Swelling in the knee after a fall: The request could not be satisfied
7 Critical Signs Your Knee Injury Is Serious
Any athlete’s worst fear—professional or amateur—is injuring themselves to a point that prevents them from continuing to work out. But, the reality is, exercise injuries are far more common than we think.
According to the Centers for Disease Control and Prevention (CDC), hundreds of thousands of exercise injuries occur each year. Among these, knee injuries are the most common.
However, experts agree that the best thing to do if you fall victim to a knee injury is to seek help (or use an effective topical cream like this one) and to know the signs that signal something serious.
You’re on a run and trip over a crack on the sidewalk, or you’re playing tennis and your knee turns at an unnatural angle while the rest of your leg stays in place. If you play any sport, particularly contact or collision sports, you’re no stranger to knee injuries.
You’re also in good company because according to a study published by the Society for Academic Emergency Medicine, the knee is the most commonly injured joint among athletes.
Knee injuries are caused by trauma or damage to the underlying structure of the knee, which could include ligaments, tendons, cartilage, or bursa (a fluid-filled sac that protects the joint from friction). Together, these tissues surround the bone and allow the knee to move with ease. Because the knee is such a complex series of mechanisms, a lot can happen to it.
The most common knee injuries include the following:
- Anterior cruciate ligament (ACL) damage is usually the result of sudden changes in direction, jumps, abrupt stops, and high-speed impact.
- A torn meniscus usually happens after a sudden twist in the leg.
- Knee bursitis, a condition in which the bursa becomes inflamed, is often a result of constant kneeling.
- Patellar tendinitis happens when the tendons that connect the front of the thigh to the shin become inflamed. The impact of running and jumping tends to cause this injury.
- Fractures, i.e., broken bones, are often the result of a fall or a car accident.
After you’ve sustained a knee injury, it’s natural to feel concerned. How do you know if you should walk off your injury or rush to the doctor’s office for an examination? Will a few days of rest be enough for your knee to heal naturally, or do you need to start evaluating options for knee surgery?
Here are seven reasons that should prompt an immediate visit to your doctor’s office.
You’re experiencing swelling.
One of the most obvious signs that a knee injury has occurred is excessive swelling that you can see or feel. This “pain freeze” cream has helped many people feel relief from their nagging pain. Based on the reviews, it’s the most effective on the market.
Swelling is most indicative of a serious cartilage or ligament injury to the knee, according to Taylor Brown, M.D., an orthopedic surgeon at Houston Methodist in Texas.
The amount of swelling that is considered “serious” is subjective. A small amount of swelling may not be cause for concern. If you notice a subtle difference between the sizes of your knees, you probably don’t need to sound the alarm just yet. It’s only extreme swelling you need to worry about.
When we talk about extreme swelling, what we mean is when one knee is significantly larger than the other. According to Dr. David Geier, a doctor specializing in orthopedic surgery, significant swelling “could be a sign of a torn ACL or a patella dislocation with a little piece of bone knocked off, and it should be checked out.”
If your knee doesn’t immediately appear swollen and you’re unsure, “feel the injured and normal knee at the same time, with a hand on each knee to compare the two,” he says. “A swollen knee will feel like a large, warm, fluid-filled balloon.”
If you experience any of the above, he recommends using a topical cream or using the RICE principle. Rest with crutches and activity reduction, ice for 20 to 30 minutes several times a day.
Compression with a soft knee sleeve brace (like this top seller) will help, and elevating your knee above the level of the heart. Over-the-counter pain medication can also provide relief until the swelling goes down.
Aaptiv has workouts specifically to help work around your knee injury. Learn more about Aaptiv here.
If your swelling is minor, you might be tempted to reach for the ice and Advil, but research suggests that some amount of swelling could be good for you. A Cleveland Clinic study confirmed that swelling is caused by a rush of cells called macrophages to the affected area.
Macrophages help repair your injury by ingesting damaged cells. This process results in swelling as fluid rushes into the holes in the tissue left by the macrophages, and this is key to muscle regeneration. Pain and swelling are an adaptive body response. While we often view them as an inconvenience, they are natural signals that we need to slow down.
When an injury causes swelling, the pain and stiffness prevent the athlete from using the injured part of their body. This is where the first part of PRICE – protection – comes into play. By protecting your knee from further injury, you have a better chance of minimizing the damage.
In addition to the severity of the swelling, the speed with which the swelling occurs could indicate a serious injury. If the knee immediately blows up and becomes the size of a grapefruit, then you’ve probably sustained a severe injury.
If you’re unsure or you have swelling that doesn’t subside after 72 hours, please consult with your doctor.
You notice an obvious deformity.
If you notice your knee jutting outward in a way it never has before, take note. A dislocated or fractured patella (kneecap) can cause injuries like this, explains Brian Schwabe, C.S.C.S., board-certified sports physical therapist based in Los Angeles.
While some deformities occur over time, when the deformity is a result of an injury, it could be the result of a fracture or chronic wear on the knee joint. If you are already experiencing any kind of misalignment in your lower extremities, then you could be more prone to this type of injury.
If you notice a bone deformity after an injury, he recommends seeking the assistance of an orthopedic doctor immediately. The doctor will likely take x-rays as well as perform a visual diagnosis to determine if you need surgery.
You felt or heard a “pop”.
Sometimes, a “popping” sound after a movement can indicate something is out of place.
“Oftentimes this type of sound upon injury is indicative of a ligamentous injury,” says Schwabe. Not all ligamentous injuries are full tears, though, and not all require surgery.
However, if you also experience excessive swelling and instability, get it checked out by an M.D. “If you only have a mild sprain then you will be able to rehab it with physical therapy,” he says.
The pop is what you hear as a result of a ligament tear, a meniscus tear, strained tendons, or a dislocated kneecap. Usually what happens is you’ll simultaneously hear and feel the pop.
If you’re not familiar with the meniscus, it’s the cartilage in the knee that functions as a shock absorber. Each knee has two menisci, and they’re shaped like horseshoes. The medial meniscus is on the inside of the knee, and the lateral meniscus is on the outside.
The popping sensation can be difficult to explain, but you’ll certainly know it when it happens to you. Though the sound originates in the knee, you’ll hear it as though it was directly in your ear. It’s as if the sensation travels up your body, and when it gets to your brain, it becomes audible.
Depending on the severity of the tear, your age, and your overall health, you may able to heal on your own. You could start by using a brace and keeping your knee elevated and protected until you can get in to see a sports medicine doctor. However, a pop will almost always bring you down to the ground, and it’s not recommended that you put any weight on it until you can stabilize it.
If the pain is severe, you’ll want to visit a doctor as soon as possible. Surgery is often the recommended course of action, but physical therapy and other non-invasive remedies may be prescribed as alternatives.
You experience greater than normal movement.
If you feel like your range of motion in the knee is higher than usual, something might be out of place or injured. This is known as joint instability.
You may feel like your knee will buckle or fold with walking, twisting, or weight-bearing.
“The sensation of the knee giving away may occur with simple daily activities or upon return to sport following what was thought to be a minor injury,” explains Dr. Brown.
“Additional episodes of joint instability may worsen the condition of a knee after an injury.” Tears of the ACL or MCL and patellar (kneecap) dislocations could also create joint instability, he says.
Hundreds of thousands of exercise injuries occur each year. Among these, knee injuries are the most common.
The best plan of action is to make an appointment with an orthopedic surgeon.
Wear a compression-sleeve-type brace or a knee brace with hinges in the interim, says Dr. Brown.
This may provide some comfort or level of support. Use crutches if you feel like you could fall and suffer additional injury because of knee joint instability.
Another type of hypermobility can occur when the kneecap moves out of place. This condition is called a patella dislocation. It’s usually painful when it happens, and it might be sore the next day. If it pops back in by itself, the injury might not be serious. The true test is whether you feel confident that you can resume regular activity later that day or the next day.
According to Dr. Geier, if the knee resituates itself naturally or if you can put it back in place with little effort, then you may be able to “see how it goes” and avoid a visit to the doctor.
However, if it’s difficult to get the knee back in place or you need assistance to do so, then you’re bound feel pain and most likely swelling as well. If this is the case, Dr. Geier recommends consulting with a doctor. If anything, he says, you’ll get peace of mind.
When the kneecap dislocation is accompanied by swelling, this could indicate that a piece of cartilage or bone got knocked out of place. If the knee feels “loose” when you resume activity, a visit to the doctor may be in order. Your doctor may take x-rays, recommend an MRI, or suggest a visit to a physical therapist.
Knee instability is often caused by weak surrounding muscles. Working on balance and isolation exercises can significantly strengthen the knee and prevent injury. Aaptiv has hundreds of workouts on the app that can build a strong base for your core and lower body. Sign up for Aaptiv today and get a free trial.
You can’t put weight on it.
If it’s immensely painful to stand or put any weight on your injured knee, there’s definitely something serious going on.
“Inability to bear weight after a knee injury could be caused by a fracture, bone contusion, cartilage injury or ligament tear,” explains Dr. Brown. “Initial treatment includes using crutches or a steerable scooter to take pressure off the injured limb and minimize additional damage to the knee.”
If this sounds like you, listen to what your body is trying to tell you. Dr. Brown warns that the old adage of “no pain, no gain” doesn’t apply in this situation.
He advises seeking orthopedic evaluation as soon as possible—even that same day if you can.
After a minor injury like a twist or fall, you might not be able to put weight on your leg immediately. That’s not necessarily a cause for alarm, but if you don’t feel like you’ve recovered within a few minutes, this could indicate something more serious.
It’s similar to when you injure a wrist or ankle. If you fall on your wrist or twist your ankle, you may experience searing pain for a moment or two. When the injury isn’t severe, you’re able to shake it off and resume your life after a few minutes at the most. However, if you’ve experienced a sprain, the pain doesn’t subside. Instead, it gets worse.
Think of a knee injury in the same way. You may experience agony for a moment, but pay attention to how long it takes to go away. If it doesn’t go away within minutes and you’re not able to put any weight on the knee without feeling excruciating pain, then you might need a doctor to help you consider treatment options.
Also, watch out for numbness after the injury. This could be a result of a pinched or damaged nerve and blood vessels. William Blahd Jr., M.D., reports that this symptom could indicate an ACL or MCL tear, a kneecap dislocation, a fractured kneecap, or loose bone.
You can’t straighten your knee or leg.
If you have trouble straightening your leg or it hurts to do so, you probably have a serious knee injury.
To test this, start in a seated position and try to lift your lower leg using your own leg muscles. “You may still be able to bear weight and walk slowly and carefully without assistance, but will probably require assistance to lift your lower leg and fully extend your injured knee,” says Dr. Brown.
“Patella fractures, quadriceps tendon tears, and patellar tendon tears all tend to be associated with an inability to straighten the leg.”
Use a knee immobilizer to hold the knee in a straight position and help with pain relief. This also makes it easier to move about until your appointment with an orthopedic surgeon, he adds.
Another test is to lie down and try to straighten your leg. The goal is to get your knee to lie flat. This might be difficult or impossible to do due to the pain, but what you should watch out for is a total inability to straighten your knee.
Some of the problems that could cause a locked knee include meniscus tears or a torn ACL. The key is to determine whether you can’t straighten your knee due to sheer pain or physical blockage. If you feel blocked, then we recommend getting in touch with a doctor sooner rather than later.
