Anatomy of the Knee
The knee is a hinge joint made up of two bones, the thighbone (femur) and the shinbone (tibia), which articulate with each other. A groove on the front side of the knee called thepatellofemoralgroove sits a small bone called the patella or kneecap. This acts as a shield and protects the joint from direct trauma. Other structures including tendons, ligaments, muscles and cartilage work together to maintain the normal function and provide stability to the knee during movement. However, knee injuries are common with sports and recreational activities.
Common Injuries of the Knee
- Fractures: This involves a break inthe femur, tibia or patella.
- Dislocations: The bone ends move out of alignment partially or completely.
- Sprains and strains of soft tissues: Soft tissue sprains and strains may include:
- Anterior cruciate ligament (ACL) injuries: Tears in this major stabilizing ligament occur during high-demand sports such as basketball and football due to overuse, a sudden change in direction or incorrect landing from a jump.
- Posterior cruciate ligament (PCL) injuries: A tear in the ligamentusually occurs during contact sports due to a blow on the front of the knee when it is bent.
- Collateral ligament injuries: The medial and lateral collateral ligaments can tear during contact sports.
- Meniscal injuries: Meniscal tears can occur during cutting, twisting, pivoting and tackling sports activities.
- Tendon injuries: The quadriceps and patellar tendons can stretch or tear from running or jumping sports.
Symptoms of Knee Injury
Knee injuries can cause pain, swelling, bruising and difficulty walking.
Diagnosis of Knee Injury
If the pain and swelling is rapid, then immediate diagnosis and appropriate medical treatment is advised. Initial diagnosis includes physical and joint examination followed by an X-ray.
Treatment of Knee Injuries
Immediately following a knee injury and before being evaluated by a medical doctor, you should initiate the R.I.C.E. method of treatment:
- Rest: Rest the knee, as more damage could result from putting pressure on the injury.
- Ice: Ice packs applied to the injury will help diminish swelling and pain. Ice should be applied over a towel to the affected area for 15-20 minutes four times a day for several days. Never place ice directly over the skin.
- Compression: Wrapping the knee with an elastic bandage or compression stocking can help to minimize the swelling and support your knee.
- Elevation: Elevating the knee above heart level will also help reduce swelling and pain.
Acute or mild knee injury does not require knee surgery. It can be treated with anti-inflammatory drugs such as Ibuprofen and it is necessary to drain out accumulated extra joint fluid with the use of a syringe or needle. If pain persists for a long time, or appears at night or while at rest, it is important to visit a doctor to seek advice. Conservative treatment may be recommended that includes taping, massage, mobilization techniques and stretching and strengthening exercises as well as exercises to improve your balance and agility. In some cases, if pain is intolerable, doctors may recommend cortisone injection. It is a good practice to avoid the use of cortisone, as it weakens and softens your cartilage, thereby leading to arthritis of the knee. More severe cases are treated by surgery followed by a period of rehabilitation to strengthen the knee.