The knee joint is the largest person. It is formed by his femoral, tibial, small-terber bone and a patella. Claimed bones are strengthened by tendon of four-headed muscles, side and intra-artistic cruciform ligaments. The knee mobility is provided with a joint liquid, a joint bag, as well as menisci (intra-articular plate cartilage).

All components of the knee during the life of a person are subjected to various kinds of injury to varying severity - bruises, fractures, breaks and stretching.

Break of knee joint

The most common injury lower extremities, of course, the bruise that a person can get any age. Externally harmless, it can be very dangerous, especially if accompanied by complications.

Symptoms

The main sign of the injury is a sharp pain, sometimes unbearable. The symptoms of the bruise include the instantal change in the color of the damaged section, the swelling of the knee joint, which appeared as a result of hemorrhage in it.

The joint becomes limited in motion due to acute pain in it.

The reasons

It is possible to injure the knee joints when falling and with direct impact on them. Who and did not run us in childhood with batters? Increased activity of children does not leave the chance to avoid such bruises.

But the most injured knees are still at professional athletes, especially the runners, football players who are engaged in combat arts.

The reason for such an injury often becomes a fall, to protect the knees more difficult. It is possible to bruise and when hitting some subject.

Diagnostics

The traumatologist defines injury with an external inspection by comparison with a healthy foot. Attention is paid to the shape of a knee joint, smoothed with hemarthritis.

Then, with the position of the patient, the movement is investigated in the joint. The presence of blood in the joint is determined by the limited movements of the patient. Checked and the ability to keep the leg in a straightened position. This, with some types of knee injuries problematic.

Treatment

After the injury, the treatment begins with patient anesthesia using non-steroidal agents.

Cold

Then the classic pain relief method is applied by cooling the injury site. Loda narrows small vessels, thanks to which the edema decreases and removes pain syndrome.

Bandage overlay

The gulling bandage is an indispensable manipulation when bruised, allowing to reduce hemorrhage and edema. After that, the patient should be put and lifted the leg to the exaltation.

Puncture

Cutting the clarity of the joint and soft tissues to suck the accumulated blood contributes to the removal of pain and the edema. The puncture is appointed with significant hemarthrosis and is carried out by the surgeon, after which the fixing bandage is superimposed into place of the injury.

• Mazi with analgesics and anti-inflammatory components of a gel, strengthening walls of vessels and destructive microtromb;
• Chondroprotective ointment and gels, for example, collagen ultra, restoring compounds due to collagen, contributing rapid restoration Knee mobility.

Physiotherapy

Assigns a week after the injury. It includes:

• UHF therapy;
• Treatment with dynamic currents.

ethnoscience

With injuries possible and treatment folk methods. For example, ointments on swine fat or sabelnik have proven well.

A mixture of swine fat with cropping leaves of a plantain, having a consistency of sour cream, significantly facilitates the patient's condition. And the ointment of semolina with bented stems of the sabelnik contributes to the rapid recovery after the knee injury.

Damage to ligaments

A common injury of the knee joint is the damage to the ligaments, observed mainly among active people of young age, most often in sports.

Such a trauma means the break of the fibers is partially or completely, with the possibility of separation in the place of attachment.

The general bunch of the knee joints includes side ligaments (outer and internal) and cross-shaped (front and rear). The break of each group of ligaments has its own specifics.

The reasons

Different types of ligaments and are traumatized in different ways, the cause of their damage is overly strong rejects, twisting limbs. But there is general reasons - This is an occupation of sports that imply a burden on the joints and direct influence on the ligaments.

From the direction and strength of the blow depends on which the ligaments will be injured:

• Cross-shaped ligaments can be broken with high impact on the back of the bent shin;
• The cruciform bundle is injured at the back, if there is a blow to the lower leg when the foot is bent or when the joint is extension;
• Both types of side ligaments can break, if you turn the leg or stupid when walking on high heels.

Symptoms

The general features of injury include:

• Painful sensations;
• Crack upon receipt of injury;
• Hematoma (hemorrhage) of soft tissues;
• Radiation of the knee joint;
• Limited joint movement;
• The inability to rely on the sore leg;
• Excessive mobility of the patella.

Symptoms are externally expressed depending on the degree of damage to the articular ligaments. With a complete break, the joint becomes breaking, unnecessarily movable.

Other specific injuries are manifested as:

1. The symptom of the injury of the outer side ligament is pain, amplifying when the shin is deviated by Knutrice. In this case, there is a hemarity, hemarthrosis. The gap often happens complete.
2. Internal side ligaments when gap causes a joint, pain in it, the shin is rejected by the dust.
3. Cross-shaped ligaments will be torn if the shin is overly moving (symptom of the drawer).

