The knee is the largest joint in the body and injuries are common, particularly as we age or if we play certain types of sport. Traumatic accidents are another common cause of knee injuries. Treatment options depend on the type and severity of the injury, along with other factors such as your age, lifestyle and general level of health.
Which parts of the knee can get injured?
Your knee joint consists of:
- Three bones – the thighbone, shinbone and kneecap
- Articular cartilage, which covers the ends of the bones, helping them to move smoothly over each other as you bend and straighten your leg.
- Ligaments, which join the bones together and keep your knee stable. You have four main ligaments in the knee – the collateral ligaments, which control side-to-side movements and the cruciate ligaments, which control forwards and backwards motion.
- Tendons, which join the muscles to the bones. Your knee has the quadriceps tendon, which connects the muscles in the front of the thigh to the kneecap and the patellar tendon, which runs from the kneecap to the shinbone.
- The meniscus – these ae two wedge-shaped pieces of cartilage that help to cushion and stabilise the knee joint, acting as a shock absorber.
Common knee injuries include fractures, dislocations and tears to the soft tissue. Sometimes more than one part of the joint gets damaged. Symptoms typically include pain, swelling and problems moving the joint. Sometimes the knee might catch, lock or feel like it is about to give way.
Among the most frequently occurring knee injuries are:
Fractures:
- A kneecap (patella) fracture can happen if you fall directly onto your knee, hit your kneecap hard during a vehicle collision or take a heavy blow to the kneecap playing sport. If you fracture your kneecap, you may not be able to straighten your knee or walk.
- Treatment for a kneecap fracture depends on the severity of the injury. For a simple fracture, wearing a cast or splint may be sufficient to support the bone while it heals. Often, however, pieces of bone may be jolted out of place when the kneecap fractures. In such cases, surgery is usually needed to repair and stabilise the kneecap.
- Distal femur fractures are fractures of the thighbone just above the knee joint. These most often occur during a high-speed road traffic accident or in older people with weakened bones. A closed fracture is one where the skin is not broken, whereas in an open fracture fragments of bone may stick out through the skin. The latter take longer to heal and have a higher risk of complications, such as infections.
- Treatment for distal femur fractures include wearing a cast or brace to hold the bones in place while they heal. Sometimes skeletal traction is needed to hold the broken pieces of bone together so they can heal in an appropriate way. If surgery is needed it is not always performed straight away unless it is an open fracture which requires urgent treatment. By delaying surgery for a few days, the orthopaedic surgeon may use an external fixator device to hold the bones in place temporarily until you are well enough to tolerate a longer operation.
Shinbone fractures normally occur just below the knee in a part of the shinbone called the proximal tibia. This type of fracture is often accompanied by soft tissue damage. It is normally caused by trauma, such as a fall, sports injury or vehicle collision. It can occur in older people who have weakened bone due to a relatively minor trip or fall.
- Treatment for shinbone fractures may be non-surgical or surgical, depending on the type of injury and overall health and lifestyle of the patient.
Dislocations:
These happen when the bones are forced out of place due to a heavy impact, fall or high-speed collision.
- Patellar instability can develop if your kneecap repeatedly slips out of the groove (trochlea) it normally sits in.
- Treatment for patellar instability is normally non-surgical the first time the kneecap dislocates. You may be given exercises to help strengthen the thigh muscles, or might need to wear a stabilising brace. If the kneecap repeatedly dislocates you may need surgery to reshape the trochlear groove, reinforce the soft tissues or correct bone alignment.
Mensical tears
- A torn meniscus is a common sporting injury that normally occurs as a result of making a sudden twisting or pivoting movement. Such injuries also occur in older people due to degeneration of the meniscus over time and may result from making even simple movements, such as getting up awkwardly from a chair. Tearing the meniscus sometimes causes a popping sensation. Most people can still walk on the affected knee but after a few days the knee may become stiff and swollen.
- Treatment for a torn meniscus depends on the patient’s age and activity levels, as well as the size and type of the injury. Most meniscal tears are treated initially using the RICE method (rest, ice, compression, elevation). Sometimes steroid injections are offered to relieve pain and swelling. If symptoms persist, you may need surgery which is normally performed arthroscopically (keyhole knee surgery) to trim or repair the tear.
Frequently asked questions
Should I use the RICE method for a knee injury?
Unless the injury is severe, using the RICE method (rest, ice, compression, elevation) at home may help to relieve pain and swelling immediately after the injury. Always seek medical help if symptoms persist however of if the injury is severe.
What is knee arthroscopy?
Knee arthroscopy is a form of keyhole surgery on the knee using an instrument called an arthroscope.
Do I need to see a doctor if I dislocate my knee?
Yes. Never try and force the knee back into position yourself as you could cause serious damage.
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