees of injury are distinguished. For example, there may be a small bruise, or perhaps a complex multicomponent fracture. Only an experienced doctor can distinguish between them clinically, since not every injury hurts greatly. It is necessary to focus not only on clinical indicators, but also on specific examination methods and instrumental studies.

This speaks to why it is so important to see a doctor if you are injured. He will determine the scope of first aid, prescribe diagnostic and treatment methods.

There are the following types of knee joint injuries:

• dislocation;
• fracture;
• other damage.

Most often, the injury occurs as a result of a fall or a blow to the knee area. Common signs of a knee injury are pain, dysfunction, swelling, and soft tissue swelling. There are visible and hidden manifestations, for example, hemarthrosis - hemorrhage into the joint cavity is not so easy to determine without special research methods.

Diagnostics is required, for which radiography, ultrasound diagnostics, and various types of tomography are usually used. Depending on what the doctor determines based on the diagnosis, treatment tactics are prescribed. Most often, this is a combination of conservative and surgical methods. Treatment depends on the severity, localization of the process, and associated injuries. After treatment, compliance with the prevention and rehabilitation program is required.

Those who play sports professionally or do a lot of active recreation should be especially attentive to the condition of the knee. The anatomical features of the knee contribute to the fact that this particular joint is often injured. Again, injuries can range from simple to complex injuries.

Knee bruises

A knee bruise most often occurs as a result of a direct fall on the joint or after a blow to it with a heavy object. The force of the impact should be strong enough to cause contusions, but not such that it causes ruptures or fractures. That is, the fall occurs from a short distance.

A patient with a bruise complains of pain in the joint area and has difficulty walking. There is swelling and swelling of the soft tissues in the projection of the knee. The contours of the knee are expanded and somewhat smoothed; hemorrhage into the soft tissues - a bruise - may be observed. It is painful for a person to make movements, so he takes care of the bruised knee and the entire limb.

Hemorrhage may occur not only in soft tissues, but also in the joint cavity. This is determined by such a symptom as patellar ballotation - it seems to “float”. A doctor can determine such a symptom; independent movements can aggravate the situation, so it is better not to try to independently diagnose hemarthrosis, which is what blood in the joint cavity is called.

Why is bleeding into a joint dangerous? The fact is that sometimes this amount of blood can be insignificant, and sometimes it reaches significant volumes, 150-200 ml. This leads to the fact that a person cannot even bend his leg at the knee, the structure is so deformed.

Treatment of a bruise without hemarthrosis involves local cooling of the knee. Gradually, the swelling and pain will go away, you just need to temporarily take care of your leg and give it rest. If hemarthrosis is present, the treatment tactics are somewhat different. Requires hospitalization in a hospital. It will not take much time, but the patient needs the supervision of medical personnel.

The limb is immobilized, and blood is removed from the joint cavity. It is eliminated using a syringe with a wide needle. This is necessary because the blood in the joint cavity coagulates into a fibrin clot, which is difficult to remove. A bacterial infection may occur, which leads to more serious complications. The doctor monitors whether blood appears in the joint again some time after the puncture. During treatment, a bandage is applied to the leg.

First aid for a bruise with hemarthrosis consists of immobilizing the leg, while fixing the hip, knee and ankle.

Other knee injuries

Consider injuries such as ligament tears and injuries.

Let's start with ligament tears. The rupture may be complete or incomplete. The first stage of the condition is micro-tears, which continue if the pathological effect on the joint is repeated. Depending on which direction the knee turns during injury, one or another ligament is torn. There are major ligaments in the knee that anchor and stabilize it during complex movements. The knee works on the principle of a hinge and that is why it is enriched with a whole apparatus of additional structures that are not found in other joints.

As an example, situations in which a knee ligament rupture can occur are rotation of the knee inward or outward with a fixed ankle, a blow to the knee from behind, a fall on straight legs, or a jump from a great height.

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Damage to the ligaments is accompanied by a pronounced clinical picture - the patient feels pain, the movement of the leg and its supporting function are impaired. Outwardly, it looks like edema, hemarthrosis, swelling of the skin and soft tissues. The leg may acquire pathological mobility - the lower leg becomes unstable. This speaks to the importance of immobilization for any injury until a diagnosis is made.

Diagnosis is carried out using arthroscopy, which can clearly visualize ligament rupture. X-ray shows a violation of the symmetry of the joint space. Also, a good imaging method is tomography, computed tomography or magnetic resonance imaging.

Surgical treatment is required - ligament plastic surgery. It is carried out delayed, when the active phase of the condition subsides. Until then, the leg remains motionless, which is ensured by a special splint. After treatment, rehabilitation is required to develop the muscles - they lose strength during treatment

Another type of pathology is rupture of muscle tendons. As a rule, the quadriceps tendon is affected. At the same time, the patellar ligament ruptures. The reason for this condition is a blow, extension of the lower leg while the thigh muscles are tense. The patient complains of pain and keeps his neck half-bent even when walking. Attempts to palpate the joint area are perceived as painful.

Treatment of knee joint injuries

There are also injuries to the meniscus. This injury often accompanies activities associated with increased stress on the legs - dancing, sports, active recreation. The meniscus can rupture completely or incompletely; there are cases of complete crushing - this depends on the force of the impact. The greater this force, the higher the likelihood of combined damage to other structures.

The clinical picture is not very specific - severe pain, swelling, and impaired motor function are observed. To determine exactly the damage to the meniscus, a series of tests are performed. The patient is asked to perform certain movements, a painful reaction to which indicates meniscus pathology.

Tomography and ultrasound are used for diagnosis. Treatment is surgery and a program to restore movement in the joint.

Knee fractures

One type of fracture is damage to the patella. This structure can break if you fall on your knee. The clinical picture consists of edema, accumulation of blood in the joint cavity, the patient cannot support the leg, and the support function is lost.

X-rays are used for diagnosis. Treatment can be conservative - long-term immobilization is carried out for a period of 6-8 weeks. If there is a displacement, surgery is required. After monitoring and confirming the restoration of integrity, rehabilitation and exercise therapy are required. This helps restore the muscles and the joint itself.

A more severe situation is a fracture of the condyles. This is a serious injury to the knee joint, which is quite dangerous in terms of complications. This requires a blow with considerable force. If there is a fracture of the condyles, there is most likely damage to other structures, ligaments, tendons, and menisci. The clinical picture is pronounced - the patient cannot walk or stand, feels significant pain, there is swelling and hemarthrosis.

The diagnosis can be confirmed using radiography and tomography. Treatment consists of prolonged immobilization or skeletal traction. The condition is monitored using diagnostic techniques. After the end of treatment, a rehabilitation program is prescribed, which includes massage, physical education, physiotherapy and helps restore range of motion after prolonged immobilization.

Damage Prevention

Injury prevention involves following safety precautions during sports, dancing, and during active recreation. If special means of protecting the knee joint are provided, they must be used. During slush or ice, you need to wear comfortable shoes and be more careful on slopes and descents.

Preventing complications from injury involves early seeking medical help. If there is a suspicion of injury, the leg should be immobilized, given a comfortable position, and cold can be applied locally. The sooner a diagnosis is made and treatment begins, the more likely it is to protect yourself from complications.

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