On the flip side, you might have trouble bending your knee. If your knee feels stuck in any way, and the feeling doesn’t go away within a few hours, you could be experiencing something more severe.
Your knee keeps buckling.
When you got hurt, did it feel like your knee gave way underneath you? We’re not talking about a temporary sensation of weakness or some wobbliness, but more like your shin and thigh bone weren’t connecting or staying in place. A buckling knee could signal an ACL tear or a cruciate ligament injury.
It could start with a small pop or crack, or you could feel it after a strenuous exercise session or a soccer game.
Either way, your knee feels unstable or weak. Your knee may give out momentarily, which is scary because you might not trust yourself to walk safely when this happens. According to Dr. Howard Luks, an orthopedic surgeon, this could indicate a tear in the patella or the quadriceps tendon.
These tendons are on the front of your knees and offer a lot of support to keep you upright. If they’re not in top form, you’re bound to feel weak in the knees (cue the terrible SWV song from the ‘90s), and you might not be able to walk at all. If this is the case, you could need surgery.
On the other hand, the weakness could be temporary, caused by wear and tear, improper footwear, or a strain. If you’re a weekend warrior or you’re over the age of 30 (sorry!), you might experience this symptom on a regular basis.
However, if the weakness is recurring and happens every time you exercise, it’s possible you have a time bomb that’s waiting to happen. When in doubt, seek advice from a physician.
This could also signal a torn ACL or a large meniscus tear. These two common injuries are both serious and could cause this symptom to occur, says Aideen Turner, physical therapist and CEO of Virtual Physical Therapists.
“If your knee buckles under you when you are walking, then it usually indicates instability,” she says.
“A lot of people have ACL tears, but if the knee still has functional stability, then surgery is not necessarily needed. But the buckling indicates damage to the cartilage, which means surgery should be performed.”
No matter what you’re going through, remember that a setback is a setup for a comeback. Whether your knee heals on its own, you need some rehab, or you have to resort to surgery, the key is to keep your entire body strong to ensure that your knees have the support and structure they need to keep you moving.
Don’t let your knee stop you from working out. Join Aaptiv today and get classes for meditation, stretching and more.
To help prevent knee injuries in the first place, we recommend taking the following precautions:
- Warm up before exercising. You can try one of our stretching routines on the Aaptiv app.
- Use proper gear designed for your chosen activity. Many sports have shoes designed specifically for playing them, and we recommend using those specialized shoes.
- Keep the muscles surrounding your knees strong.
- Use the correct exercise techniques. Subscribers to the Aaptiv app get the benefit of having virtual trainers guide them through workouts, ensuring that they’re doing the exercises safely.
There’s no magic formula for preventing knee injuries, but taking some precautions before you step out onto the field or the court and knowing the signs of serious injury can help protect your joints.
How to Care for a Swollen Knee (And When to Seek Help)
This blog post was updated for content on October 20. 2020. Existing comments have not been modified or removed.
Knee swelling occurs when excess fluid accumulates on or around the knee joints. Doctors call this an effusion, and some people call it water on the knee. Sometimes, swelling (and the pain that accompanies it) will go away with home treatments. Other times, it may require visiting a doctor for medical treatment.
Symptoms of a Swollen Knee
- The skin around the kneecap is puffy
- The knee is stiff and it’s difficult to bend or straighten it
- It’s painful and bearing weight is difficult or impossible
- Redness or warmth
Swelling that does not go away, also known as chronic swelling, can lead to joint damage, cartilage degradation, or bone softening.
What Causes a Swollen Knee
There are many causes of swelling in the knee, but often it is due to an injury. Damage to ligaments, especially the anterior cruciate ligament, or ACL, causes fluid to build up around the knee. Tearing the cartilage, overuse, and breaking bones can also cause fluid buildup.
However, other underlying conditions like osteoarthritis, rheumatoid arthritis, infection, gout, pseudo-gout, bursitis, cysts, and tumors, can also cause swelling.
Home Treatment for Swollen Knees
It is important to consult with your physician before choosing a treatment plan. If advised by your doctor, over-the-counter anti-inflammatory medications can aid in treating minor cases of knee swelling. Usually, these cases are due to knee osteoarthritis, non-septic knee bursitis, or a minor injury.
The RICE formula can also work. RICE is rest, ice, compression, and elevation.
- Rest: Rest for a period of 24 hours or longer to give the joint time to recover.
- Ice: Icing the area for 20 minutes three to four times per day can help decrease swelling and aid in healing. It is important to avoid putting ice directly on the skin.
- Compression: Wrapping the knee with an elastic bandage can help to limit swelling, but make sure it is not too tight.
- Elevation: Elevate the knee to help reduce blood flow to the area, which can help to reduce the swelling.
With RICE, swelling often goes down in one to three days.
When to See a Doctor
If the swelling doesn’t go down in one to three days of using the RICE method, it’s time to call a doctor.
Also, call a doctor immediately if there are any of these symptoms:
- The knee is severely swollen or has a pronounced abnormality
- The knee cannot fully straighten or flex
- The knee is severely painful
- The knee feels like it will give out or cannot support any weight at all
- The skin near the knee is hot or red
- A fever
- Swelling has not gone down after three or more days
If you’re experiencing knee swelling that will not go away or have pain, connecting with a specialist is always a good idea. There’s no need to rush into surgery. At Flexogenix, we specialize in cutting-edge, non-surgical treatment options, and can help you move past achy knees and into your best life—without invasive surgery. Contact us today to schedule your free consultation.
Learn More About Your Knee Pain
Knee Pain After a Fall
Image Credit: lzf/iStock/GettyImages
Falls happen, even to the most graceful and coordinated among us. The knee is particularly vulnerable during a fall and is among the most commonly injured joints of the body. Knee pain after a fall might signal any of several types of injuries involving the bones, tendons, cartilage or ligaments of the joint.
A fall directly onto your knee typically leads to a contusion, or bruise. Your knee is likely to feel tender and swell a bit. Some mild discomfort when walking might also occur. If the pain is severe, you likely have a more extensive knee injury.
Four ligaments support and stabilize your knee joint, namely the anterior cruciate, posterior cruciate, medial collateral and lateral collateral ligaments. A fall that involves twisting of your knee can damage one or more of these ligaments resulting in pain and joint instability. Overstretching or a partial or complete tear of a ligament is called a sprain. The anterior cruciate ligament, or ACL, is particularly suceptible to injury. Other knee damage often occurs with an ACL tear. In addition to pain, knee sprain injuries commonly lead to swelling, tenderness, decreased knee range of motion, and difficulty bearing weight or feeling the knee is giving way.
The meniscus is a cartilage cushion that separates the bones of your upper and lower leg at the knee. A fall on a twisted knee can lead to a meniscus tear. Signs and symptoms vary depending on the location and severity of the tear and might include a popping sensation, swelling, stiffness, pain, inability to fully bend or straighten the knee, and knee buckling or catching. Traumatic meniscus tears are often accompanied by knee ligament damage.
A fall sometimes leads to a partial or complete dislocation of the kneecap, or patella. With a partial dislocation, or patellar subluxation, the kneecap usually pops back into place on its own when the knee is straightened. Complete dislocations occur less frequently and typically involve damage to the ligament that normally holds the kneecap in place. Patellar dislocations cause immediate, severe pain until the kneecap is back in place. The pain diminshes but persists after the dislocation is relieved. Other symptoms include swelling and inability to bear weight.
A hard fall can lead to a bone fracture involving the knee joint. Symptoms of a patella fracture include immediate pain, swelling, inability to completely bend or straighten the knee, and inability to walk. A fall that involves hitting the inside or outside of your knee can lead to a fracture of the large bone of the shin at the knee. This injury, known as a tibial plateau fracture, typically causes pain, swelling, limited knee mobility and difficulty or inability to bear weight. The knee might appear deformed with a severe fracture.
Warnings and Precautions
Minor knee pain and bruising not associated with difficulty moving your knee or bearing weight after a fall often responds well to home treatment with periodic application of an ice pack, rest and over-the-counter pain medication. If your pain is moderate to severe, you cannot fully bend or straighten your knee, or you cannot bear weight, seek immediate medical evaluation. Seek emergeny medical care if your knee injury is accompanied a cold or pale foot, or numbness or tingling below the affected knee. These symptoms often signal damage to the blood vessels at the knee, an injury that requires immediate treatment.
What Knee Injuries Can I Get From Falling on Concrete?
Unfortunately, falls onto concrete can be quite common. Knee injuries of varying severity often occur with these falls. After you get past the initial pain, it becomes important to closely monitor your progress over the next few days. Persistent or worsening pain may indicate a much more severe injury.
The proper diagnosis and treatment is based on how the injury occurred. Generally, knee injuries suffered on concrete involve some kind of blunt force with direct contact of the knee with the concrete. These injuries can result in:
- Patella, or knee cap, fractures: can occur when the knee is bent at 90 degrees, forcing the knee cap to absorb the full force of your body weight.
- Dislocation of the knee cap: may occur from either direct contact or a twisting injury. This often results in visible movement of the knee cap to the outside of the knee and it may even become stuck.
- Thigh bone and/or Shin Bone Fractures: fractures of the tibial plateau (shin bone) or the femur (thigh bone) can occur with falls onto concrete. This most commonly occurs with falls from an elevated height, such as off a ladder or high step.
- Knee sprains: knee ligament injuries, or sprains, can occur with twisting injuries or when a force is applied to only one side of the knee. Most often, the Medial Collateral Ligament (MCL) is the concern.
- Meniscus tears: this can occur during a sudden twist of the knee while it is bearing weight. There is often a sensation of the knee “giving out,” especially while carrying something heavy or if you are in an awkward position. The meniscus is made of cartilage and is the shock absorber of the knee, keeping your two leg bones from directly contacting each other.
- Anterior Cruciate Ligament (ACL) injuries: ACL injuries are not common with a fall onto concrete, given they usually require extreme angles, extension or rotation of the joint.
Any of the above injuries can worsen over time. Serious knee injuries left untreated can lead to bone deformities, early onset of knee arthritis or even problems walking. If you suffered this injury during work activity, it is important to seek treatment quickly to ensure safe return to activity.
Signs of Serious Knee Injury
The following are recognized signs of a serious knee injury that should be evaluated by an orthopedic knee specialist:
- The knee has more than minor swelling.
- There is an obvious deformity.
- You can’t put weight on it or the knee buckles easily when you do.
- You can’t straighten the affected leg.
- You felt or heard a ‘pop’.
- Your knee feels loose and unnatural when you try to rotate or stress it.
Don’t let knee pain linger. Walk into our orthopedic urgent care or make an appointment with one of our knee specialists at OrthoNebraska.
Is My Knee Injury Serious? 5 Signs to Look For.
Your knee twists, you hear a pop, and now you have knee swelling and pain when trying to walk or with bending your knee. Perhaps you were struck by another player and have bruising, but no swelling. Are these severe knee injuries? When should you consider seeing a Sports Medicine Doctor following a knee injury? Let’s go over 5 things that trained professionals look for to determine if your knee injury is serious.
As an active athlete or competitor, you know that severe knee injuries are common. Both contact and non-contact knee injuries can be severe. This post will cover five signs to look for to help determine if you might have a severe knee injury. In general, the most common and worrisome finding is immediate, significant swelling.
