Medial Collateral Ligament Injuries
One of the most commonly injured ligaments, the MCL provides stability to the inner part of the knee and feels tight when your leg is straight. It connects your thigh bone to the bone of the lower leg and stops the knee bending inwards. Its often injured when the knee is knocked sideways and, in some cases, can be damaged alongside other ligaments in the knee.
Professional Help For Knee Injuries
- Aspiration if the knee joint is grossly swollen, the doctor may release the pressure by drawing off some of the fluid with a fine needle.
- Physiotherapy including techniques to reduce pain, kneecap taping, exercises for increased mobility and strength, and associated rehabilitation techniques.
- Arthroscopic surgery or keyhole surgery, where the knee operation is performed by inserting slender instruments through small incisions . Cartilage tears are often treated with arthroscopic surgery.
- Open surgery required when the injuries are more severe and the entire joint needs to be laid open for repair.
When Should I See My Healthcare Provider
Talk to your provider if youre experiencing symptoms like pain or swelling that get worse after a few days or if you cant move your knee like you usually can.
When should I go to the ER?
Go to the emergency room if you notice any of the following:
- Extreme pain.
- Swelling thats getting worse.
- You cant move your knee at all.
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What Are The Types Of Arthritis Of The Knee
There are around 100 types of arthritis. The most common types that might affect your knees include:
- Osteoarthritis is the most common of the types on this list. Osteoarthritis wears away your cartilage the cushioning between the three bones of your knee joint. Without that protection, your bones rub against each other. This can cause pain, stiffness and limited movement. It can also lead to the development of bone spurs. Osteoarthritis gets worse as time passes.
- Post-traumatic arthritis is a type of osteoarthritis. The cartilage starts thinning after trauma to your knee . Your bones rub together, and that causes the same symptoms as osteoarthritis: pain, stiffness and limited movement. Your knee arthritis symptoms might not start until years after the trauma.
- Rheumatoid arthritis is an autoimmune disease. A healthy immune system causes inflammation when it’s trying to protect you from an infection, injury, toxin or another foreign invader. The inflammatory response is one way your body protects itself. If you have rheumatoid arthritis, you have an unhealthy immune system that triggers inflammation in your joints even though theres no foreign invader. The inflammation causes pain, stiffness and swelling of the synovial membrane, which can also wear away your cartilage.
Your Knee Keeps Buckling
When you got hurt, did it feel like your knee gave way underneath you? Were not talking about a temporary sensation of weakness or some wobbliness, but more like your shin and thigh bone werent 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 theyre not in top form, youre bound to feel weak in the knees , 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 youre a weekend warrior or youre over the age of 30 , you might experience this symptom on a regular basis.
However, if the weakness is recurring and happens every time you exercise, its possible you have a time bomb thats waiting to happen. When in doubt, seek advice from a physician.
If your knee buckles under you when you are walking, then it usually indicates instability, she says.
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How Is Knee Pain Treated After A Fall
Treatment for a knee injury caused by a fall usually involves rest and if necessary, a brace to stabilize the joint. In most cases, anti-inflammatory pain relievers, such as ibuprofen , may be helpful.
Minor knee injuries can often be treated at home. However, its important to see a doctor if symptoms worsen or if the pain is accompanied by:
- significant joint swelling
- an inability to bear weight
- a feeling of giving way
- other signs of ligament or tendon damage
When the injury is serious, surgery may be necessary to restore function and eliminate pain.
Posterior Cruciate Ligament Injuries
The posterior cruciate ligament is often injured from a blow to the front of the knee while the knee is bent. This often occurs in motor vehicle crashes and sports-related contact. Posterior cruciate ligament tears tend to be partial tears with the potential to heal on their own.
Learn more about PCL injuries:
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Prevention Tips For Knee Injuries
- Warm up joints and muscles by gently going through the motions of your sport or activity and stretching muscles.
- Wear appropriate footwear.
- Avoid sudden jarring motions.
- Try to turn on the balls of your feet when youre changing direction, rather than twisting through your knees.
- Cool down after exercise by performing light, easy and sustained stretches
- Build up an exercise program slowly over time.
Meniscus Tear Of The Knee
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Overview of a meniscus tear
They can be damaged or torn during activities that put pressure on or rotate the knee joint. Taking a hard tackle on the football field or a sudden pivot on the basketball court can result in a meniscus tear.
You dont have to be an athlete to get a meniscus tear, though. Simply getting up too quickly from a squatting position can also cause a meniscal tear. According to Boston Childrens Hospital, more than 500,000 meniscal tears take place in the United States each year.
Depending on the severity of your injury, treatment options can vary from at-home remedies to outpatient surgery. You can help prevent this injury by doing exercises thatll strengthen your leg muscles and using proper techniques during contact activities or sports.
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Treatments For A Meniscus Tear Or Strain
Treatments for a meniscus tear or strain depend on the severity of the tear or strain, the location of the tear and your age and activity level. In many cases, patients can recover with resting, icing, compressing and elevating the injured area.
You may also need physical therapy and rehabilitation to help you regain as much strength and flexibility in the knee as possible.
Work with your physical therapist to determine the best program that will allow you to reach your rehab goals at your pace.
If your symptoms do not resolve with nonsurgical treatment options, surgery may be necessary. Your orthopedic surgeon will determine what type of surgery is needed based on the size of the tear, the location of the tear, your age and activity level as well your surgeons experience.
- Arthroscopic surgery a small hole is created to allow for a camera to provide a clear view of the inside of the knee, the surgeon will insert surgical instruments into the hole and will repair the tear.
- Partial meniscectomy removal of unstable meniscal fragments and smoothing of the remaining meniscus edges to ensure there are no frayed ends.
