Surgery For Knee Injuries
Your doctor or physiotherapist may refer you to an orthopaedic surgeon for some knee injuries. You may need surgery to repair the damage to your knee especially if other treatments havent worked.
Your surgeon is more likely to suggest you have an operation if you have one of the following injuries.
- Youve torn your anterior cruciate ligament , especially if you do a lot of sport or have also torn a meniscus. In ACL reconstruction, your surgeon will take a piece of tendon to replace the damaged ligament.
- Your knee is still painful or locks after an injury to your meniscus. Your surgeon may repair or partially remove your damaged meniscus.
- Youve injured your medial collateral ligament and it hasnt healed after three months of other treatments. Your surgeon may repair or reconstruct your MCL.
You may be able to have a type of keyhole surgery called knee arthroscopy to get to the damaged area of your knee.
Knee Injury Risk Factors
- Sports – Many sports require movements that place added stress on your knees Skiing, for example, can lead to stress on the knees due to the restricted movement of your feet. Another example is basketball where players have to pivot and jump. These sudden and repetitive movements can put stress on the knees.
- Previously injured knee – If youve already hurt your knee once, then it may not be as strong as it was before. Unfortunately, this could make it easier for you to injure your knee again.
- Excessive weight – If you put on a lot of weight, your bones have more work to do to support that mass. For those who are very overweight, even ordinary daily activities can cause wear and tear on the knees.
- Weak muscles – A lack of strength and flexibility in your muscles can also contribute to knee injuries. Strong muscles protect bones and joints. Aside from this, they also make you very stable and balanced, thereby decreasing the risk of falls.
- Gender – Women are more likely to develop knee injuries simply because of how their bodies are built, for example, the way their hip bone is attached to the thigh bone and the fact that they carry greater mass on the lower body.
Causes Of Knee Pain And How To Fix Them
Sports doctor Jordan Metzl explains the most common knee injuries and how to manage them.
So youve got knee pain from running. Whether youre a complete beginner, or youre two weeks into your latest cycle, knee pain is frustrating. We spoke to sports doctor Jordan Metzl, who explains four of the most common causes of knee pain from running, and what you can do about them:
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Torn Acl Symptoms And Signs
With an acute injury, the patient often describes that they heard a loud pop and then developed intense pain in the knee. The pain makes walking or weight-bearing very difficult. The knee joint will begin to swell within a few hours because of bleeding within the joint, making it difficult to straighten the knee.
If left untreated, the knee will feel unstable and the patient may complain of recurrent pain and swelling and giving way, especially when walking on uneven ground or climbing up or down steps.
The knee is one of the most commonly injured parts of the body. Sports, falls, and motor-vehicle accidents account for the vast majority of knee pain and injuries to the knee.
The different types of common knee injuries to the knee are defined by the affected anatomy of the knee and the mechanism by which it’s injured.
Knee sprains are injuries to the ligaments that hold the knee together. There are multiple ligaments that stabilize the knee and keep it in alignment. The anterior cruciate ligament and the posterior cruciate ligament stabilize the knee in movement from front to back and cross each other in the middle of the knee joint. The medial collateral ligament and lateral collateral ligament stabilize the knee so that the bones do not slide from side to side.
Ligament sprains are graded by the amount of stretching or tearing of the ligament fibers and how much instability it causes as follows:
Knee Pain Can Be Caused By A Handful Of Different Conditions
Common conditions include runners knee , IT band syndrome, ligament tears , and meniscus tears . Some of the aches and pains associated with these conditions might go away with the right glutes-, quad-, or hip-strengthening regimen, serious foam rolling, footwear changes, and certain stretches. But some require more attention, including rest and/or physical therapy.
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What Can Be Torn In Your Knee
1. Cruciate Ligament Tears
These are two short, strong ligaments located at the center of the knee joint.
They cross each other to form an x shape, connecting to the femur and tibia.
The ACL, anterior cruciate ligament, and PCL, posterior cruciate ligament, stabilize the knee.
The ACL is the most likely to tear, while the PCL is much stronger and harder to damage.
2. Collateral Ligament Tears
The collateral ligaments are long, ropy cords of soft tissue on each side of the knee.
The medial collateral ligament is on the inner side of the knee, while the lateral collateral ligament is on the outer side.