Even though most of the injuries I see in the office turn out to be mild, it is essential for you to know what the warning signs are to look for a potentially severe knee injury.
1. Your Knee Is Swollen
Swelling in the knee immediately or shortly after an injury is a common sign that indicates you may have sustained a serious knee injury. In many cases, the swelling is due to blood. The bleeding will stop, but the swelling will remain. Blood in the joint is called a hemarthrosis. Blood in the knee joint can cause a lot of pain due to inflammation. If we suspect that you have blood in your knee joint, that often means that you sustained a severe injury. The bleeding is usually due to something inside the knee tearing.
Common causes of swelling after a severe knee injury include:
- A tear of the ACL
- Patella or kneecap dislocation
- A meniscus tear: specifically a Bucket-Handle Tear.
- An MCL tear
- Injury to the articular cartilage.
Over 70% of athletes with a swollen knee who felt a pop while running and pivoting will have an ACL tear or a patella dislocation. Patella (kneecap) dislocations are more common than you think. All of you dread an ACL tear. But most of you are surprised when we see you in the office and tell you that your kneecap dislocated. Most dislocated kneecaps will reduce spontaneously on the field. That means that the kneecap will go back into place on its own.
Patellar dislocations may hurt just as much as an ACL tear. Because patella dislocations are such a common sports injury we wrote this post to go into far more detail about them.
With any of the above issues, most of you will find it very difficult to walk without severe knee pain. Crutches, icing, and elevation are beneficial in these cases. These knee joint injuries need to be evaluated for an X-ray. Fractures are rare, but they do occur. Very few knee injuries will require a brace unless you want to use it for comfort. The most important reason for seeing a sports medicine physician after an injury that causes swelling is to look for these most common severe injuries.
Many of these severe knee joint injuries should be evaluated sooner rather than later. The initial treatment will be a reliable examination to arrive at a diagnosis, which will be followed with an MRI to confirm the diagnosis. Depending on what we think you injured, we may consider rest, physical therapy, or surgery.
2. Your Knee Is “Locked” And You Can’t Straighten It
If you had a knee injury and you are not able to fully straighten the leg, you might have a “locked knee.” A locked knee is simply a knee that cannot fully straighten. There are different reasons a locked knee might occur. In some patients, swelling and inflammation can prevent you from fully straightening the knee. In others, a meniscus tear has flipped into the middle of the joint and is causing mechanical locking. You cannot straighten it with the meniscus in that position.
Many athletes who have a locked knee will also find it very painful to bend the knee too. They may feel sharp knee pain when bending which can occur when these bucket handle meniscus tears move.
The most common cause of a locked knee is a unique meniscus tear called a bucket handle tear. A bucket handle tear is considered a serious knee injury and will require surgery to fix or repair the tear. The reason these tears are serious is that a large piece of the meniscus tears flips over and becomes stuck in the middle of the knee joint. You need that meniscus to protect the knee. The vast majority of bucket-handle tears can be repaired. So the sooner we start the treatment process, the better the outcome might be after a meniscus repair.
Although we discuss bucket handle tears here. Not all locked knees will be found to have a bucket handle tear. In older athletes, a flap tear, or different types of meniscus tears typically occur. These types of tears are also essential to identify early on. Most bucket handle tears are repairable. The torn bucket handle should not be removed from the knee, if at all possible. These tears, which cause a locked knee, are often very large. If the piece is removed and not repaired, then you have a significant chance of developing osteoarthritis. These bucket handle tears do not require emergency surgery, but they are urgent, and you should see a sports medicine doctor if you feel like something is preventing you from straightening your knee all the way.
3. Your Knee Feels Unstable, or You Felt a Pop
Most ACL tears and patella dislocations occur from a twisting, non-contact injury. A typical story is that you were turning or twisting hard, and you felt a pop. As I mentioned earlier, most patella dislocations will reduce or go back into their usual place on their own. But if your patella remains dislocated the knee will look strange.
If you felt or heard a loud pop as you twisted or turned to avoid another player, then you may have torn your ACL. Other causes of popping include a patella or kneecap dislocation. If you felt or heard a loud pop in your knee, then there is a strong chance that you have a severe knee injury. Most ACL injuries and patella dislocations are non-contact injuries. A running back turning to head upfield. A striker moving laterally to avoid the defense. These are familiar stories when we see high school and college athletes who have torn their ACL.
This post dives further into the immediate management of suspected ACL injuries.
Once again, another prevalent severe knee injury following a loud pop is a patella dislocation. They are more common than most people think. Everyone has heard of an ACL tear, but most are not aware that the patella or kneecap can dislocate. Many patella dislocations will spontaneously reduce or go back into place. That means that the patella was only dislocated for a second or two. Patients with a patella dislocation often require an MRI to see if you injured the cartilage on the patella when it dislocated. Surgery to repair the patella ligaments is usually not necessary for a first dislocation. This post provides more information about patella dislocations.
4. You Have Significant Weakness Trying To Straighten Your Knee
Severe weakness when trying to straighten the knee, even a few days after the injury, could mean that you suffered a severe tendon injury. Common causes of weakness include patella dislocations, patella tendon tears, and quadriceps tendon tears. Patella tendon and quadriceps tendon tears are not common in youth or collegiate sports, but we will see a few of these every year.
In older weekend warriors who are wondering why their knee is weak after a serious injury, patella tendon and quadriceps tendon injuries are far more common. If you are over 35 and felt a loud pop in your knee while pushing off during tennis, or basketball then you need to consider that you have seriously injured your patella or quadriceps tendon(s).
After an injury to one of these large, critically important tendons, you will find that the knee will feel unstable. You will think that the knee is unable to support your weight without giving way. You should be promptly evaluated by a Sports Medicine physician to determine the type of injury you had. Both quadriceps and patella tendon injuries require surgery to repair these large essential tendons.
We discuss the management of patella tendon injuries in this post. The management of quadriceps tendon tears is very similar.
Patella dislocations occur mostly in younger athletes. Most patella dislocations happen when the knee is bent, the athlete is twisting, and then they are struck on the inner side of the knee. The patella will usually snap back into place, but the damage is done. Any suspected patellar dislocation should be evaluated by a sports medicine physician since patella dislocations can cause injuries to the cartilage or the ligaments which hold the patella in place.
5. You Have Significant Difficulty Walking
Of course, many knee injuries make it painful and hard to walk. For people with severe knee injuries, it is usually very hard if not impossible to walk. You will often need to be helped off the field and require crutches. Anyone who is placed on crutches should be considered to have a serious knee injury until an Orthopedic Surgeon evaluates you. In many of these cases, an urgent X-ray is useful to rule out a fracture if the athlete cannot put any weight on the knee.
Take-Home Message: What to look for if you are worried that you might have a serious knee injury.
- Your knee is swollen
- You felt a pop
- Your knee is locked and will not straighten
- You have a significant weakness when trying to straighten the knee.
- You have persistent, significant difficulty walking or putting weight on your leg.
Knee injuries are common across all sports. Most knee injuries are mild, and the athlete can expect to return to play relatively soon. Identifying the serious or severe knee injuries and acting quickly can make all the difference when it comes to getting you back in the game and minimizing your risk of further damage.
Disclaimer: this information is for your education and should not be considered medical advice regarding diagnosis or treatment recommendations. Some links on this page may be affiliate links. Read the full disclaimer.
Meniscus Tear | Cigna
What is a meniscus tear?
A meniscus tear is a common knee injury. The meniscus is a rubbery, C-shaped disc that cushions your knee. Each knee has two menisci (plural of meniscus)—one at the outer edge of the knee and one at the inner edge. They keep your knee steady by balancing your weight across the knee. A torn meniscus can prevent your knee from working right.
What causes it?
A meniscus tear is usually caused by twisting or turning quickly, often with your foot planted while your knee is bent. Meniscus tears can occur when you lift something heavy or play sports. As you get older, your meniscus gets worn. This can make it tear more easily.
What are the symptoms?
Symptoms of a meniscus tear depend on the size of the tear. Small tears may cause a little swelling and some pain. Larger tears usually cause more pain, swelling, and stiffness. The knee may catch, pop, or lock. It may be hard to walk.
How is it diagnosed?
Your doctor will ask questions about your knee and what you were doing when it started to hurt. He or she will look at both knees and check for tenderness and range of motion and see how stable your knee is. You may also have X-rays or an MRI.
How is a meniscus tear treated?
Treatment may include resting your knee, using ice on it, wrapping it with an elastic bandage, and propping it up on pillows. It may also include physical therapy and surgery. Your treatment depends on the type of tear, where it is, and how serious it is. It also depends on your age and how active you are.
Knee Injuries (for Parents) – Nemours Kidshealth
The knee is a joint that joins the thigh bone (femur) to the top of the shin bone (tibia). It is made up of bones,
cartilage, muscles, ligaments, and tendons. These parts work together to make the legs bend, straighten, and swivel. A knee injury can damage one or more parts of the knee.
What Causes Knee Injuries?
Kids and teens may injure a knee in a fall or accident. Active and athletic kids might have overuse knee injuries. These happen when someone trains too much or makes repetitive motions involving the knee.
Common knee injuries in kids and teens include:
- sprains: when a ligament stretches or tears; for example, an anterior cruciate ligament (ACL) or medial collateral ligament (MCL) tear
- strains: when a muscle or tendon tears part or all of the way
- tendonitis: when a tendon gets irritated or inflamed, usually from overuse or poor training (for example, in jumper’s knee)
- meniscal tears: when the cartilage between the upper and lower leg bones (the menisci) tears
- fractures: when a bone breaks
- dislocation of the patella (kneecap): when the kneecap slides out of place
- Osgood-Schlatter disease:
inflammationof the tendon that attaches the kneecap to the shinbone
- Osteochondritis dissecans: when a small piece of bone in the knee loses blood supply and breaks off
- bursitis: swelling of one of the fluid filled sacs that cushion the knee.
What Are the Signs & Symptoms of a Knee Injury?
The signs and symptoms of a knee injury depend on the cause. Most knee injuries cause pain. A knee injury may also lead to the knee feeling weak, “giving way,” or “locking.” Someone with a knee injury might not be able to fully bend or straighten the knee. The injured knee may be swollen or bruised.
How Are Knee Injuries Diagnosed?
To diagnose a knee injury, health care providers ask about how the injury happened and what symptoms it causes.
The health care provider will do a physical exam that includes pressing on the knee and legs and moving them in certain ways. These tests can show what part of the knee is injured.
Imaging tests done sometimes used include:
- X-rays to check for injuries to the bones
- a CT scan or MRI to look inside the knee
How Are Knee Injuries Treated?
Treatment for a knee injury depends on the cause. Some knee injuries just need RICE:
- Compression (with an elastic bandage)
- Elevation (raising the injured knee)
Other knee injuries may need bracing, physical therapy, or even surgery.
Can Knee Injuries Be Prevented?
To help prevent knee injuries:
- Make sure your kids wear the recommended protective equipment for sports (such as knee pads and shin guards).
- Make sure your kids wear supportive athletic shoes that are in good condition.
- During workouts, kids should always warm up and cool down.
- Encourage kids to do regular strength training to support muscles, and stretching or yoga to improve flexibility.
- When jumping, kids should bend the knees while landing. This takes pressure off the ACL and prevents injury.
- If kids cut laterally or pivot frequently (as in soccer), encourage them to crouch and bend at the knees and hips to reduce the chances of an ACL injury.
