Knee injuries - the cruciate ligaments of the knee, menisci or patella - are quite common, especially in physically active people. The knee joint, although it is inherently stable, is injured when its structures have to bear loads that exceed their physiological endurance.

A knee injurymost often occurs during sports, usually when the exercises are performed incorrectly. Themeniscuslocated between the articular surfaces of the tibia and femur are particularly susceptible to damage. absorb shock. The second structure that is often injured is theknee stabilizing ligaments . In third place arepatellar injuries- the triangular bone that forms the joint.

Bruise or large knee injury?

If you are able to walk after an injury, you think it's just a knee bruise or microtrauma that will heal quickly by itself. This is often the case, and you can deal with unpleasant symptoms such as knee pain or swelling on your own. You need to cool the aching knee, e.g. with a frozen food taken from the freezer or with a spray preparation, then it is worth applying ointments or gels with anti-inflammatory and analgesic properties and avoid burdening the joint. If after 2 or 3 days the symptoms do not improve or even worsen, it is better to see an orthopedist.

When you must not delay visiting a doctor? Quickly look for help from him, if:

  • you cannot straighten your leg completely
  • effusion in the pond
  • you have a feeling of unstable knee
  • you are in severe pain
  • something snapped in the joint during the injury

Various effects of a knee injury

  • Meniscus Injury- In the case of a medial meniscus injury, pain appears on the inside of the knee when squatting and walking. With much rarer damage to the lateral meniscus, the pain is located on the outside of the knee. If these injuries are not treated, the destruction of the menisci worsens and secondary damage to the articular cartilage occurs, i.e. acceleration of degenerative changes. A symptom of meniscus damage may also be the lack of free knee extension as a result of the joint being blocked by its torn off fragment. Such a situation requires an urgent visit to an orthopedist.
  • Tear of the medial collateral ligament- pain occurs on the inside of the knee, especially when it is valgus, that is bending inwards. This ligament heals quite well on its own, but if left untreated, the process takes longer and a painful scar can develop.
  • Anterior cruciate ligament injury- most often it occurs as a result of a massive torsion knee injury. Some patients feel that something inside has broken. The joint hurts after the injury, usually there is some exudate in it. A knee "runaway" may occur. The consequence of not treating this injury is instability of the knee joint. The posterior cruciate ligament is less likely to be damaged.
  • Dislocation of the kneecap- usually the patella slipping in the lateral direction is clearly felt. The consequence may be instability of the patella, its subsequent dislocations, secondary damage to the meniscus and cartilage. The kneecap is usually self-adjusting, but during dislocation and later re-adjustment, a piece of cartilage is sometimes torn off the articular surface. Its torn off fragments can then "swim" in the pond and mechanically block it.
Important

Let's not underestimate the pain in children and adolescents

Since they are very active physically and often carelessly, we tend to ignore the complaints of children and adolescents about knee pain, thinking that it is just a bruise. And yet in them, and in young adults, the cause of pain may be sterile cartilage and bone necrosis (secretion of a piece of cartilage in the joint), sterile bone necrosis (e.g. Osgood-Schlatter disease, i.e. "tearing out" of the ossification nucleus of the tibial tuberosity by the muscle quadriceps, common in active adolescents), anatomical defects (e.g. thyroid meniscus). You shouldn't forget about bone cancer as well.

A good diagnosis is essential

Sami, of course, we will not make a diagnosis based on the symptoms mentioned above. But they should prompt us to visit an orthopedist. It is better not to delay treatment, often surgical, because failure to do so may lead to greater damage to the structures of the knee joint. Before it is taken, a diagnosis is needed. The orthopedist puts it on the basis of clinical symptoms and imaging tests.

The basic one is X-ray of the knee joint. It is supplemented by ultrasound, which, among others, allows for the so-called dynamic tests, i.e. the assessment of the efficiency of e.g. ligaments. However, sometimes it is necessary to extend diagnostic tests to include magnetic resonance imaging and computed tomography. The first examination perfectly shows the cartilage, bone structure and ligaments. The second clearly shows the fractures, toocompression (indentations of the articular surfaces), which are not always visible on the X-ray image.

Problem

Good diagnostics is extremely important. Meanwhile, many medical facilities are focused on the "execution of the procedure", and not on the quality of the examination. Therefore, the physician may not always be able to properly assess the disease on the basis of the results of these tests. After all, further therapeutic treatment depends on it. Therefore, it is best to perform them in a place that specializes in musculoskeletal research, although it may be associated with higher costs.

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