These ligaments form an internal brace that keeps the tibia in position and prevents it from moving sideways.
Tears to these ligaments usually occur in contact sports, such as soccer and football.
A sideways fall while skiing can also injure these ligaments.
This injury occurs much less often than any other type of ligament tear in the knee.
3. Meniscal Tears
The smooth layer of cartilage within the knee joint are the menisci. These are the lateral and medial meniscus.
Each horseshoe-shaped piece of cartilage rests between the femur and tibia.
The cartilage may become damaged as a result of sports, but it can also deteriorate over time.
When it wears thin this can cause a tear.
Damage to the meniscus cartilage increases the risk of other cartilage damage in the knee joint, such as the articular cartilage.
Broken Knee Ct Scan With 3d Reconstruction
3D-CT Scan is a highly sophisticated investigation, which artificially reconstructs the geometry of the bony structures of the knee joint. It is a 3 dimensional x-ray image, which gives the precise location and orientation of the bone fragments in a broken knee. Thus, it is very important in intra-articular and comminuted fractures of knee joint, and greatly helps in pre-operative planning of a broken knee surgery.
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Knee Pain And Weight Loss
If joint pain is caused by excess wear and tear, then it makes sense that carrying around an extra 10, 20, or 30 pounds of body fat would be bad for your knees.
Sure enough, that seems to be the case.
Specifically, overweight men and women are four to five times more likely to develop osteoarthritis, which is the gradual degeneration of cartilage in joints. Osteoarthritis is different from rheumatoid arthritis, but both involve increased levels of inflammation and cartilage degeneration.
Due to the mechanics of the knee joint, every pound of weight loss translates into about four pounds of reduced load on the knee, which is why reaching a healthier weight reduces your chances of developing knee joint degeneration by 20 to 30 percent.
In other words, losing 20 pounds is the equivalent of losing 80 pounds as far as your knees are concerned.
But theres more to the story.
Shouldnt being overweight just hurt load-bearing joints like the hips, knees, and ankles? Why would it damage other joints, too?
Well, the answer seems to be that obesity damages joints partly by raising levels of inflammation in the body. Knee joint degeneration is alsolinked with higher levels of inflammation, which further explains why losing weight protects your knees.
Hamstring Curls On A Weight Bench
Muscles involved: Hamstrings and gluteal muscles.
This exercise is a variation of the standing hamstring curl. A person can try this version if they have access to a weight bench that is purpose-built for this exercise. It may be more challenging than the standing hamstring curl, depending on how much weight a person uses.
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Rare And Unusual Knee Instability Causes
Causes of knee instability that occur even less frequently include the following.
- Partial dislocation: If you do something strenuous enough to damage the ligaments, it is likely that you will have damage to the cartilage around the knee bone as well. The patella, or kneecap, can become partially or completely dislocated. A partial dislocation is called a subluxation. Dislocation can occur if the ligaments are damaged and are not holding the kneecap firmly in place as usual.
- Cartilage tears: The cartilage at the ends of the upper and lower leg bones, which meet under the kneecap, can become torn. This often happens along with a ligament sprain.
- Cartilage wear: Cartilage can gradually wear away over time, causing pain and difficulty moving since there is no longer enough cushioning material between the bones.
- Birth deformity: You may have been born with knee structure that makes the joint vulnerable to slipping out of place.
This list does not constitute medical advice and may not accurately represent what you have.
What Is The Prognosis Of A Knee Injury
The prognosis of a knee injury depends on the type and severity of the injury.
Most minor knee injuries heal on their own with conservative treatment. The prognosis for these types of injures is good.
Ligament or cartilage injuries that lead to dysfunction or instability of the knee may require surgery. These injuries generally respond well to surgery and patients can ultimately gain full or nearly full range of knee motion.
Key Points To Heal A Knee Naturally
- You must be consistent. This isn’t the kind of thing you can do when you remember and hope for the best. If you can’t be consistent you need to accept that natural remedies may not work for you.
- Consider your diet. Diet is ABSOLUTELY CRITICAL to healing. I recommend a clean diet that eliminates inflammation as much as possible. No processed food. Stay away from triggers.
- You Can’t Skip the Exercises. Everything else can help to reduce inflammation to the point that you can rehab your knee, but you are still going to have to do the work.