- For kids who play just one sport, conditioning and training year-round — even if it’s at a lower intensity than during the competitive season — can help them stay in shape and make an injury less likely.
What Else Should I Know?
If your child’s knee hurts, it is important to know why. Take your child to a health care provider to find out what’s causing the pain and to get treatment.
90,000 Knee bruised, swollen and sore – what to do
When do you need help from a traumatologist
Determining whether a victim needs to see a doctor is fairly straightforward. The main symptom is severe knee pain that does not improve even after first aid. In this case, the indications for contacting a doctor are:
- knee deformity;
- crunch when trying to bend a joint;
- the formation of a hematoma at the site of the injury;
- the appearance of a lump, which continues to increase in size;
- swelling and edema that appeared several hours after the injury;
- numbness of the leg in the knee area.
All these symptoms may indicate not just a bruise, but serious damage to the joint, which requires qualified medical attention and long-term treatment. Therefore, if a knee hurts after a bruise, then a specialist should answer the question of how to treat it. It is he who can give the answer to the question of what kind of knee bruise it is and how to treat a swollen one.
If the knee is swollen after a bruise and you do not know what to do, the traumatologist will not only provide the necessary medical assistance, but also prescribe effective treatment.However, first you will have to undergo an examination using an X-ray, and, if necessary, make a computer diagnosis to determine the degree of damage to the joint and soft tissues.
Methods of knee recovery after injury
Treatment of the spine and joints by surgery is an extreme measure that specialists resort to in cases where bone and muscle tissue is seriously damaged. For common fractures and cracks, plaster is applied; in all other cases, a tight knee bandage is recommended.
So, what should you do if your knee is swollen and sore after a bruise? Any traumatologist will say that you will have to resort to the help of anabolic steroids, which are taken orally or applied to the site of the injury in the form of an ointment. If a large hematoma has formed at the site of the injury, it is punctured to allow blood to drain and relieve pressure on the injured area. If, with a knee injury, the leg is swollen below, and the injury itself is accompanied by an open wound, it is carefully treated and a sterile bandage is applied. If the wound has healed, and the leg continues to hurt and the tumor does not subside, ointments are prescribed that effectively remove swelling, as well as drugs that reduce pain.
First aid provided: what’s next?
It is not surprising that with serious injuries of a bruised knee, the leg hurts for a long time. In addition to the medicines prescribed by the doctor, you can use traditional medicine. If your knee hurts badly after a bruise, and you do not know what to do, and the prescribed remedies do not bring relief, you need to reduce the load on the injured leg, and ideally give up walking for a few days. A tight knee bandage will help minimize joint movement and reduce pain.In the first days after the injury, you should stop drinking in large volumes to prevent swelling of the limbs. Sometimes, after such injuries, patients may have a fever – then it is worth using antipyretic drugs.
If a lot of time has passed after the injury, the mobility of the joint is restored, but the knee still hurts when flexing after a bruise, it is worth contacting your doctor again, who will prescribe additional physiotherapy procedures.It can be massage, warming up, physiotherapy exercises, which will help relieve pain symptoms, will be the last stage of rehabilitation after an injury.
90,000 Meniscus tear: Operation, rehabilitation, cost of treatment
Surgical treatment of an injured meniscus is carried out using two methods. Meniscectomy involves removing a portion of the damaged meniscus to flatten the articular surface. During arthroscopic surgery, meniscus injuries are treated with a surgical suture.So, the knee joint is freed from blockages that damage the articular cartilage. Arthroscopic suturing is only possible if the tear is near the base of the meniscus, which is well supplied with blood. © Alila Medical Media
Meniscus rupture is one of the most common knee injuries. Every fall or accident that leads to a dislocation or other injury to the knee can lead to a tear in the meniscus. The knee is often bruised during a fall.How dangerous the injury is and the rupture itself depends on how much weight falls on the knee, as well as on the degree of human activity. The more the knee moves inward, and the more intensely the metatarsophalangeal joint of the first toe is bent, the higher the risk of a meniscus rupture.
The knee joint of every person has both an internal and an external meniscus. In this case, we are talking about the cartilaginous structures of soft tissues, having the shape of a crescent, serving as shock absorbers between the tibia and the femur of the knee.Acute injuries and tears of the knee meniscus immediately cause severe stabbing pains, swelling and limiting knee mobility. In this case, the joint seems to wedge and the person experiences difficulties in bending and extending the leg. Over time, the meniscus wears out, which leads to severe pain after exercise, as well as to a change in the degree of activity.
Sometimes complaints associated with a ruptured meniscus can go away on their own, with the help of immobilization, physical rest and accompanying physical therapy.If the pain has become chronic and the joint is sometimes immobile, the meniscus rupture is treated with surgery.
Meniscus rupture: causes and course of the disease
Rupture of the meniscus can form with severe dislocation or injury of the ankle joint. Simple overloading of the knee joint after jerking loads (start / stop) or sudden rotational movements can lead to overstrain and, as a result, to rupture of the meniscus.
Meniscus tear and sport
Meniscus rupture is a common pathology in people involved in skiing, namely when the skis are tilted to the side.If a skier is moving at full speed, then the kinetic energy of his body can provoke a dislocated knee joint, a meniscus rupture. Football, basketball, as well as other so-called contact sports associated with strong acceleration and often with excessive uncontrolled external force (eg an opponent) can cause injury of this nature.
Rupture of the meniscus during the working day
Certain categories of occupations place the knee joint under extreme stress.These activities include squatting (eg tilers). Excessive flexion of the knee joint, as well as the effect of the whole body weight on the leg, negatively affects the knee joint and causes severe pain.
The next challenge is lifting a heavy load from a squatting position. As a rule, the position of the back recommended by doctors during such work is actually very stressful. And if the knee has already been damaged, then you need to choose – to overextend the meniscus or intervertebral discs.
Degenerative meniscus rupture in elderly patients
Most often, in patients of a more mature age, the connective tissues of the cartilaginous structure of the knee lose their elasticity and become less mobile. Since the meniscus is a cartilaginous tissue and wears out quickly, minor injuries can cause it to rupture.
Preexisting injuries of this nature are taken into account by our specialists when drawing up a treatment plan. Full recovery of a degeneratively injured meniscus can only be achieved with long-term treatment.
In younger patients, meniscus rupture is observed after severe traumatic exposure. Elderly patients can simply turn or stumble inadvertently.
Meniscus tear: Orthopedic aspects of the disease
Every regular overstrain of the knee joint can lead to a weakening of the meniscus. Therefore, excess weight is one of the main criteria when it ruptures or degenerates (wear). Violation of the axis of the lower extremities, due to valgus (X-shaped) or varus (O-shaped) deformity of the legs, negatively affects the forces acting in the knee joint and thus can accelerate the process of wear of its individual parts.
A previous cruciate ligament rupture also puts some strain on the menisci. In addition, it should be noted that the cruciate ligaments are located in the cavity of the knee joint and are responsible for centering the femur and lower leg. They also possess signaling receptors through which they transmit information to the muscles of the legs about the expected onset of injury. When the cruciate ligaments rupture, all tangential, inertial and braking forces act directly on the meniscus to such an extent that they lose the role of a seat belt inside the knee joint.
In case of a meniscus rupture, contact an orthopedist as soon as possible: After all, such an injury often leads to pinching, irritation and impaired motor functions of the knee joint. A visual signal of a meniscus rupture is a painfully swollen Baker cyst in the popliteal cavity (popliteal cyst), which is caused by inflammatory irritation of the joint capsule. Often, in order to avoid pathologies such as joint wear and arthrosis, surgical treatment is necessary. Only an experienced diagnostics and knee treatment specialist will be able to assess the condition of the patient’s knee joint and tell if the injury will heal on its own.
When is a meniscus tear surgery necessary?
Meniscus rupture is not always treated by surgery. Pathology can pass without the intervention of a surgeon. However, this depends on the shape, size, as well as the position of the tear, the age of the patient, and the condition of the meniscus tissues.
Meniscus rupture is operated only if the nature of the damage clearly indicates the impossibility of treatment with physiotherapy. The aim of the surgery is long-term pain relief, stability and preservation of the functionality of the knee joint.Surgical intervention should help the patient return to their previous lifestyle and give the opportunity to play sports as before. In addition, a healthy and full-fledged joint prevents (arthrosis), that is, degenerative changes due to overstrain of the cartilaginous surfaces of the knee joint.
Meniscus Surgery: How is Meniscus Rupture Treated in Young Patients?
For young patients with traumatic meniscus rupture, there are fairly clear indications for surgery:
- long-term knee pain after meniscus rupture
- blockade in the knee joint
- patchwork gap
- damage to the inner (intermediate) region of the meniscus
Surgery of degenerative meniscus rupture in mature patients
The situation is more complicated with degenerative changes.Depending on the intensity of the complaints and the degree of limitation of mobility, the specialists of the Gelenk-Clinic will try to delay the operation using conservative methods. In case of a meniscus rupture caused by degenerative changes, that is, due to wear, it is necessary to level the articular surface and release the knee joint from blockages that damage the articular cartilage until arthrosis occurs
What happens before a meniscus tear is surgically treated?
A knee injury visualizes a clear horizontal meniscus tear along its longitudinal axis (yellow markings on the left).The other meniscus of the knee joint (on the right) is not damaged, as evidenced by a more voluminous darkened area. © joint-surgeon
Before the operation, the doctor conducts a comprehensive clinical examination. Typically, an experienced knee therapist will be able to diagnose a rupture during the history and physical examination of the patient. During a clinical examination, the doctor checks the knee joint mobility in different positions, assesses the gait, and also tests how the leg flexes and extends.Especially in the area of the joint space, a meniscus rupture causes clear pain, which is a fairly accurate confirmation of the diagnosis from a clinical point of view.
For knee pain, patients are always referred for x-rays, as this examination helps the doctor more accurately assess the condition of the knee joint. An X-ray taken in a standing position gives an idea of the thickness of the cartilage tissue. Thus, the specialists of our clinic can rule out that the cause of the stitching pain in the knee is arthrosis of the knee joint.Concomitant injuries of sprains, curvatures or dislocations of the knee joint can also be bone injuries. With the help of an X-ray, orthopedic specialists at Gelenk-Clinic will be able to exclude the presence of fractures.
Unlike X-rays, which mainly visualize bones, MRI (magnetic resonance imaging) provides accurate pictures of all soft tissue structures. This way, your doctor will be able to assess the condition of the tendons, ligaments and cartilaginous menisci.The ability to obtain detailed images of the meniscus rupture makes this examination particularly significant. With the help of MRI, you can see the exact position of the break, as well as establish its length and course.
How is the operation going at Gelenk-Klinik?
Knee specialist performs arthroscopy © Viewmedica
If a meniscus rupture gives the patient severe pain in the knee and limits his mobility, surgery should be performed immediately. Surgical interventions on the menisci are always performed arthroscopically, that is, using a minimally invasive technique.During this operation, the surgeon makes small incisions on both sides of the knee joint in the patella, through which the camera is inserted using narrow tubes. Laparoscopic surgery speeds up the wound healing process and also reduces the likelihood of postoperative complications.
Basically, patients are offered two treatment options for meniscus rupture: Suture or partial removal.
