Are you aware of the impact of Knee injury?

Health
Tuesday, 03 November 2015 571 Views 0 Comments
Are you aware of the impact of Knee injury?

Recently, Bournemouth winger, Max Gradel, suffered a knee injury which involved a tear of the anterior cruciate ligament (ACL). Now he might not be able to play till 2016. This is the extent to which serious knee injuries can affect the careers of runners, players and athletes.

In study documenting 17, 397 patients with 19,530 sport injuries over a 10-year period of time; 6434 patients (37%) had 7769 injuries (39.8%) related to the knee joint. Out of the total, 68.1% were men and 31.6% were women. Nearly 50% of the injured patients were less than 30 years of age. Most commonly suffered knee injury was ACL lesion (20.3%), followed by, medial meniscus lesion (10.8%), lateral meniscus lesion (3.7%), medial collateral ligament lesion (7.9%), lateral collateral ligament lesion (1.1%), and posterior cruciate ligament lesion (0.65%).[i]

Ligaments, menisci, tendon and cartilage stabilise the knee joint. Sometimes, during a sports accident, these may get injured which puts additional pressure on other knee structures. A research study highlighted that 32.6% of all sports injuries involve the knee[ii] and 20-25% of all knee injuries occur while performing sports[iii].

Patello-femoral pain syndrome, tear of the ligament, tendon and cartilage are the common knee injuries. Full recovery is possible only when immediate medical attention is given. Physiotherapy and surgery are the two routinely followed options for the treatment of knee injury.

According to a study published in Sports Medicine Journal, female athletes are at greater risk of suffering from sports-related injuries, especially knee injuries[iv]. This is largely attributed to gender differences such as pelvis width, foot alignment, lower extremity alignment, lower levels of conditioning, physiological laxity and tibial rotation. Female athletes have higher incidence of ACL injury and patella-femoral pain syndrome.

Tear of Ligament

Ligaments are the thick band of connective tissues holding the knee joint. Sudden movements, excessive force and twists as a result of alternating jumping or running with abrupt halts leads to tearing of the ligament. This may cause pain, inflammation and laxity of the joint. Knee joint gives in when the person tries to walk or stand up.

The most commonly injured ligament of the knee is the anterior cruciate ligament (ACL) which is located at the middle of the joint. The estimated US incidence is 100,000-200,000 ACL tears per year. Football players along with skiers and gymnasts are the most affected population.  Sports where the player has to do sidesteps or crossover cuts poses greater risks. Muscle weakness, fatigue and hyperlaxity are another reason for the injury. Women seem to be more prone to Ligament tears than men. Reconstructive surgery is the only way to treat tear of anterior cruciate ligament (ACL).

Tear of Tendon

Tendons join the muscles to the knee joint. On being overstretched, tendons rupture and bleed. However, unlike ligament tear, they heal on their own and do not require surgical intervention.

Tear of Cartilage

To give support and strength to the knee joint, there are additional strips of cartilage on either sides of the knee joint. These cartilages are known as ‘menisci’. Sudden twists, turns or force results in tearing of the meniscus and this manifests as pain, redness and inflammation. The runner may not be able to straighten the leg. Treatment involves surgical trim or removal of the damaged cartilage.

Patello-femoral Pain Syndrome

Bending and straightening the knee in an unusual way such as squatting, climbing up and down the stairs, walking uphill or downhill, sitting for prolonged periods of time causes wear and tear of the cartilage surrounding the back of the kneecap. This results in gradual pain which exacerbates with daily movements.

Prevention

Here are some tips that can help you prevent knee injuries:

  • Proper warm up before beginning your sport or physical activity
  • Stretching exercises for muscles
  • Wear appropriate footwear
  • Cool down after the sport or activity
  • Increase the intensity and duration of activity gradually over a period of time.

First-aid

If you have an injured knee, this is what you can do in the first 24-72 hours to ease the pain:

  • Stop the activity that has caused pain immediately
  • Give rest to the knee joint
  • Apply ice packs for 15 minutes every 3-4 hours
  • Keep the injured leg in an elevated position
  • Put a bandage and wrap it on the lower leg
  • Avoid any massages and heat therapy.

Treatment

Treatment options will vary by type of injury and extent of damage. However, treatments can be broadly classified into four main types:

  1. Physiotherapy involves exercises and techniques to decrease pain, improve mobility and strength of the muscle.
  2. Aspiration involves using a fine needle to remove the fluid from the knee if there is a lot of swelling.
  3. Keyhole surgery is commonly done to treat a tear of the cartilage
  4. Open surgery is done for severe knee injuries.

References
[i] M. Majewski, Habelt Susanne, Steinbru ck, Klaus c. Epidemiology of athletic knee injuries: A 10-year study. Elsevier. 2006
[ii] Steinbru¨ck K. Epidemiology of sports injuries—25-year analysis of sports orthopedic-traumatologie ambulatory care. Sportverletz Sportschaden 1999;13(2):38 – 52
[iii] Maes R, Andrianne Y, Remy P. Increasing incidence of knee ligament injuries in alpine skiing: epidemiology and etiopathogenetic hypotheses. Rev Med Brux 2002;23(2):87 – 91.
[iv] Mark Hutchinson; Mary Ireland. Knee Injuries in Female Athletes. Sports Medicine. April 1995. Volume 19, Issue 4, pp 288-302.

(Dr. Rohan Habbu is an Orthopedic Hand, Nerve & upper Extremity Surgeon. He has done Fellowship in Arthroscopy & Sports Surgery and is an avid runner. To know more, reach out to him on rohanhabbu@gmail.com or +91 982017 13941)

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