The knee joint is a complex structure with various bones, muscles, ligaments, tendons and cartilage working in sync for seamless movement of the knees and legs.
The concerned bones are thigh-bone (femur), shin bone (tibia) and knee-cap (patella). The concerned ligaments are anterior cruciate and posterior cruciate (ACL, PCL), medial collateral and lateral collateral (MCL, LCL).
The knee too is vulnerable to various conditions. These should not be ignored and must be attended to by experienced orthopedic doctors.
What are the most common knee injuries?
Cuts and Bruises
- An abrasion happens when the knee rubs against a hard surface. Some portion of the skin may peel off and this can be treated with dressing and topical ointments.
- A laceration happens when there is a puncture or a hole caused in the skin and soft tissue, most likely by a sharp object such as a nail or metal sheet. This is treated by dressing, tetanus shots and stitches.
- A contusion happens when the knee hits a hard surface with force, like in a fall. A blood-vessel may tear, causing bleeding and a clot to form. This is typically treated by dressing, rest, ice, compression and elevation (RICE), and oral medicines.
There are 4 ligaments that connect the bones in the knee joint to one another. When one or more ligaments get stretched badly, which typically happens in contact-sports like football, one may experience a sprain. Falling hard on the knee or any accident that delivers a hard knock on the knee can also cause a sprain. While minor sprains can heal with adequate rest, serious ones that cause a lot of pain must be attended by a doctor.
When one or more bones that make up the knee-joint are moved out of their original position, this is called a dislocation. Its characterised by sharp pain and loss of movement in the knee. This typically happens during motor-vehicle accidents, falls and contact-sports. People with congenital structural deformities can also suffer from such sprains.
If the person sustains a severe fall on the knee, more often than not, it causes a fracture in the knee-cap. This can also happen due to motor-vehicle accidents. People with osteoporosis can sustain a fracture when they trip or keep a wrong step due to uneven surfaces.
The ACL is one of the four ligaments that connect the bones in the knee joint and provides stability to the knee. Contact-sports such as football, gymnastics, and motor-vehicle accidents can cause a tear in the ACL. The degree of tear is graded as 1, 2 or 3, with 1 being mild and 3 being severe. While grade 1 tears heal slowly on their own, grades 2 and 3 tears will require some form of intervention. ACL tear is a common problem with sportspersons as well as those in professions that require weight-bearing or heavy manual work. One of the risk factors for ACL tear is stopping suddenly or changing direction sharplywhile running.
The menisci (singular – meniscus) are 2, C-shaped pieces of cartilage present in the knee joint. They act as shock absorbers and cushion the movement between the femur and tibia. Contact-sports such as football can cause one or both menisci to tear, causing a popping sound. The person may suffer pain, tightness or swelling in the knee for a few days after the tear. Age-related degeneration can also cause meniscal tears in elders.
In addition to the bones, ligaments, tendons and cartilage, the knee joint also contains fluid-filled sacs called bursae which cushion the movement of the ligaments and tendons in the knee. Sometimes, over-exercising (common with sportspersons) or repeated kneeling down due to various activities can cause inflammation in the bursae, with the condition being called Bursitis. Generally, not a serious problem, bursitis can be healed through rest. In some cases, antibiotics or draining out the excess fluid (aspiration) may be required.
The patellar tendon which connects the patella (knee-cap) with the shin-bone (tibia) can develop inflammation and this condition is called patellar tendonitis. This typically happens to sportspersons who jump a lot, but can happen to anybody who is physically very active.
The different tendons in the knee-joint can tear, and this is quite common in sportspersons who stretch a lot or elders who sustained a fall or tripping. Direct impact on the knee due to an accident of any kind can also cause tendon tears.
Collateral ligament injuries
The MCL and LCL are 2 ligaments that prevent the femur from sliding side-wise. Sportspersons or anybody who collides with another person or object with an impact can suffer injuries to these ligaments.
Iliotibial Band Syndrome
There is a long thin ligament that runs the entire length of the leg right from the pelvis to the tibia. In some people, such as long-distance runners or those who over-exercise, this band becomes tight and rubs against the femur. This can cause pain between the hips and knees.
Posterior Cruciate Ligament Injuries
When the knee joint is bent and it suffers an impact due to a fall, collision or accident, the PCL can get injured.
When to see a doctor ?
If you have suffered a recent injury to the knee and are experiencing one or more of the below, you should consult an orthopaedic doctor immediately.
- Severe pain in the knee
- Limping due to the above pain
- Inability to move the knee freely
- Inability of the knee to bear weight
- The knee buckles backwards when rising or standing
- The knee appears deformed or swollen
- Hearing a pop sound when you fall
What is the best treatment for knee injury?
- Immobilization of the knee using casts, braces, and the use of a crutch
- Physical therapy which includes special exercises to relieve pain and strengthen the legs
- Medication such as aspirin and ibuprofen to reduce pain and swelling
- Minimally invasive surgery to treat tears and degeneration of the knee-cap