In case of fresh ruptures, especially in the area of the joint capsule, where the blood vessels supplying it (base) enter the meniscus, healthy tissue can be preserved with the help of minimally invasive intervention.Ideal arthroscopic sutures, especially in the anterior and lateral areas, are achieved using modern surgical techniques and special sutures. When choosing a suture technique, the surgeon takes into account the size and position of the tear.
Even with more serious types of rupture, the so-called “pen-watering” injuries, our surgeons will try to preserve the meniscus when the arthroscopic suture is poured and thus reduce the risk of arthrosis of the knee joint.
How long does it take to recover from an arthroscopic suture?
Movement in the first days after meniscus tear surgery should be limited for approx.six weeks. The patient is allowed to fully load the knee joint only if the leg is in a fully extended position. As soon as the knee joint bends, any load is contraindicated, otherwise the seam may break under the influence of shearing forces.
This position is ensured by a special splint (orthosis), which can be fixed to prevent the impact of gravity on the knee joint. If the patient wants to bend the knee or sit up, the block can be removed and the leg can be flexed without tension.It is recommended to suspend sports for 6-8 weeks. Sports that involve stress on the knee joint can be resumed no earlier than 6 months later only by agreement with the surgeon.
Meniscus resection: Partial removal
If the shape and position of the meniscus tear indicate the failure of conservative treatment and arthroscopic surgery, it is necessary to resect the torn part. By this intervention, the articular surface is leveled and the efficiency of the articular cartilage is increased.Even with such an intervention, it is very important to preserve as much healthy tissue as possible. After all, the larger the stored component, the longer the meniscus will retain its original function.
How long does it take to recover from meniscus resection?
After partial removal of the meniscus, the patient can exert stress on the knee on the day of surgery. Elbow crutches will help balance the tension on the knee joint. As a rule, you will be on sick leave from one to two weeks.A longer stay at home may be required only if the patient’s profession implies special loads.
After a week, you can cycle again and do light sports. Swimming will be possible only when the wound has healed completely and when the stitches are removed.
In 3-4 weeks you will be able to play football, tennis or go jogging again.
Meniscus tear: transplant and synthetic implant
Donor material can be used for transplantation.In younger patients with more severe trauma, this is most often the only way to prevent knee wear. Transplantation of an artificial implant is also possible.
Both transplantation and the use of artificial material are emergency interventions that are carried out after previously unsuccessful operations, during which it was not possible to preserve the functions of the meniscus.
Very often, the operation is performed with an incision than necessary and more tissue is removed than the situation actually requires.The results of surgery with the introduction of synthetic implants are encouraging, but there is still no long-term effect of the operation.
Therefore, these interventions should not be considered as the main methods of treatment for meniscus rupture. Therefore, patients after an injury should contact a knee specialist as soon as possible, who will carry out the necessary diagnostics and make the right decision regarding further therapy. Regardless, the goal of any treatment for a meniscus tear should be to preserve the actual tissue, preserve the natural function of the meniscus, and thus avoid transplant surgery.
Meniscus transplant: Meniscus tear surgery with donor
Arthroscopic surgery is sometimes not considered by surgeons as a treatment for a meniscus tear. This may be due to size, an unfavorable tear location, or extensive tissue loss. In this case, doctors often use donor material, which helps prevent the initial stages of arthrosis, as well as ruptures of the articular cartilage in young patients.
During this operation, both the inner and outer menisci can be replaced.As part of the diagnosis, it is very important to determine the exact size and position of the injured meniscus. The required donor material arrives at the Gelenk-Klinik in Gundelfingen from the International Center for Transplantology. Although sometimes patients have to wait a long time for a suitable donor. Due to various bureaucratic obstacles in Germany, there is no single donor system for meniscus tissue. Basically, the material for transplantation is imported from the Benelux countries. Fortunately, when transplanting donor menisci, there is no rejection reaction, as is sometimes the case with transplantation of other organs.
Since the implant is removed and tested for germs under sterile conditions, the risk of infection is minimal.
A minimally invasive procedure, during which the surgeon inserts a prepared implant through a microscopic approach and then sutures it in the right place, takes about two hours.
Synthetic meniscus transplant
Synthetic fabrics are used primarily to compensate for partial tears of the inner and outer meniscus.Due to its porous structure, the recently developed sponge material is particularly suitable for this kind of surgery. Blood vessels grow into its dense structure, which in turn contributes to the formation of endogenous tissue. As soon as new tissues begin to perform their function, the implant dissolves in the body. And in this case, surgeons resort to arthroscopy through a small incision and subject to maximum preservation of healthy tissue.
What kind of doctor performs the meniscus tear operation?
One of the features of Gelenk Clinic is the trusting relationship between doctors and patients.That is why your attending physician will take care of you from the first examination to the operation of the meniscus rupture.
He will also monitor your condition after the operation.
Thus, in Gelenk-Clinic you will have a contact person to whom you can contact at any time convenient for you.
The best and most highly qualified specialists in the treatment of knee joint diseases are Prof. Dr. Ostermeier and assistant professor Dr. med. Dr. Markvas.
What type of anesthesia is used in the surgical treatment of a meniscus rupture?
Meniscus tear surgery is usually performed under general anesthesia.In order to avoid the risk, there is the possibility of spinal anesthesia. To do this, the surgeon injects an anesthetic into the spinal canal of the lumbar spine. In this case, the patient is fully conscious. What type of anesthesia is most suitable for the patient is determined during a conversation with the anesthesiologist. Our doctors are true masters of their craft, who during the appointment will offer the best method for you, corresponding to all the indicators of previous examinations.
Postoperative care, rehabilitation and aids after meniscus tear surgery?
During the first week after the meniscus rupture operation, the knee is immobilized using a special splint.In order to relieve tension from the knee joint, you will need to use elbow crutches. Then the load on the knee will gradually increase. As long as the patient is only partially straining the knee, thrombosis prophylaxis (eg Hepoarin / Enoxaparin) is mandatory. You should also wear compression stockings until your doctor allows you to fully load your leg. After the operation, we will provide you with everything you need.
Will I feel pain after surgery?
Each operation is associated with a specific pain – and the operation of tearing the meniscus is no exception.As a rule, we try to minimize pain after meniscus tear surgery. In most cases, the anesthetist will give a special injection to numb the knee for about 30 hours. After that, the pain is significantly reduced and the patient’s treatment is continued with conventional drugs. The main thing for us is to ensure a painless postoperative period.
What are the conditions of stay at Gelenk-Klinik?
Private ward in Gelenk-Klinik – Gundelfingen, Germany
During your stay at Gelenk Clinic, you are usually in a separate room with a shower and toilet.In addition, we provide towels, bathrobes and slippers. You can also use the safe and minibar. All rooms are equipped with a TV. You should only take medicines, comfortable clothes and nightwear with you. Patient care is provided around the clock. Attending medical staff, as well as physiotherapists of Gelenk Clinic will always answer all your questions. Basically, the hospital stay is 3 days. Your relatives can stay at a nearby hotel.Our staff will be happy to take care of your room reservation.
What to look for after meniscus tear surgery?
Immediately after surgery, the knee should be held in a raised position and a cooling compress should be applied. After about 5 days, the stitches are removed and you can shower again.
Monitor your movements for several weeks to avoid complications. The length of the sick leave depends on the type of your professional activity and can last up to six weeks.Prevention of thrombosis is also mandatory. Comprehensive physiotherapy treatment at this stage is very important, since these procedures prevent muscle breakdown and help restore the functions of the knee joint.
A return ticket should be booked no earlier than 7 weeks after the operation. However, we recommend staying in Gelenk-Klinik for at least 10 weeks.
- Inpatient treatment: 3-4 days
- Recommended length of stay in the clinic: 10-14 days
- When can I return home: 7 days after surgery
- When recommends leaving the clinic: 10 after the operation
- When is it allowed to take a shower: after 5 days
- How long is it recommended to be on sick leave: 2-6 weeks (depending on professional activity)
- When the stitches are removed: after 5 days
- Outpatient physiotherapy: 2 weeks
- When can I drive again: after 6 6 weeks
- Light sports activity: no earlier than 8 weeks
- Habitual sports: after 6 months
Cost of arthroscopic knee surgery in Germany
In addition to the cost of surgical treatment of a meniscus rupture, it is worth considering the additional costs of diagnostics, appointments with doctors and aids (for example.elbow crutches), amounting to approximately 1.500 to 2.000 euros. If you plan to undergo outpatient physiotherapy after meniscus tear surgery, we will be happy to provide you with a preliminary cost estimate.
Information regarding the cost of hotel accommodation and possible additional treatment in the rehabilitation center can be found on the corresponding website.
How to sign up for a meniscus tear operation for a foreign patient?
To begin with, the specialists of Gelenk-Clinic will need up-to-date MRI and X-ray images to assess the condition of the knee joint.After you send us the required documents through our website, we will send you patient information and cost estimates within 1-2 days. …
Foreign patients can sign up for a meniscus rupture operation in a short time. We will be happy to assist in obtaining a visa after the prepayment specified in the estimate is received on our account. If a visa is not issued, the amount received will be returned to you in full.
Due to sometimes long flights, we try to keep the time between the first examination and the operation to a minimum.During outpatient and inpatient knee joint treatment, you can use the services of qualified medical personnel who speak several foreign languages (eg English, Russian, Spanish, Portuguese). The payment for the translator (eg in Arabic) is made on a separate basis. We also organize a transfer, we can book a hotel room and show you how to spend time in Germany for you and your relatives.
Reconstruction of the anterior cruciate ligament of the knee joint
If the knee is unstable after an injury and does not feel confident, cruciate ligament repair should be performed to maintain normal life.
How can you get a ligament rupture?
The inside of the knee joint is held by two very strong cruciate ligaments that hold the knee in place during movement. Ligament rupture is one of the most serious injuries of the knee joint, which can be obtained quite easily – while playing sports or at home. Most often, the cruciate ligaments are damaged during sports training (for example, when skiing or dancing, playing football, basketball, etc.)in everyday life (for example, when jumping from a height, falling, stumbling, etc.), as well as during car accidents, etc. Injury can occur when the muscles did not have time to cope (with improper rotation, twisting of the knee) and the entire load fell on the ligament, which, unable to bear it, breaks. Sometimes the meniscus, the cartilage that provides additional shock absorption to the knee joint, is also damaged at the same time.
Is this a ligament rupture or a fracture?
The moment of injury – ligament rupture – is very painful.For example, when skiing, if each ski goes in its own direction, then the knee is everted and a ligament rupture occurs, which connects the bones. And a large blood vessel passes through the ligament. It is also damaged, so the blood rapidly fills the knee joint, causing pain and an increase in the size of the knee, about two times. It is very painful and the knee swells rapidly. If the knee is not swollen, then the ligament is most likely intact, but usually the pain is so severe that medical intervention is required to ensure the integrity of the bones.If the bones are intact, then the knee needs a rest regime of at least 3-4 weeks.
After the injury, the pain and swelling persist for about a week, the state of health improves after about a month, but the feeling of insecurity and instability remains in the leg. An injury to the cruciate ligament does not interfere with walking, but you can no longer play sports, dance, or perform various normal activities. The cruciate ligament ensures stability of the knee joint, therefore its injury significantly changes physical activity in later life, since (according to the patients themselves) the knee bends and leaves its place.
What to do?