- Don’t Skip Supplements.; The oils didn’t HEAL my knee. The supplements didn’t HEAL my knee. They, along with a good diet helped reduce the inflammation to the point I could rehab it.
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 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. Its 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.
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Diagnosis Of Knee Injuries
Your doctor will ask about your symptoms and examine you. They may feel for fluid in your knee joint by pressing gently around your kneecap. Theyll also ask you to describe how you hurt yourself, where your pain is and what type of pain it is.
Your doctor may ask you to walk, sit or lie down so they can test for any injury to your knee ligaments or soft tissues. Theyll bend and straighten your knee and move your leg into different positions.
If your doctor believes you need surgery, theyll refer you to an orthopaedic surgeon .
You may need to have some other tests too.
- An X-ray or CT scan this can check for a broken bone or arthritis.
- An MRI scan this may help to show up damage to the cartilage or soft tissues of your knee after an injury.
- Knee aspiration your doctor may remove a sample of fluid from your knee.
- Knee arthroscopy your surgeon may look inside your knee using a telescope attached to a tiny camera. This can help to show if theres damage to a meniscus, cartilage or ligament. Your doctor may treat your damaged knee at the same time.
First Aid For Knee Injuries In The First 48 To 72 Hours
- Stop your activity immediately. Dont work through the pain.
- Rest the joint at first.
- Reduce pain, swelling and internal bleeding with icepacks, applied for 15 minutes every couple of hours.
- Bandage the knee firmly and extend the wrapping down the lower leg.
- Elevate the injured leg.
- Dont apply heat to the joint.
- Avoid alcohol, as this encourages bleeding and swelling.
- Dont massage the joint, as this encourages bleeding and swelling.
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Rest Ice Heat Compression And Elevation
Doctors recommend a combination of rest, ice, compression, and elevationcalled the RICE regimenfor one or two weeks after diagnosis. The time frame for RICE treatment varies depending on the severity of the knee injury and is determined by your doctor.
Resting the affected ligaments, tendons, muscles, and cartilage gives the knee time to heal. Your doctor may provide a cane or crutches to help you keep weight off the affected knee for about a week. After the swelling starts to subside, most people can walk while wearing a knee brace.
During the first 3 days after the injury, your doctor may recommend applying ice to your knee 3 times a day for 15 minutes at a time to reduce swelling. After this, applying a heating pad or another heat source, such as a heat wrap, can increase blood flow to the injured area and speed healing. Elevating the knee 3 times a day for 15 minutes at a time may also help reduce swelling.
Until the inflammation fully subsides, doctors recommend avoiding the activity that caused the injury, as well as other activities that put stress on the knee. Returning to work or sports too soon greatly increases the risk that a knee injury may heal slowly or worsen or that another injury may occur.
Your doctor determines when your knee has healed based on relief of your symptoms.
Broken Knee Injury Recovery Time
The length of hospital stay for broken knee can vary from a few days to a month, depending on the severity of the knee injury. Common knee injuries of the knee cap or other bones around knee, generally heal within 6 weeks and the person is discharged from the hospital almost on the same or second day. Complicated knee fractures with several open wounds require intensive management for replacement and maintenance of adequate blood volume. Broken knee surgery has to be done in an emergency along with repair of other injured structures, like torn knee ligaments and tendons and broken knee cartilage. Knee injury recovery can take even up to 6 months, in a broken knee cast, followed by broken knee exercise to have a complete functional knee injury recovery.
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What Type Of Orthotics Are Best For Runners Knee
This is where the question can get tricky There is no one size fits all approach with orthotics. The best advice I can give you is to see a specialist musculoskeletal podiatrist, who takes a keen interest in running.
However, if you do choose a pair of off-the-shelf orthotics , it is important that you find the orthotic comfortable.
If you have a flexible foot, you are likely to benefit from an orthotic with a significant medial arch support, similar to a stability shoe.
If you have stiff ankles, you are likely to benefit from an orthotic with a heel raise, which will increase the heel-to-toe drop of your running shoes. You can learn more about heel-to-toe drop in this article about running shoe seleciton.
I do hope this article helps you decide whether or not you wish to try orthotics as a treatment option for your patellofemoral pain. If so, Id suggest speaking to your physio about it. Good luck!
Dr. Brad Neal
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