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Tuesday, September 20, 2011

A Family Doctor's Tale - KNEE LIGAMENTS INJURY

DOC I HAVE A KNEE LIGAMENT INJURY


Knee Ligaments Injury is a common disorder of the knee caused by damage of the ligaments of the knee.

There are 4 ligaments, 4 bands of tough tissues in the knee to stabilize the joint :

1.Anterior Cruciate Ligaments (ACL) - starts from front of middle of lower tibia to middle of the back of femur
2.Posterior Cruciate Ligaments (PCL)- starts from middle of front of femur to the middle of back of tibia.
3.Medial Collateral ligaments (MCL) located on the inside of the knee
4.Lateral Collareral Ligaments (LCL) located on the outside of the knee

The causes of Knee Ligaments Injury are:
Injury to the knee ligaments are the main cause.

1.Anterior Cruciate ligament of the knee-soccer players who use rapid twisting movements of the knee (as when the knee stops and changes directions suddenly) are at higher risk of Knee Ligaments Injury .
The anterior Cruciate ligaments can also be injured when the twists on landing or as a direct result of a direct contact or collision during a soccer tackle.

2.Posterior Cruciate Ligament of the the Knee- injury to the posterior Cruciate Ligaments of the knee occurs when direct force is applied to the the front of the knee especially when the knee is bent.
The ligament can also be pulled or stretched in a twisting or hyperextension injury.

3.Collateral ligaments - injury to the Collateral Ligaments such as a fall or direct hit to the knee.
It can also occur as a twisting injury.
It can also occur together with ACL and PCL ligaments injury.

4.Obesity cause more strain on the Knee Ligaments

The symptoms and signs of Knee Ligaments Injury are:
Symptoms:
1.Immediate Pain in the knee after injury

2.Swelling of the knee within 1 to 12 hours

3.Difficulty in bending or straightening the knee

4.A popping sound occurs when the anterior cruciate ligament ruptures

5.difficulty in walking because of the pain

6.instability in the knee with the joint giving way during sport or daily activities.

Diagnosis:
1.history of a fall or injury followed by limitation of movement of the knee

2.MRI will show if there is Knee Ligaments damage

3. An X-ray is done to exclude fracture of the bone

The Treatment of Knee Ligaments Injury is:
Conservative treatment:
1.rest,elevation and ice compress treatment of the knee upon injury

2.Pain killers such as NSAID(non-steroidal anti-inflammatory drugs) for pain relief and reducing inflammation

3.Muscle relaxant to relax muscles

4.crutches can reduce the weight off the affected limb

5.Physiotherapy such as traction, shortwave diathermy help to increase knee muscle strength and improve flexibility of movement of the knee

Surgery is usually indicated in Knee Ligaments Injury if the condition does not improve with conservative treatment.
1.A keyhole or arthroscopic repair is done to repair the torn ligaments

2. A cast is placed around the knee to protect followed by physiotherapy 1-2 days after surgery.

Prognosis depends on the severity of the ligament injury

In most cases Knee Ligaments Injury may recover with conservative methods.

Some cases however may require surgical treatment

Prognosis is good after surgical treatment.

Prevention is to avoid weight bearing, reduce obesity and muscle strengthening exercises.

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