Action plans may vary. It depends on the desire and requirements for life, but young and physically active people should strive to repair a torn ligament. Of course, you can somehow adapt and live without a ligament for years, but every time you have to walk on a slippery, uneven surface, the knee will jump out of its place. This is not safe, as friction of the bones destroys the cartilage of the joint and every time some changes occur in the joint.In a week, a month, or even a year, nothing terrible may happen and will not happen, but over a long period of time, the cartilage will wear off and contribute to the development of arthrosis, which may lead to the need for arthroplasty. Therefore, it is important to repair the ligaments so that the knee does not have free mobility, as instability of the knee can lead to new injury and damage to the structure of the knee joint.
Usually, immediately after a ligament injury, the operation is not performed. In this case, if the leg is unstable or there are other complaints, a visit to a traumatologist-orthopedist is required to perform examinations.To clarify the diagnosis, it is best to use magnetic resonance imaging, which allows you to accurately determine the damage to the ligament, and mechanical ruptures, and fluid in the knee joint, etc.
How is the operation performed?
The operation is endoscopic, which means that the integrity of the knee joint is preserved. Optical and surgical instruments are inserted through 2 small holes. The surgeon monitors the progress of the operation on the monitor screen, where everything is displayed with multiple magnification.A torn ligament is a bundle of connective tissue, about a centimeter in diameter, that connects one bone to the other in specific places – it is impossible to sew. If it is torn, then there is no way and no strength to connect its ends, since both ends are pulled in like a linen gum when it breaks. Therefore, you need to create a new bundle.
For transplantation, tissue of the body itself is usually taken, for example, for this, a less important tendon of the leg muscles is donated. Without this muscle, a person can live calmly and not notice its absence, but a new strong ligament is formed from this tendon, stronger than the previous one.Then it is fixed in the right places. Immediately after surgery, the leg is fixed in a splint so that the knee is protected from unsuccessful movements and injuries. The duration of the operation is about an hour. To relieve the patient of pain and discomfort, spinal anesthesia is used, the duration of which is 4-6 hours. Then pain relievers and anti-inflammatory drugs are used, as in a conventional surgery.
When can I go home? How is the healing process going?
Sometimes, if there is no swelling and the knee looks good, you can go home the same day.If you don’t have to travel far and the patient doesn’t have a problem showing up for dressing the next day, then you can go home. However, for safety reasons, the patient should remain in the hospital under the supervision of doctors. It is necessary that he is in bed, at rest, as sudden movements immediately after surgery can cause bleeding. The next day, after dressing, you can go home with crutches.
The transplanted ligament was placed in the place where it needs to be engrafted, in a stretched state, but not so strong that you can lean on the leg, therefore, about a month after the operation, you need to move on crutches so that there is no load on the knees.To prevent the muscles of the legs from losing their tone and not atrophying, a special set of exercises must be performed repeatedly every day, which promotes the outflow of fluid in the knee and promotes the healing process. The stitches are removed after 10 days. After the operation, there are 2 sutures of 0.5 cm on each side of the knee joint and one, about 3 cm, lower.
A month later, they begin to develop the leg – they increase the load, then after 2 weeks it will be possible to remove the splint and start walking without crutches. Then you need to start moving, active exercises and undergo a course of physiotherapy, which will strengthen and restore all the functions of the knee.
How long will it take to get back in shape?
If you work purposefully, the fastest when you can get back in shape is in 3 months – but this is a record. On average, it takes 4 months and you can already feel good. You can run, ride a bike and much more, which is not associated with a sharp direction of movement. In professional sports, you can return to the previous level after a year; in ordinary life – after six months you can ski.
How long will you have to be away from work?
It depends on the type of work. If this is a sedentary work at the computer, then you can go to work after 2 weeks, of course, on crutches. But if the work is associated with walking, standing and lifting weights, then on average, you should count on 2-3 months.
Cost of services
Treatment of ruptured ligaments of the knee joint
Description of the disease, symptoms and causes, methods of treatment.
Rupture of the knee ligaments is the most common injury among patients of all ages, resulting from twisting and abrupt movements in the bent joint or a strong blow to the knee, as well as to the thigh and lower leg. Most often, such damage occurs in athletes when playing basketball, volleyball, football, martial arts and alpine skiing, but it can also occur in everyday life, for example, when falling.
The main causes of injury
The functions of the knee joint stabilizer are performed by four ligaments: two lateral ligaments, which prevent external deviations of the lower leg and inward displacement, as well as cruciate elements, which are located inside the joint and ensure its rotational stability.
The mechanism of injury is usually indirect:
- abrupt change in direction of movement and twisting of the limb;
- unsuccessful jump and landing on one leg;
- falling while doing one of the sports.
However, ruptures of the cruciate ligament of the knee can also occur with direct exposure. About a third of such pathological conditions are caused by road traffic accidents, when, with a sharp contact with the dashboard of a car, the front of the knee displaces the lower leg and ruptures the posterior ligament of the knee joint at its thinnest part.
Injury to the PCA is also possible when a person is struck from the front on the knee at the moment of its full extension, when the foot has taken a fixed position on a hard surface.
The most rare occurrence is damage to the internal lateral process, more characteristic of breaststroke swimmers experiencing excessive hallux valgus.
Types and degrees of damage
There are three main degrees of violation of the integrity of the ligaments:
- 1 degree.The patient complains of moderate localized pain, there is practically no swelling and swelling, and there is no hemorrhage. The mechanical integrity of the dense formation is preserved, only a part of the fibers is torn;
- 2nd degree. The main complaints concern limited walking and pain in the injured area. A large number of fibers are damaged. Slight instability is felt in the knee;
- 3 degree. The patient complains of severe pain.There is marked swelling of the affected area and bruising, instability in the knee. All fibers are torn.
Due to excessive pressure and a high range of motion created by an uncontrolled landing on one leg, a complete or partial rupture of the ligaments of the knee joint, popularly called “stretching”, can occur.
Symptoms of damage
Violation of the integrity of the knee stabilizer is accompanied by sharp pain, patients can hear a characteristic crunch during its destruction.You can often hear the phrase that the knee “came out and fell into place abruptly.”
The main symptoms of a ruptured knee ligament are:
- acute pain at the time of injury, which can persist for a long time;
- redness of the skin, edema, extensive subcutaneous hematoma;
- limitation of functions, a feeling of instability.
Due to damage to the nerve endings, accumulation of fluid and severe pain in the knee, the patient cannot lean on the limb immediately after the accident, he spares his leg and limps.Often there is a specific fear associated with the “displacement” of the knee.
Strong pain and lack of stability in the joint is always a cause for concern and a specialist consultation. During the examination, an orthopedic traumatologist will assess the presence of edema, fluid in the joint and carry out the necessary tests (ligamentous and meniscus). Also, the patient may be recommended to MRI of the damaged joint, ultrasound and X-ray examinations to prevent bone tissue defect.
In the case of a partial rupture of the cruciate ligament of the knee joint, the mobility of the joint may be somewhat limited, and in the event of a rupture, the amplitude is too large due to a change in the position of one of the bones, therefore, such simple movements as flexion-extension of the knee in the joint are impossible for the patient.
Since the symptoms of a closed fracture and sprains may be the same, additional diagnostics may be required to make an accurate diagnosis.
Cruciate ligament rupture of the knee: Treatment
For the complete restoration of the damaged ligament, it is necessary to use accurate diagnostic measures and the correct approach to treatment. This will avoid the aggravation of symptoms, the development of undesirable consequences in the form of early arthrosis and joint destruction, as well as facilitate subsequent treatment.
At first, after an unsuccessful jump or fall, the following measures must be taken:
- to provide rest to the injured area, protecting the limb from unnecessary stress;
- apply cold to relieve pain, inflammation and bruising;
- apply a tight bandage that immobilizes the damaged joint and relieves swelling;
- put a pillow under the limb to improve venous outflow, reduce swelling and pain threshold;
- take analgesics and anti-inflammatory drugs.
With the timely implementation of these measures at home, the swelling will be removed as quickly as possible, and the injured leg will receive the necessary rest. The conservative treatment of partial rupture of the ligaments of the knee is based on the use of an elastic bandage and the use of analgesics, but for an accurate diagnosis, an appointment with a specialist is required. The full course of treatment is about 4 weeks, and full recovery will take at least 10-12 weeks.
A complete rupture of the cruciate ligaments of the knee requires plastic surgery. In 20% of situations, a reconstructive operation can be dispensed with, but in the remaining 80% of cases, delamination takes place and such ligaments can no longer be sewn. Then they resort to plastic replacement of the ligament, using the patient’s existing tendon and special implants to fix the manufactured ligament at the points of its attachment. Rehabilitation after a complete rupture of the knee ligaments can take more than six months.
Treatment for ruptured anterior cruciate ligament
Rupture of the anterior cruciate ligament Upon admission to traumatology, the patient is sent for X-ray to exclude damage to the bone. The knee joint is punctured to relieve symptoms, pain and accumulated blood.
Among the main purposes: local cold, elastic bandaging, ensuring an elevated position of the leg, fixation with an orthosis, lasting up to 7 days.
With a decrease in pain and a decrease in edema, the patient can try to lean on the limb after injury and perform flexion-extension in the knee joint. An MRI is performed to make an accurate diagnosis.
If the patient feels instability in the joint or displacement forward, his lower leg is tucked when walking and during professional sports, such a decrease in functionality becomes the main indication for reconstructive surgery.Otherwise, an increase in swelling and pain is possible, which not only affects the quality of human life, but can also lead to abrasion of the articular cartilage, secondary rupture of the meniscus and the rapid development of osteoarthritis.
Conservative treatment in this situation has no prospects, since due to insufficient blood supply, the torn fibers do not grow independently.
The patient can be recommended arthroscopic reconstruction with the production of a new ligament from the tendons and the use of various grafts.For this, the tendons of the tender and hamstrings can be used – the ideal option, which is most suitable for all characteristics of the strength of the ligament. The constructions RIGID-FIX, ENDO-BUTTON, BIO-RCI and BIO-INTRAFIX serve as clamps.
The arthroscopic technique has the following patient benefits:
- less traumatic treatment;
- shorter rehabilitation period;
- return to previous sports loads within 7–8 months after surgery.
Recall that previously, a rupture of the anterior cruciate ligament of the knee joint for an athlete could turn into the end of his professional career. At present, this damage no longer poses a threat to his sporting future and can be easily repaired thanks to the mastered technique.
The first few days after the operation, the athlete is in a hospital, where his condition is monitored by the attending physician. In the future, the treatment is carried out on an outpatient basis, the need to visit the center arises only when the dressing is performed.
During the rehabilitation period, the patient is advised to spare the leg with the installed autograft and limit the load on it. For this, immobilization of the operated leg is provided. Strengthening the muscles and changing the volume of movement is carried out gradually under the supervision of a rehabilitation therapist.
Treatment for a ruptured posterior cruciate ligament
Injury to the knee ligaments symptoms and treatment In case of damage to the PCL, less blood accumulates in the joint cavity than in the case of a rupture of the anterior ligament and menisci.But this is still a reason to perform X-rays in several projections, so as not to miss the damage to the bone.
Further conservative therapy is carried out:
- ensuring the raised position of the leg;
- applying cold and bandaging;
- limiting the load and taking painkillers.