- Total meniscetomy the entire meniscus is removed surgically
How Do People Over 50 Typically Get Knee Meniscus Tears
There are two types of causes for meniscus tears, especially in individuals 50 and up.
The first is an acute injury, meaning something suddenly caused the meniscus to tear, strain, or stress. This can include stepping out of the car wrong, landing in a strange position, or taking a fall.
The other cause of meniscus tears occurs through chronic injuries, such as arthritis. Arthritis causes wear and tear on the joints, causing the connective tissue to slowly wear out.
When this happens, many individuals start to complain that they are unable to move their knees through a full range of motion and often experience pain when bending over or squatting down.
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Treating A Strained Knee
How Are Tears In The Medial Collateral Ligament Diagnosed
Your doctor will ask you to describe how the knee was injured, whether you have had other knee injuries and how your knee has felt since the injury. You may be asked about your physical and athletic goals. This helps your doctor decide what treatment might be best for you.
During the physical exam, the inside of the injured knee will be checked for pain or tenderness. Pressure will be put on the outside of the knee while the leg is both bent and straight. Depending on the degree of pain or looseness of your knee joint, the injury will be classified as:
- Grade 1 Some tenderness and minor pain.
- Grade 2 Noticeable looseness in the knee when moved by hand major pain and tenderness at the inside of the knee swelling, in some cases.
- Grade 3 Considerable pain and tenderness at the inside of the knee some swelling and marked joint instability. The knee opens up about 1 centimeter when the doctor moves your leg around. A grade 3 MCL tear often occurs along with a tear of the anterior cruciate ligament.
If the immediate pain and swelling makes it too difficult to judge how severe the injury is, you may need to wear a light splint, apply ice and raise the knee. Once the swelling and pain have lessened, your doctor will make the diagnosis.
Your doctor may order a magnetic resonance imaging scan. An MRI has an accuracy rate of nearly 90 percent in determining whether and how badly a medial collateral ligament tear is.
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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.
Can I Prevent A Meniscus Tear
Because they generally happen without any warning, meniscus tears can be hard to prevent. You can reduce your risk, though, by taking these precautions:
- Get regular exercise, including strength training for your leg muscles. Strong leg muscles help stabilize and protect the knee.
- Always warm up and stretch properly before playing sports or engaging in any strenuous activity involving your legs.
- Give your muscles plenty of time to rest and recover between activities.
- Get the right footwear for your sport, and keep shoes, boots, or skates laced up tight while you play.
- Learn and use the proper techniques for your sport.
- If you’ve previously had another knee injury, a brace or wrap can give your knee added support.
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Will I Need Surgery
Only your doctor can tell you for sure. Though there can be exceptions, most collateral ligament tears dont need surgery.
However, when a cruciate ligament is completely torn or stretched beyond its limits, the only option is reconstructive knee surgery. In this procedure, a surgeon will take tendons from other parts of your leg — or from a cadaver — to replace the torn ligament.
A ligament reconstruction for an ACL or PCL injury is complicated and involved. It’s not the right choice for everyone. A person who has knee pain or severe instability may choose to have it. So might an athlete who wants to regain their level of performance.
But if the pain is not a problem, you may choose to skip the surgery and accept the risk of some lifelong instability in your leg. You may also opt for a custom-made brace. Talk about the treatment options with your doctor.
What Are Complications Of Knee Injuries
Knee injuries are rarely life-threatening, though severe injuries may be disabling. Some knee injuries lead to chronic, irreversible damage to the knee and may result in complications such as long-term dysfunction. Knee-joint dislocations can cause blood vessel injuries and can lead to severe disability.
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What Is A Dislocated Knee
A dislocation occurs when the bones of the knee are out of place, either completely or partially. For example, the femur and tibia can be forced out of alignment, and the patella can also slip out of place. Dislocations can be caused by an abnormality in the structure of a person’s knee. In people who have normal knee structure, dislocations are most often caused by high energy trauma, such as falls, motor vehicle crashes, and sports-related contact.
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Medical History And Physical Examination
Your doctor may ask specific questions about your activities, symptoms, and prior injuries, and want to know whether your symptoms appeared immediately after an injury or in the days afterward. This helps your doctor determine if pain is a sign of osteoarthritis or other problem of the knee.
Your doctor may ask you to stand and walk to assess whether an injury affects your gait or causes a limp. You may need to bend and straighten your leg while you sit on the exam table for an evaluation of the range of motion in the knee.
During a physical exam, your doctor can often determine which type of knee injury you have. Imaging tests may be needed to confirm the diagnosis and to distinguish between other knee injuries.
How Are Tears In The Medial Collateral Ligament Treated
The medial collateral ligament has a good blood supply and usually responds well to nonsurgical treatment. Depending on how bad the injury is, it may be enough to rest the knee, wear a brace, take over-the-counter pain relievers such as ibuprofen and have physical therapy.
To keep the knee from moving, your doctor may recommend a lightweight cast or brace that allows your knee to move backward and forward but limits side-to-side motion. This usually is recommended for 72 hours. Depending on how well your pain and swelling improve, you may be able to start a rehabilitative program in a few days.
Once pain and swelling have gone down, you should be able to start exercises to restore strength and normal range of motion to your knee. If you are still sore while doing exercises, you should proceed slowly to prevent further irritation. It may take a week to eight weeks to completely recover, depending on the seriousness of your injury.
A torn medial collateral ligament is rarely treated with surgery. When surgery is done, it is usually done through a small incision on the inside of your knee. It is not done arthroscopically, since this ligament is not inside the knee joint.
If the medial collateral ligament has been torn where it attaches to the thighbone or shinbone, the surgeon will reattach the ligament to the bone using large stitches, a metal screw or a bone staple. If the tear was in the middle of the ligament, the surgeon will sew the torn ends together.
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