Understanding Knee Examination and Common Injuries: A Guide for Patients

Welcome to our blog! Today, we're focusing on an important topic: knee injuries. Knee injuries can be quite common, especially in active individuals and athletes. Understanding how these injuries occur and what to expect during a knee examination can empower you to take proactive steps in your knee health. Here we will cover common knee injuries, particularly ligament injuries, their symptoms, diagnosis, and treatment options

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Common Knee Injuries: Reasons for Knee Examination

1. Anterior Cruciate Ligament (ACL) Injury

The ACL is one of the key ligaments that helps stabilise the knee. Injuries to the ACL are often characterised by:

Mechanism of Injury: ACL injuries frequently occur during activities that involve sudden stops, jumping, or changing directions, such as basketball, soccer, or skiing.

Symptoms: Patients may hear a "pop" sound at the time of injury, followed by severe pain, swelling, and instability in the knee

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Knee Examination Findings: If the knee swells rapidly after the injury, it is more likely that the ACL has been torn. An MRI is often needed for a definitive diagnosis, especially if the knee is too painful to examine thoroughly.

2. Medial Collateral Ligament (MCL) Sprain

The MCL is located on the inner side of the knee. It can be sprained or torn due to:

Mechanism of Injury: Direct impact to the outside of the knee, causing it to bend inward.

Symptoms: Pain and tenderness on the inner part of the knee with varying degrees of swelling depending on the severity of the sprain.

Treatment: MCL injuries are rarely surgical and are usually managed conservatively with rest, ice, and rehabilitation exercises.

3. Posterior Cruciate Ligament (PCL) Injury

The PCL is another crucial ligament that stabilises the knee.

Symptoms: A PCL injury may cause a 'posterior sag' sign—where the shin bone drops backward compared to the thigh bone when the knee is flexed.

Treatment: Most PCL injuries can be treated conservatively with rehabilitation; surgery is only required in about 10% of cases.

4. Meniscus Tears

The meniscus is cartilage that acts as a cushion between the shinbone and thighbone.

Symptoms: A locking sensation in the knee when trying to straighten it or a "pseudo-locked" knee feeling suggests a possible meniscus tear.

Diagnosis: A thorough assessment and possibly an MRI can confirm a meniscus injury.

Diagnostic Techniques

When evaluating knee injuries, specific tests and imaging techniques are essential for accurate diagnosis:

Physical Knee Examination: Assessing the range of motion, stability, and pain points of the knee.

McMurray’s Test: Helps identify meniscus tears by rotating and bending the knee.

Dial Test: Used to assess posterolateral corner injuries by comparing the external rotation of the tibia against both legs.

Imaging

X-rays: Can reveal any fractures related to ligament stress.

MRI: Provides detailed images of soft tissues and is vital for diagnosing ligament injuries.

Treatment Options

Conservative Management

Many knee injuries can be initially managed with conservative measures:

Rest, Ice, Compression, Elevation (RICE): This approach reduces swelling and alleviates pain.

Rehabilitation: Tailored exercise programs are essential for strengthening the knee post-injury and improving range of motion.

Surgical Intervention

Surgery for ACL Injuries: Surgical decisions should be made cautiously. A study (Frovel et al., 2013) suggests that surgery may be necessary only if conservative treatment fails. Careful patient selection can improve outcomes, but early intervention may help prevent long-term joint issues like meniscal damage.

Rehabilitation Post-Surgery

A comprehensive rehabilitation program is critical following knee surgery. There are two main theories of rehabilitation:

Time-Based Theory: Typically spans 9 to 18 months, focusing on recovery over a set period.

Goals-Based Theory: Also spanning 9 to 18 months, this approach is tailored to individual performance objectives.

Emerging therapies like Photobiomodulation may accelerate healing, strengthen muscles, and enhance collagen deposition during rehabilitation.

Conclusion

Knee injuries can vary widely in severity and type but understanding them equips you to respond appropriately. If you suspect an injury, especially following a high-impact activity, it’s crucial to seek professional medical advice. Remember, timely intervention and proper rehabilitation play vital roles in recovery and long-term knee health. Should you have further questions or concerns, don't hesitate to reach out to a healthcare professional or visit your local orthopaedic surgeon for expert guidance.

Stay active and take care of your knees!

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For further information or personal consultation regarding knee injuries, contact us at Foothouse Podiatry.

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I hope this helps! If you need any further assistance, with foot and lower limb issues, feel free to ask. 😊