If, after the pain sensations subside and the return to the previous rhythm of life, the patient continues to complain of instability in the joint, this may indicate a ligament rupture.An MRI is required to clarify the diagnosis. With the help of radiography, it is possible to reveal the detachment of the posterior ligament from the place of its fixation with the bone fragment. If this occurs early after the injury, the patient is assigned to be refixed using cannulated screws.
In the event of a partial rupture of the anterior ligament of the knee joint, conservative rehabilitation therapy is performed, which allows creating the necessary conditions for strengthening the muscles and fusing the fibers of the ligament of the damaged joint.
With prolonged sensations of lack of joint fixation, when there is a complete rupture of the PCR, conservative treatment may be ineffective. This is an indication for surgical intervention, including strengthening with synthetic threads and arthroscopic plastics.
Treatment for rupture of the lateral ligament of the knee
The treatment tactics used in this case are conservative, even if we are talking about the third degree of destruction of the lateral ligament.Appointed:
- elevated limb position;
- exposure to cold;
- elastic bandage;
- exclusion of overloading the injured limb;
- use of a brace equipped with sturdy side panels.
Radiography is mandatory, and in a controversial case – under stress.An MRI is required to determine the definitive nature of the rupture and to identify other joint damage.
Tears and sprains of the external lateral ligament are less common than injuries of the internal ligament. The most likely cause of this injury is a sharp blow to the shin or knee. Usually, the opposite leg protects the knee joint from such a nuisance, but if, for example, there was an attempt to hit the ball from the summer, the knee becomes unprotected from direct impact directed from the inside to the outside.Also, indirect injury is not excluded when the leg is twisted during a sharp change in the direction of movement of the athlete.
It may take about 1 month until the damage is repaired, provided that the above conditions are met. In rare cases, non-union of the ligament and preservation of weak stability in the joint are possible. Then plastic surgery is performed using an autograft.
A complete rupture of the lateral ligament with trauma to other structures of the joint (menisci and ligaments) is always a surgical intervention.If the lesion is fresh, the ligament can still be sutured, but plastic surgery with an autograft is usually used to ensure complete stability of the joint.
As part of the rehabilitation period, anti-inflammatory, antibacterial and symptomatic therapy is carried out.
To reduce edema, cold applications are used, shown within two weeks after plastic surgery for 15–20 minutes.Patients are advised to spare their leg and use crutches for 7 days or more. Removal of stitches occurs on the 14th day.
The joint is fixed by means of an orthosis, which is worn for two weeks, after which an elastic bandage or compression hosiery is applied (up to 1 month).
In the following weeks, the patient needs to limit the load on the leg. It is allowed to give up crutches only three weeks after the operation. It is during this period that exercise therapy, active muscle development and restoration of range of motion can be used in case of rupture of the ligaments of the knee joint.
The patient can start sports training in 3 months, and to go in for sports without any restrictions – after 9-12 months.
The Rehabilitation Center for Sports Medicine “New Step” offers its services for the recovery of patients after sprains and ruptures of the knee ligaments.
We can undergo all types of diagnostics, including MRI, special X-ray and ultrasound studies. Patient examination is carried out in a short time, after which an individual program of treatment and rehabilitation is selected for the patient.The center offers massages, physiotherapy, training on special equipment and medical gymnastics.
Damage to the femoral condyles, fracture of the femoral condyles
Damage to the femoral condyles arises from the direct action of a traumatic agent. Most often, such an injury occurs as a result of a blow to the knee or a fall on it. Also, the fracture of the condyles occurs when falling from a height.
Condyle is a paired fragment of the femur, which is located in its lower part and forms the knee joint.Distinguish between medial (closer to the median axis of the body) and lateral (lateral) condyles. Their fractures are classified as low-energy or high-energy, depending on the nature of the injury. There may be an isolated fracture of one of the condyles or their combined damage. some fractures are accompanied by the formation of fragments.
Causes of trauma development
- injury during a sports activity;
- falls from a height;
90,087 accidents, road accidents.
In a car accident, kicking the front seat or dashboard is important. if the legs are bent at the knee joint, a fracture of the condyles is more likely to occur. With strong blows, the direction of force also plays a role – this injury is characterized by a direct action in the lateral projection of the knee.
Low energy trauma occurs with a minor impact or a normal fall. The main role here is played by a violation of the structure of bone tissue, which occurs in osteoporosis or as a result of age-related changes.
If an isolated fracture of the lateral condyle has occurred, most likely the cause is a violent deflection of the lower leg outward. If it moves in the median direction, the fracture will occur in the area of the medial structure.
How to recognize a fracture of the femoral condyle?
The main syndrome with this injury is pain. The localization of pain is the knee joint, which becomes smoother and loses its usual contours;
Internal hemorrhage leads to tissue protrusion, edema, pain on palpation;
Pressing the patella makes it possible to feel its unusual position and how it “bounces” under the pressure of the blood collected inside the joint;
If there is a displacement of the condyle, this is reflected in the deviation of the lower leg to the side;
The patient cannot make active movements, and passive ones cause severe pain.
Similar symptoms accompany fractures of the patella, lower leg condyles, as well as knee ligament sprain and meniscus injury. Therefore, for an accurate diagnosis, additional diagnostics are required. The difference between fractures of the femoral condyles from damage to similar structures of the lower leg is the fact that in the first case the pain is localized above the joint space of the knee, and in the second – below it.
Diagnosis of pathology
Diagnostics is carried out on the basis of clinical data and additional research methods.The diagnosis begins with a patient survey and examination. The doctor notes the visual signs of fractures that are characteristic of damage to the condyles. During the collection of anamnesis, due attention should be paid to the nature of the injury received, therefore, the patient should clearly describe it in conversation with the doctor.
The “gold standard” is the X-ray. The picture is taken in two projections – direct and lateral. There are also additional research methods, but they are used less often.
If the X-ray data is not very informative or there are doubts, a tomography is performed on a computer machine.
Magnetic resonance imaging does not provide the necessary data on the state of the bone – this method is used if there is a risk of damage to soft tissues and it is necessary to exclude their injury.
Modern methods of treatment of damage to the femoral condyles
Condyle injury is treated in a hospital setting.If a patient is diagnosed with a fracture without displacement of bone fragments, the treatment tactics are as follows:
- evacuation of blood from the joint cavity;
- adequate pain relief;
- limb immobilization;
- – repeated punctures of the joint if necessary.
One of the important principles of treatment is to limit the stress on the joint. The patient is recommended a sparing regimen, walking with crutches for 2-3 months from the start of treatment.
If there is a displacement of the fragment, manual reduction is performed under local anesthesia – that is, the restoration of the anatomical position of the fragment. To do this, the doctor deflects the lower leg in the direction opposite to the injury. Correct movement involves the ligaments of the joint and the condyle itself “falls” into place. After manipulation, immobilization of the limb is still necessary.
Surgical treatment is required for some types of injury and when conservative methods are ineffective.The operation is performed in the early period after injury and is accompanied by anesthesia.
Blood and small fragments are removed from the articular cavity. after this, the condyle is reduced and the displacement is eliminated. To strengthen the fragment, several metal screws are inserted into it. After suturing the wounds, a plaster cast is applied to the leg from the foot to the upper thigh.
Recovery period after operation
Rehabilitation measures include the use of skeletal traction or plaster casts after surgery.When restoring physical activity, the patient is recommended physical exercises, which are first passive and then active.
The early postoperative period is accompanied by rational antibiotic therapy, thromboprophylaxis, and adequate wound care.
Knee contusion – causes, symptoms, diagnosis and treatment
Knee contusion is a closed traumatic injury to the soft tissues of the knee joint.It is one of the most common injuries and belongs to the category of minor injuries. The cause is usually a fall or bump in everyday life or during sports. Less commonly, a knee injury is observed due to industrial accidents, traffic accidents and falls from a height. It manifests itself as pain, bruising, swelling of the joint, limitation of support and movement. Often accompanied by hemarthrosis. The diagnosis is clarified using radiography, MRI, and arthroscopy. Treatment is conservative.
Knee contusion is a closed soft tissue injury in the area of the knee joint, in which there are no obvious injuries to the intra-articular structures. It can be detected in patients of any age and gender, but children and young people leading an active lifestyle are more likely to suffer. Injuries received at home or while playing sports, as a rule, are isolated. With high-energy injuries, combinations with a fracture of the pelvis, fractures of the bones of the upper and lower extremities, TBI and other injuries are possible.Knee bruises are treated by orthopedic traumatologists.
Knee contusion develops when falls or hits with a blunt heavy object in the knee joint area: the number of children – during the summer holidays.
The severity of tissue hemorrhage, which plays a significant role in the clinic of knee bruises, depends on the fragility of the vessels and the state of the blood coagulation system. With hemophilia, vitamin deficiencies and some other conditions, damage occurs even as a result of a minor traumatic effect, and is characterized by a more severe course.
The severity of a knee injury is determined by the characteristics of the traumatic agent (weight, movement speed, surface nature, hardness, etc.) and the type of tissue. Muscles and fatty tissue are most susceptible to bruises, fascia and tendons are less affected. With minor damage, a reflex vasospasm occurs, followed by their expansion. Revealed congestive plethora, tissues are saturated with fluid that goes beyond the vascular bed. Traumatic edema develops.
With moderate knee bruises, small vessels rupture, hemorrhages appear, tissues in the affected area become saturated with blood, and hematomas form when blood accumulates in the intermuscular and interfascial spaces. When blood is poured into the joint cavity, hemarthrosis occurs. Severe bruises are accompanied by significant tissue destruction without compromising the integrity of the skin. Subsequently, foci of necrosis are formed in the affected area.
Traumatic edema with moderate and severe injuries is replaced by reactive edema, which explains the long-term preservation of swelling and changes in tissue density.In the process of aseptic inflammation, dead cells and accumulated fluid are absorbed. Depending on the severity of the lesion, the duration of the recovery period ranges from 1-2 weeks to a month or more.
Symptoms of a bruised knee
The patient is worried about pain in the knee joint and difficulty walking. The joint is swollen, its contours are smoothed. On the front or anterolateral surface of the knee, bruises are often detected, in the first days – red-purple, after 5-6 days – bluish-purple, after 10-12 days – greenish-brown.A slight or moderate restriction of movement is determined. The support is usually preserved.
Despite the fact that there is no serious damage to the intra-articular structures with a bruised knee, the tissues of the joint react to injury, this can be manifested by hemarthrosis or synovitis. The knee increases in volume, becomes spherical. On the anterolateral surfaces of the patella, bulging is visible above and below the bone. With a large and moderate amount of blood in the joint, fluctuation and ballot of the patella are clearly visible.
With a small amount of liquid, a special technique is used: check the symptom of the patella ballot, after squeezing the joint from the sides (this helps to increase the severity of the symptom). The amount of fluid in the knee can vary greatly. On average, during the first puncture, it is possible to extract 30-50 ml. blood. In some cases, hemarthrosis reaches 100-150 ml.
Unlike hemarthrosis, synovitis with fresh bruises of the knee joint occurs extremely rarely, this symptom is typical for stale injuries (more than a week ago).The amount of liquid can also vary. With relatively recent damage, the exudate is usually liquid, light straw in color. With old injuries and the absence of treatment, the liquid darkens, loses its transparency, becomes thicker and more viscous. Sometimes delicate thin flakes are visible in the punctate.
