With the increase in traffic accidents and the development of national fitness sports, knee injuries are becoming more common, how to correctly understand knee injuries, timely consultation, prevention and control of joint sports injuries has become an urgent concern of the general public.
A. Common injuries to the knee joint are as follows
1. Anterior cruciate ligament and posterior cruciate ligament injuries.
ACL rupture: This is the most common serious injury to the knee, mostly seen in basketball players. Jumping up to grab the ball or grabbing the rebound when falling twist the knee, sometimes you will hear a sound, after which you can no longer stand up, the knee swells up quickly, afraid to step on the ground to walk, it takes 1-2 weeks for the swelling to gradually dissipate. After the swelling disappears in two or three weeks, you can almost walk normally, but you don’t dare to run, jump, or play ball again, and the knee will become loose in the front and back (playing soft recession phenomenon). It is also common to see anterior fork ligament injuries in the knee caused by riding electric bikes in our city, mostly due to sprained knee joints from falling with weight on one leg or sprained knee joints caused by heavy pressure from electric bikes.
Posterior cruciate ligament injury: Mostly seen in car accidents, caused by posterior displacement of the tibia due to the impact on the knee. As the posterior cruciate ligament is thicker, the force of the injury is generally greater, and knee pain, swelling, and deformity during knee flexion are more obvious when the knee is completely ruptured.
2, medial and lateral collateral ligament injury: If the knee is in an external position when injured, the medial collateral ligament is often injured, and there is pain, pressure and bruising on the inside of the knee.
If the knee joint is turned inward when injured, the lateral ligament is often injured and there is pain, pressure and bruising on the outside of the knee joint.
3. Meniscus rupture: This often occurs when the knee lands slightly to the inside or outside of the knee when jumping and landing, causing a rupture to the medial or lateral meniscus. Meniscus injury also often occurs when standing up after a long squat. The pain after a meniscus injury is mild and you can still walk. Sometimes there is slight joint swelling that disappears quickly, but there is prolonged pain and discomfort in the knee. If the ruptured fragment is large, it may drift and get stuck in the middle of the joint, causing the knee to become stuck and immobilized, resulting in limited knee motion. A ruptured meniscus is unlikely to cause movement problems, but when running and jumping, you may feel pain on the inside or outside of the joint.
4.Rupture of articular cartilage: If the joint surface of the femur and bone of the knee is hit too hard, it may cause cartilage rupture and serious joint hematoma, and if the fragment falls in the joint cavity, it will cause pain to the bone and prevent normal movement.
5, patella (kneecap) dislocation: occurs during sports or trauma, sudden severe pain in the knee joint, patella displaced to the outside, most of the patella can return to its original position after straightening the knee joint, post-injury knee swelling, pain is heavy, the pressure pain on the medial side of the patella is obvious. After dislocation, the medial patellofemoral ligament is ruptured and there may be patellar avulsion fracture.
6, knee dislocation: one of the most serious injuries to the knee joint, caused by large violence such as a car accident or a fall injury. Urgent knee repositioning is required. The injury causes serious deformity of the knee joint, serious tearing of the ligaments around the knee joint, mostly more than three groups of ligaments around the knee joint rupture, may be accompanied by nerve and blood vessel damage around the knee joint.
Second, the knee injury should be treated differently according to the situation
After a knee injury, rest and ice packs should be applied to reduce pain and swelling, and hematoma can be extracted from the knee cavity to reduce swelling and joint movement. X-rays usually show normal bones, but for soft tissue injuries, an MRI is required for a definitive diagnosis and appropriate treatment. Injuries to the tissues outside the knee cavity will generally recover without serious sequelae, except for injuries to the medial collateral ligaments, which require a knee brace for 4-6 weeks to heal without ligamentous laxity. As for injuries to the tissues in the joint cavity, they can be treated with arthroscopic surgery if necessary, for example, ACL rupture can be treated with arthroscopic ACL reconstruction, meniscal rupture can be treated with arthroscopic meniscal repair or partial resection, and articular cartilage rupture can be treated with arthroscopic removal of fragments and cartilage repair.
1, the anterior fork ligament injury treatment: the anterior fork ligament is located in the joint, the repair and healing ability is very poor after rupture, after a clear diagnosis of anterior fork ligament rupture need to perform arthroscopic anterior fork ligament reconstruction surgery treatment. After surgery, correct rehabilitation exercises are needed to achieve good therapeutic effect.
2, posterior cruciate ligament injury: the posterior cruciate ligament is partially located outside the joint, there is a certain self-repair ability, mild posterior cruciate ligament injury (1 degree to 2 degrees of injury) can be conservative treatment, perform lower limb plaster fixation or brace extension position fixed for 4 weeks. Severe posterior cruciate ligament injury (3rd and 4th degree) causes knee instability and affects joint weight bearing, if not treated in time, it will cause premature knee degeneration and requires arthroscopic posterior cruciate ligament reconstruction.
3, medial and lateral collateral ligament injury: mild medial and lateral collateral ligament injury (degree 1, degree 2) can be treated conservatively, the knee brace extension position fixed for 4 weeks, or plaster fixed for 4 weeks, after 4 weeks of functional exercise, the vast majority of patients can recover. Severe medial and lateral collateral ligament injury (degree 3) requires medial and lateral collateral ligament reconstruction.
4, meniscus injury: meniscus rupture can be made arthroscopic meniscectomy or molding, only about 10% of patients can be meniscus suture repair. The meniscus is a tissue with less blood flow, only the outer 1/3 part has blood flow, so only in the part where blood flow exists can the tear be healed after suturing, or the part near the part with blood flow can be torn and healed after suturing, the rest of the parts are not suitable for meniscus suturing because there is no blood flow and the healing ability is very poor, only suitable for meniscoplasty, that is, partial resection.
5, osteochondral injury: articular cartilage rupture available arthroscopic removal of fragments, and do cartilage repair. If the cartilage injury is large, especially with subchondral bone, osteochondral block fixation is feasible.
5, patellar dislocation: the first patellar dislocation can be conservative treatment, knee brace fixation or plaster fixation for 4 weeks. Some patients can heal. For young patients, due to more movement, after the first patellar dislocation conservative treatment, most patients will have another dislocation, called recurrent patellar dislocation, which requires arthroscopic surgery. Surgical options: 1. Arthroscopic laxity of the lateral support band and tightening of the medial support band (or medial patellofemoral ligament reconstruction), if the patient has a large Q angle, tibial tuberosity transposition may be required.
6, knee dislocation: need to pay attention to the vascular and nerve injury around the knee, if accompanied by vascular injury, need to deal with the vascular situation first, if the treatment is not timely, can cause ischemic necrosis of the lower leg. If there is no peripheral vascular and nerve injury, the knee joint should be repositioned and given temporary fixation and swelling reduction, and arthroscopic reconstruction of the ruptured ligament of the knee joint should be performed after 10-14 days.