Knee Injuries and Treatments

Introduction

Knee injuries can be a little overwhelming to understand at first, so in this article, we will unravel the mysteries of knee injuries and explore the most effective treatments available. Whether you're an athlete nursing a sports-related injury or simply dealing with the wear and tear of everyday life, we will guide you towards the answers you need to get back on your feet on strong knees. 

Understanding your knee: a complex and vital joint

Before we delve into knee injuries and treatments, it is crucial to understand the incredible complexity and importance of this joint. Your knee is the largest joint in your body and plays a pivotal role in your daily activities, allowing you to walk, run, jump and perform countless other movements with ease. It's a hinge joint (which means it primarily moves in one plane) formed by the meeting of three bones: the femur (thigh bone), tibia (shin bone), and patella (kneecap).¹

Inside your knee joint, a symphony of ligaments, tendons and cartilage work together to provide stability and facilitate movement. Cartilage acts as a cushion between bones, reducing friction and preventing damage during movement. Ligaments are known as connective tissue and their primary function is the bond bones and organs in place. Lastly, tendons are the cord-like tissues that connect muscles to the bones to facilitate movement. As you can imagine, when any part of this intricate system is compromised, it can result in pain, limited mobility and discomfort.¹

Common knee injuries: causes and symptoms

Knee injuries can strike anyone, from athletes to weekend warriors to those simply going about their daily routines. These injuries often occur due to a variety of factors, including accidents, overuse and even the natural ageing process. 

Sprains and Strains: These injuries typically involve overstretching or tearing of ligaments (sprains) or muscles/tendons (strains) in the knee. Symptoms may include pain, swelling and difficulty moving the joint.^2,3

Meniscus Tears: The meniscus is a wedge-shaped cartilage in the knee that acts as a shock absorber which can tear due to twisting or overextension. This can lead to pain, swelling and a sensation of the knee "locking" or "giving way."^3,4

ACL Tears: The anterior cruciate ligament (ACL) is a vital ligament that stabilises the knee. Tears often occur during sports activities and can result in severe pain, swelling and instability.⁵

Patellar Tendonitis: Also known as "jumper's knee," this condition involves inflammation of the patellar tendon. It causes pain just below the kneecap and can worsen with activities that involve jumping or squatting.⁶

Osteoarthritis: A degenerative condition, osteoarthritis of the knee results from the gradual wearing down of cartilage. Symptoms include pain, stiffness and decreased range of motion.⁷

Bursitis: Bursae are fluid-filled sacs that reduce friction in the knee. When they become inflamed, typically due to repetitive kneeling or excessive pressure, it can lead to pain and swelling.⁸

Diagnosing knee injuries: the key to effective treatment

Medical evaluation

Accurate diagnosis of any medical condition is the foundation of effective treatment, ensuring that the chosen approach addresses the specific issue at hand. A medical professional, usually a GP initially, who may then refer you to a specialist doctor, will want to know more about you and the injury at hand. This will begin with a medical history where the healthcare provider will ask about your symptoms, the circumstances of your injury and your overall health history. Afterwards, a hands-on examination of your knee joint is critical. Your healthcare provider will assess your knee's range of motion, stability and any signs of swelling, tenderness, or deformity.^3,7,8

Imaging tests

To gain a deeper understanding of the injury, your healthcare provider may recommend one or more imaging tests:

X-rays: These can reveal bone fractures, joint degeneration and some soft tissue problems. While X-rays are useful for ruling out certain issues, they may not provide a full picture of soft tissue injuries.^3,5,7

MRI (Magnetic Resonance Imaging): An MRI is a powerful tool for visualising soft tissues like ligaments, tendons, and cartilage. It is valuable for diagnosing conditions like meniscus tears, ligament injuries, and more.^3-5,8

CT Scan (Computed Tomography): CT scans provide detailed cross-sectional images of the knee, offering valuable insights into complex fractures, joint abnormalities or structural issues.^3,5

MRI and CT scans may look similar from the outside, but there are a few key differences. They are tailored towards understanding different parts of the anatomy. CT scans use X-rays to focus on the bones while MRI uses radio waves and focuses on the soft tissues. Due to their size and the nature of the machines, it is common for people to get claustrophobic during these tests, however in the case of knee injuries, the machine will focus on the knee area only (depending on the injury) resulting in a a more pleasant experience. It is also worth noting that an MRI scan of the knee might take around 30-60 minutes while a CT is quicker and may take less than 20 minutes. However, it is worth noting these times may vary from person to person depending on their injuries. 

Diagnostic procedures

In some cases, diagnostic procedures may be necessary to confirm or further assess the injury:

Arthroscopy: This minimally invasive procedure involves inserting a tiny camera into the knee joint through small incisions. It allows for a direct view of the joint and is often used to diagnose and treat various knee conditions simultaneously^.9

Joint Aspiration: In this procedure, a small amount of fluid is extracted from the knee joint to evaluate for infection or inflammation. Once again this might be a diagnostic procedure and a treatment at the same time.⁸

Ligament Stress Testing: For suspected ligament injuries, your healthcare provider may perform specific stress tests to assess the stability of the knee joint.¹⁰

Laboratory tests

Blood tests might be prescribed to exclude underlying medical conditions or to detect indications of infection or inflammation in the knee.^3,7,8

After confirming the diagnosis, your healthcare provider will team up with you to craft a customized treatment strategy adapted to the type and severity of your knee injury.This plan may involve some of the treatments we discussed earlier in this article, such as rest, physical therapy, medications, or surgery.