The main complications of knee contusion are hemarthrosis and synovitis. A small amount of fluid in the joint dissolves on its own, there are no relapses.In severe bruises, repeated punctures are required. Soft tissue injuries negatively affect the condition of the joint in the presence of chronic diseases, can provoke exacerbation of gonarthrosis and other pathologies.
Contractures against the background of a bruised knee are very rare, usually detected in severe injuries, which are accompanied by injuries to other structures of the knee, necrosis, detachment of soft tissues and recurrent synovitis, require prolonged immobilization. The risk of restriction of movement and atrophy of the periarticular muscles increases in elderly and passive patients, with refusal to engage in physiotherapy exercises, and non-compliance with medical recommendations.
The diagnosis is established by a traumatologist. The first priority for a knee injury is to exclude more severe injuries using objective and instrumental methods. The following procedures are carried out:
- External inspection . When conducting a clinical examination, the absence of deformity, crepitus, pathological mobility and sharp pain is established, which may indicate in favor of fractures and damage to the ligamentous apparatus.Determine the severity of the injury, taking into account the severity of the symptoms, reveal the accumulation of fluid in the joint cavity.
- Imaging Techniques . They are used according to indications. To assess the condition of the patella and the articular ends of the tibia, fibula and femur, an X-ray of the knee joint is prescribed. It is possible to exclude damage to soft tissue structures using ultrasound of the joint, MRI or arthroscopy.
Fresh knee bruises are often quite difficult to differentiate from meniscus injuries (especially with a fairly pronounced pain syndrome and moderate or significant hemarthrosis), since in the early stages of meniscus ruptures, general nonspecific symptoms prevail.If necessary, sonography is performed; if there is evidence for damage to the meniscus, arthroscopy is performed.
Instrumental studies allow assessing the state of all soft tissue structures of the joint, therefore, they can be used in the differential diagnosis of bruises with damage to the ligaments. The expediency of appointing certain additional studies is determined individually, taking into account specific symptoms.
Treatment of a bruised knee
At the first aid stage, it is necessary to ensure rest of the limb, give it an elevated position, apply cold to reduce swelling and severity of hemorrhages.The victim is taken to the emergency room. Treatment of a bruise is symptomatic, usually carried out on an outpatient basis and is generally carried out according to a single scheme.
In the absence of hemarthrosis or synovitis, it is sufficient to limit physical activity. Patients are prescribed a sick leave, they recommend walking less and giving the leg an elevated position at rest. While walking (if it has a positive effect), you can use an elastic bandage, but only for fixation, without applying it too tightly so as not to disrupt the blood supply in the area of damage.
The bandage must be removed at rest. In the early days, cold should be applied to the leg (a heating pad with cold water or an ice pack wrapped in a towel). Dry heat can be used from the third day. In no case should you warm your leg in hot water – this will increase the swelling and can provoke the development of hemarthrosis.
Urine therapy is categorically contraindicated. Firstly, this method is anti-scientific and does not bring practical benefits, but it can cause irritation and the appearance of pustular skin lesions.Secondly, the application of compresses to the knee joint in some cases causes the development of recurrent synovitis, and sometimes even severe “urinary” arthritis.
For severe injuries and bruises of the knee of moderate severity, accompanied by hemarthrosis or synovitis, a plaster splint is applied, it is recommended to limit the load, analgesics and UHF are prescribed. With hemarthrosis and synovitis, a puncture of the knee joint is shown, during which fluid is removed and the joint is washed with a solution of novocaine.If necessary, repeat the puncture in a few days.
After relief of acute events and removal of the splint, rehabilitation measures are carried out to restore the range of motion, strength and muscle tone. Physiotherapy exercises are prescribed, which helps to speed up the rehabilitation process, prevent muscle atrophy and the occurrence of contractures. In the treatment of a knee injury, the following physiotherapeutic techniques are used:
- CMB-therapy – an electromagnetic field stimulates local blood circulation, makes it possible to reduce the time of edema resorption, reduce inflammation;
- laser therapy – exposure to an infrared laser stimulates blood circulation, activates local metabolic processes, and reduces pain;
- Ultrasound therapy – effective in the treatment of post-traumatic synovitis, eliminates edema, accelerates metabolism, has a positive effect on the course of biochemical processes;
- inductothermy – improves metabolic rates, prevents the development of pathological changes in cartilage tissue, eliminates edema and pain.
Operations for knee bruises are rarely used, they are performed routinely in a trauma hospital.
- In case of intense hemarthrosis and intense bursting pain, arthroscopic revision and sanitizing lavage of the joint can be performed. In some cases, surgical hemostasis is performed during knee arthroscopy.
- In the process of treating professional athletes, the treatment of damaged hyaline cartilage is sometimes carried out: the exfoliated fragments are cut off, then the surface of the cartilage is polished.
After the manipulation, plaster is applied, UHF and other physiotherapeutic procedures are prescribed, and after the immobilization is stopped, the patient is sent to exercise therapy.
The prognosis for knee bruises is favorable. In the vast majority of cases, all symptoms disappear within a few days or weeks, there are no residual effects. With severe injuries, recurrent synovitis is possible, with concomitant pathology of the knee joint, slow recovery is sometimes observed, exacerbation of the underlying disease.
Prevention includes compliance with safety measures when performing household activities and during sports. Reducing child injuries is ensured through parental control, construction of non-traumatic playgrounds, specially equipped sports grounds. Preventive measures to combat work-related and road traffic injuries involve adherence to safety or traffic regulations.
Types of knee injuries.
Anterior cruciate ligament (ACL) injury
The anterior cruciate ligament is responsible for the dynamic stability of the knee joint, fixing the lower leg from non-physiological displacement forward and inward. ACL is called the first knee stabilizer; without it, the joint cannot function normally. Injury to the anterior cruciate ligament is the most common knee injury, which is recorded absolutely everywhere: at home, on the road, in sports, etc.d.
The mechanism of anterior cruciate ligament injury is most often a sudden inhibition or stopping when running and walking, hyperextension in the knee joint and a sharp turn of the body on the supporting leg.
Symptoms of damage to the anterior cruciate
Some patients report crunching or clicking in the knee at the time of injury. It is accompanied by instability of the knee joint when walking. Usually the knee joint swells shortly after the injury.This is due to bleeding into the knee joint cavity from the ruptured blood vessels of the damaged ligament.
Treatment: most often rupture of the anterior cruciate ligament requires surgical intervention by a surgeon. The operation to restore the cruciate ligament at this stage in the development of medicine is performed using arthroscopy, through the smallest possible incisions. The recovery period takes from 4-6 months after the admission of the attending physician. In our medical center, we carry out restorative rehabilitation with the following treatment methods:
3) Kinesio taping
5) Joint massage
6) Lymphatic drainage apparatus or manual massage, excluding the area of intervention
7) Exercise therapy complex for the rehabilitation of the joints of the lower extremities
Injury of the posterior cruciate ligament (PCL)
In contrast to the anterior cruciate ligament, injuries to the posterior (PCL) are much less common.The posterior cruciate ligament keeps the lower leg from displacement in the knee joint from behind. Her damage is the result of a serious injury.
The mechanism of injury. To tear the posterior cruciate ligament requires a very strong force. The most common rupture mechanism is a blow to the lower leg from the front, which occurs in road traffic accidents and in sports.
Symptoms of posterior cruciate ligament injury
As a rule, a rupture is accompanied by pain, limitation of movement, knee swelling due to hemarthrosis (accumulation of blood in the joint).With a posterior cruciate ligament injury, patients sometimes hear a crackling sound or immediately feel the knee joint instability. However, immediately after the injury, the pain is so pronounced that the person instinctively begins to spare the leg, not load it, and therefore instability is not felt.
Treatment.Partial ruptures of the posterior cruciate ligament are successfully treated conservatively. After an acute period, during which the knee is completely immobilized, blood is removed from the joint (hemarthrosis) and the pain is relieved, they proceed to a gradual recovery.Movement in the knee joint is not completely limited due to the orthosis, which allows flexion and extension of the leg at the knee and excludes movements that lead to posterior displacement of the lower leg. In the subacute period, for conservative treatment, we use:
3) Kinesio taping
5) Exercise therapy complex for the rehabilitation of the joints of the lower extremities
Damage to menisci
Injury to the meniscus is a very common injury, and there are many possible causes.We all know that menisci act as shock absorbers in the knee joint, preventing intense friction during intense physical exertion.
The mechanism of injury. The main cause of damage to the meniscus is trauma, which can occur as a result of a sharp extension of the joint, atypical rotational movements, as well as direct impact (impact, fall).
The acute period occurs immediately after damage to the knee joint.At this time, the patient is worried about intense pain syndrome, limiting the movement of the limb. In addition, blockade phenomena are possible – fixing a limb in a certain position. The damage is accompanied by bleeding into the articular cavity, as a result of which there is a characteristic edema in this area. Often on the basis of these symptoms, a diagnosis of “bruise” or “rupture of ligaments” is made.
Treatment: of meniscus rupture, modern minimally invasive technologies are used, which can reduce surgical trauma, reduce blood loss, minimize the likelihood of complications and accelerate the patient’s postoperative recovery.The recovery period lasts from 1.5-2 months. In the postoperative period we use:
3) Kinesio taping
5) Joint massage
6) Exercise therapy complex for the rehabilitation of the joints of the lower extremities.
Damage to collateral ligaments
Injury to the internal or external collateral ligament is a fairly common knee injury.Damage to these ligaments is usually associated with significant trauma, such as a fall while skiing or a direct hit to the knee.
Mechanism of collateral ligament injury, they can be damaged during sports activities such as skiing or football. With a direct impact on the outer surface of the knee, the joint space opens on the inner side of the knee, the internal collateral ligament is excessively stretched and torn.
Collateral ligament rupture is usually associated with significant trauma.Damage to the ligaments of the knee stave causes severe pain. Some patients hear a clicking or popping sound at the time of injury. Swelling develops in the tissues surrounding the knee joint. In the projection of the damaged ligament, on the outside or inside of the knee joint, subcutaneous hemorrhages (bruises) are formed.
Isolated injuries of the internal and external collateral ligaments sharply require surgical reconstruction. Partial injuries to the ligaments of the knee joint (grade 1.2) usually do not cause instability in the joint and are usually treated conservatively, treatment is aimed at reducing pain, swelling, limiting limb movements (using a splint).The splint is usually used up to 4 weeks, the load on the limb is usually allowed as the pain syndrome decreases, it is better to move with the help of crutches. For conservative treatment we use:
3) Kinesio taping
5) Lymphatic drainage massage (manual, hardware)
6) Joint massage
7) Exercise therapy complex for the rehabilitation of the joints of the lower extremities
Isolated ligament injury (grade 3) or multiple knee ligament injuries are injuries that can cause joint instability and require surgical treatment.Depending on the part of the ligament rupture, various surgical interventions are performed.
If you are prescribed surgical treatment, then do not waste time and do not wait for the day of the operation. Be sure to undergo preoperative preparation. With any surgical treatment, there is a so-called preoperative period. The main goal of the preoperative preparation of the patient is to minimize the risk of an upcoming operation and the possibility of developing postoperative complications and the duration of recovery and rehabilitation of the patient.In the preoperative period, we strengthen the muscles, since in this period we have a restriction of movement and we are unable to perform any exercises in this electromyostimulation will help us. Strengthening the muscles, we reduce the recovery time and prevent muscle atrophy during surgical treatment.