TREATING COMMON KNEE INJURIES MAY HELP AVOID ARTHRITIS

Rajeev_Verma-_Orthopaedics

Knee injuries are commonly treated at home by the patients, but some are serious enough to need further evaluation and treatment. The patients should be aware of such injuries and should consult their doctor.

The knee joint is a complicated joint. It moves like a hinge and hence allows a person to bend and straighten their legs so that they can do activities required for routine day to day work like sitting, running, jumping and squatting.

The upper part of the joint is made by femur, also known as the thighbone. The lower part of the knee joint is made by shinbone, or tibia. The patella or kneecap covers the front of the joint between the femur and tibia.

The cartilage is the tissue that cushions the bones of the knee joint, helping the bones to glide over one another during motion and protecting the bones from impact.

There are four ligaments in the knee that hold the bones together and provide stability to the knee joint.

Injury to any of these components increases the rate of wear and tear of our joint and increases the incidence of arthritis.

The most common injuries of the knee are:

1. Fractures

Any of the bones; femur, tibia or patella can be fractured. The most commonly broken bone in the knee joint is the patella or kneecap. Trauma, such as a fall or car accident, causes most knee fractures. Fracture if involving the joint surface causes restriction of movement and development of arthritis.

2. Anterior cruciate ligament injuries

The anterior cruciate ligament (ACL) runs diagonally within our knee joint and provides stability to the joint. ACL injury most commonly occurs during contact sport such as football. But there are other ways in which a person can injure his ACL.Improperly landing from a jump or quickly changing the direction of motion can lead to a tear in the ACL.Injuries to the ACL cause excessive gliding between the bones of our knee joint and leads to early development of arthritis.

3. Dislocation

In a knee dislocation, one or more of the bones are not in their normal position. Trauma,falls, and contact sports, can cause a knee dislocation. Abnormal forces are generated in our knee joint during dislocation and can lead to abrasive damage to the cartilage which leads to development of arthritis. Dislocations also lead to ligament injuries which lead to further problems if left untreated.

4. Meniscal tears

The menisci are two rubbery wedges of cartilage between the thighbone and shinbone. These pieces of cartilage can tear suddenly during sporting activities or during rotatory motion between the thighbone and shin bone.With a sudden meniscus tear, a pop may be heard or felt in the knee. After the initial injury, pain, swelling, and tightness may increase over the next few days.Sometimes the torn meniscus gets caught in between the bones and lead to difficulty in straightening the knee. Meniscus injury increases the forces acting on the bones during walking and leads to early degenerative changes in our joint,

5. Collateral ligament injuries

Collateral ligaments connect the thighbone to the shinbone. Collateral ligament tears often occur due to a direct impact or collision with another person or object. They prevent the joint from opening up on the inside or the outside. Their damage too leads to instability and development of arthritis.

6. Posterior cruciate ligament injuries

The posterior cruciate ligament is located at the back of the knee. This ligament prevents the shin bone from gliding backwards over our thigh bone.The posterior cruciate ligament injury occurs when the knee is in a bent position and a sudden force is applied. This level of force typically happens when someone falls hard onto a bent knee or is in an accident that impacts the knee while it is bent. It acts in a manner opposite to ACL.

All these factors suggest that the risk of knee arthritis from knee joint injury is high. The high incidence of arthritis after injury highlights the need to direct increased efforts toward primary prevention of knee injury and improved management of knee injury.

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