Remember that a correct diagnosis is the first step towards a successful recovery. Through active participation in the diagnostic process and close collaboration with your healthcare provider, you can ensure receiving the most appropriate treatment to effectively manage your knee injury.

Treatment options: your path to recovery

Now that we've identified some common knee injuries and their symptoms, it's time to explore the exciting world of treatment options. The good news is that modern medicine offers a plethora of solutions to address knee injuries and help you regain your quality of life. Here are some tried-and-true methods for knee injury treatment:

Rest and Ice: You may have heard this one before; for mild knee injuries, like strains or minor sprains, rest and ice can work wonders. Allow your knee sufficient time to heal by refraining from strenuous activities and applying ice to alleviate inflammation. Immediate application of ice after the injury can reduce pain and inflammation by constricting blood vessels in the affected area._^2,3,7-9

Physical Therapy: As it is the case for most orthopaedic injuries, the affected area usually suffers from loss of strength and reduced mobility. A physical therapist can create a customised rehabilitation plan to strengthen the muscles around your knee and improve mobility. This is often crucial for recovery after surgery or severe injuries.^2,3,6-9

Medications: Over-the-counter pain relievers like paracetamol or ibuprofen are usually advised to help manage pain and reduce inflammation. However, In some cases your doctor may prescribe stronger medications for pain management.^3,7,8

Bracing: Knee braces provide stability and support. Depending on the type of injury your healthcare professional might suggest bracing which can be particularly helpful during the healing process or for chronic conditions like osteoarthritis.^3,7

Cortisone Injections: Hydrocortisone injections are used to treat swollen or painful joints. For conditions like bursitis or inflammation, cortisone injections can provide quick relief by reducing swelling and pain. This injection will be done into the affected joint directly by a trained healthcare professional.7

Surgery: In cases of severe injuries or advanced osteoarthritis, surgery may be necessary. Procedures such as ACL reconstruction, meniscus repair or knee replacement can restore function and alleviate pain.^3-5,9

Lifestyle Changes: Knees are under constant pressure from our bodies during our daily lives. Reducing the likelihood of knee injuries can be achieved by keeping a healthy weight and steering clear of high-impact activities. Physical conditioning and proper warm-up techniques are essential for athletes and active individuals.^2,3,7,9

Alternative Therapies: While additional studies are necessary to substantiate this assertion, certain individuals might experience relief through alternative therapies like acupuncture, chiropractic care, or herbal supplements. While not a guaranteed solution, they can be worth exploring with your healthcare provider's guidance.

It's important to note that the right treatment for your knee injury depends on its type and severity. Your healthcare provider will assess your condition and recommend the most appropriate course of action to ensure a successful recovery.

Recovery and beyond

Recovering from a knee injury can pose a challenging journey, yet with the appropriate mindset and treatment regimen, you can regain mobility and pursue a fulfilling life. Here are some essential tips for a successful recovery:

• Follow Your Treatment Plan: Whether it's physical therapy exercises, medication or surgery, adhere to your healthcare provider's recommendations diligently. Consistency is key to a swift recovery.2,3,6,7

• Listen to Your Body: Some people have a higher pain threshold than others which means sometimes further injuries happen. A way to get ahead of this is to pay attention to your knee's signals. If an activity causes pain or discomfort, it's crucial to modify or avoid it until you're fully healed.

• Stay Active: While rest is essential, maintaining overall fitness is also vital. You can work alongside your healthcare provider to develop a safe and effective exercise plan that promotes your recovery.^2,3,7

• Use Assistive Devices: If your healthcare provider recommends assistive devices like crutches or a brace, use them as directed to protect your knee during the healing process.³

• Patience is a Virtue: Understand that recovery takes time. Be patient with yourself and recognise that progress may be slow, especially after surgery.

• Seek Emotional Support: Dealing with a knee injury can be emotionally challenging as well as being physically limiting. In times of need, reach out to the people close to you, or seek professional support from a therapist.

• Prevent Future Injuries: Once you have recovered, take steps to prevent future knee injuries by maintaining a healthy lifestyle, proper conditioning, and using protective gear when necessary.

Summary

Knee is a complex joint that is essential for most of our daily activities. Even though the symptoms of knee injury might be similar for everyone, the reason behind it can be very different from issues with the bones to ligaments to tendons. Accurate diagnosis is essential for effective treatment, necessitating physical examinations and imaging tests to determine the correct diagnosis. For medical problems, it is almost impossible to find a “one size fits all” treatment and knee injuries are no different. Although there might be similarities in symptoms it is important to remember to follow your healthcare professional's guide throughout which might range from simple ice and rest to medications to surgery.