Illustration from https://www.knee-pain-explained.com/knee-joint-anatomy.html
Knee injuries are commonly seen in sports activities, but also occur in everyday activities. What course of action should you take if you have a knee injury?
Some injuries are caused by a direct blow to the knee, while others are the result of a twisting force often without contact. Fractures of the bones around the knee often require a direct contact mechanism, but many significant ligament and meniscal (cartilage) tears occur due to the twisting force of the injury. Some injuries are a combination of both mechanisms.
Symptoms to pay attention to are swelling, giving way (instability), and catching or locking with movement of the knee. Swelling can be immediately after the injury or may not show up for 24 hours. Giving way with weight bearing suggests a possible ligament injury. Catching or locking symptoms with knee motion is more indicative of meniscal or cartilage tears.
What Should I Do After a Knee Injury?
When a knee injury occurs, initial treatment should be rest, ice, compression, and elevation. Crutches are often helpful if you are unable to bear weight. If significant pain occurs with motion, then a straight leg brace, such as a knee immobilizer, is beneficial. If a bone fracture is suspected due to deformity at the knee, then a trip to the Emergency Room for x-rays is indicated. But most knee injuries do not require immediate evaluation and can wait a few days to be evaluated by a physician. Often times, the exam is more helpful after the initial pain of the injury has settled.
Orthopedic surgeons are specially trained to evaluate and treat injuries of the bone and joint system. They are the specialists regarding knee injuries. Evaluation by the Orthopedist will include the history of the injury, to include the mechanism of injury, as well as discussion of the symptoms of swelling, giving way, and locking or catching.
The examination at this time is very important. Based on location of pain, laxity of various ligaments, and results of certain manipulative tests, an experienced Orthopedist can narrow down the possible structures that have been injured. X-rays are usually taken to rule out subtle fractures or underlying structural problems of the bones. An MRI of the knee may be ordered but sometimes is not needed to establish the diagnosis.
What Will Treatment of My Knee Injury Be?
Many knee injuries will heal without surgery. Mild sprains of the collateral ligaments just need protection for a few weeks in a brace and do well. The torn ACL may need surgery, but there is no benefit to early surgery, and waiting a month may help with motion post-operatively. Meniscal tears usually require surgery within the first few weeks. Severe tears of the lateral collateral ligament and posterolateral structures need to be addressed within the first two weeks of injury. Multiligament injuries may require a staged surgical approach. Luckily, these injuries are not frequent.
In summary, knee injuries are common in sports and everyday activities. The majority of these injuries heal without surgery within 6-8 weeks. If symptoms are not improving significantly within a week, then evaluation by an Orthopedic Specialist is reasonable. History of the injury and examination of the knee, with x-ray studies if needed, will help guide the treatment plan. Discussion of the various treatment options can lead to the appropriate plan for each individual patient.
