Common Knee Injuries

Ligament injuries
• Lateral collateral ligament
~ damage caused by impact to the inside of the knee
• Medial collateral ligament
~ damage caused by impact to outside of the knee
~ common injury in contact sports e.g. football, rugby
• Anterior cruciate ligament
~ damage caused by twisting the knee or impact to the side of the knee
• Posterior cruciate ligament
~ damage caused by hyperextension or bending the knee back the wrong way

Cartilage/meniscus injuries
• Lateral meniscus
~ damage caused by internally rotating the knee with the foot, over-bending the knee backwards or forwards, or from over use
• Medial meniscus
~ damage caused by twisting the knee, over flexing (bending) or over use
• Osteoarthritis
~ affects articular cartilage

Tendon injuries
• Damage can be in the form of inflammation (as a result of overuse), tear/rupture or avulsion.
Tendons most commonly affected include:
~ patella tendon (aka ‘jumper’s knee’)
~ quadriceps tendon
~ hamstring tendons

Dislocations
• Patella
~ pain, instability, dislocation and fracture all common
• Tibiofibular joint
~ occurs most commonly when one sustains an impact or falls with knee in a fully flexed position, with foot pointing inwards (inversion) and downwards

Other
• Bursitis
~ prepatellar or infrapatellar
• Iliotibial band syndrome
~ aka ‘runner’s knee’
~ caused by the iliotibial band rubbing against the lateral femur and becoming inflamed
• Fat pad impingement
~ the fat pad is soft tissue between the patella and the femoral condyle. It can get pinched, often as the result of a hyperextension of the knee resulting in knee pain
• Septic arthritis

First aid and emergency management of a knee injury:

Rest
Use crutches, splinting, slings etc.
Prevents further damage
Reduces blood flow and oxygen demand which promotes clotting
Reduces pain, allows healing
Ice
Decreases bleeding, swelling and pain
Rules:
o Never apply directly to skin
o Leave on for no longer than 20 mins, then 20 mins off, 20 mins on etc.
o Check skin colour and distal pulses
o Apply as often as possible for 2-3 days
Compression
Reduces swelling and healing time
Use compression bandage
o Monitor circulation
Elevation
Above the level of the heart
Reduces bleeding and swelling

AVOID:
Heat
I.e. hot baths, heat packs, showers, saunas
Alcohol
Increases bleeding, swelling and delays healing
Running
Exercise will cause further damage
Massage
Increases bleeding and swelling

Medication:
NSAIDs are recommended for controlling the inflammatory response to speed the recovery process - either topical or oral
Paracetamol

Hemarthrosis:
· Aspiration (withdrawal of fluid) as necessary