Diagnostics

Using the method of arthroscopy of the knee joint, the cause of injury is determined and the diagnosis is made for subsequent treatment. The following points are the reading to its conduct:

• Big blood accumulation as a result of injury;
• Effusion in the articular cavity (cluster of fluid);
• Incomprehensible pain;
• Suspicions of damage to the internal elements of the knee joint.

Arthroscopy is carried out with an anesthesia, while the arthroscope is introduced into the joint along with the mini-video camera. The doctor makes a diagnosis on the basis of the study of meniscus, finishing femoral and tibial bones, a patella and other parts of the knee.

Treatment

The correct diagnosis allows to carry out effective treatment, which involves conducting such events:

• Ensuring immobility and peace by damaged leg;
• Fixation of the affected knee joint with tires, bandage, elastic bandages;
• The impact of cold for pain relief and edema in the first 2 hours after injury;
• Ensuring the sublime position of the limb to reduce the edema of soft tissues;

Anesthesia using anti-inflammatory and painkillers;

• The use of warming compresses and warming ointments in the following days after injury;
• Physiotherapy;
• Exercise, massage.

All of the above treatments are sometimes ineffective. With full breaks, the treatment is possible only surgical, which involves two small cuts. It is possible to replace the injured ligaments with transplanted tendons. The operation passes with endoscopic equipment.

Damage to Menishov

Menisky is 2 cartilaginous formations in the form of a crescent in the articular cavity serving the protection of the articular cartilage and performing the role of shock absorbers when loading on their knees. One of them is internal, and the other is outdoor.

Menisky very traumatic elements, occupying 1st place by number of injuries among the structures of the knee joint. Often such injuries happen to athletes - football players, figure skiings, skiers and ballet artists.

Menisk injury is accompanied by a frequent breakdown and displacement fractures, which requires immediate access to a surgeon or traumatologist.

Symptoms

The main symptoms indicating damage to the meniscus are:

• Sharp pain with localization on the inner or outer part of the knee, especially during physical exertion;
• Difficulties in the rise or descent from the stairs;
• The appearance of a characteristic sound when flexing the joint ("click" symptom);
• Small atrophy (reduced muscle tissue);
• Existence of excess fluid in the joint;
• Increased temperature in the field of knee joint;
• Increased joints in volume. The presence of this symptom requires an immediate appeal to the doctor.

The reasons

Most of the damage to the meniscus occurs with the unsuccessful coincidence of the circumstances in a person of any age - when the leg is converted, strikes the knee of anything. Most often, such injuries happen in athletes and lovers of extreme sports, as well as those who love to sit down on squatting and squat.

Predispose to such injuries and people with weak or too mobile (breaking) from the birth of ligaments, as well as sick gout and arthritis.

High the chance of obtaining a trauma of meniscus in a person having muscle spasms of the front of the thigh, with overwear straight and worshi-lumbar muscles.

Diagnostics

An experienced surgeon or traumatologist is able to make a diagnosis of damage to the meniscus based on the visual inspection of the patient and its story about the history of injury. To clarify the degree of damage to the patient is examined using hardware diagnostic methods:

• MRI (magnetic resonance therapy). Reliable method, allowing to clearly determine the type of injury - a blast, separation or pinching of the meniscus;
• Artroscopy (examination that allows to obtain maximum information about the state of the structures of the knee joint).

In case of late production of the diagnosis of menisk tissues, dangerous rebirth in the cyst is possible.

Treatment

Meniscus damage is three species: pinching, blasting and complete separation.

Most often pinching and manifolding (up to 90% of cases), which can be cured, without resorting to the operation. With the separation of meniscus, only its operational removal is possible.

The choice of a method for treating meniscus is determined by the severity of injury. With minor damage, conservative treatments are used, and more serious injuries need surgical intervention. In any case, the decision on the treatment method takes the doctor on the basis of a diagnostic study.

Phased treatment of damage to the meniscus occurs as follows:

1. Physiotherapy.

After refueling the joint, it is restored with the use of a laser, magnetotherapy and ultrasound with a hydrocarticison.

1. Restorative surgery.

In the absence of serious gaps, it is possible a non-operational treatment, which consists in:

• removal of pain and edema in the joint;
• fixation of the knee joint;
• imposing cooling dressings;
• classes with medical gymnastics;
• the use of non-steroidal anti-inflammatory and painkillers, reception of chondroprotectors to restore cartilage tissue.

1. Menischetomy.

This treatment method is to remove meniscus by arthroscopy, which implies a small surgical intervention using an endoscopic installation.

The advantages of this method:

• lack of large cuts;
• fast rehabilitation after surgery;
• no superimposition of a special gypsum bandage;
• abbreviated period of stay in the hospital.

Several less often use arthrotomy, that is, conducting an open operation. Surgical treatment is in the eush, resection, removing the meniscus in whole or in part.

The embedding is appointed taking into account the age of the patient, the state of the damaged area, the stability of the knee joint.

1. Rehabilitation.

The necessary stage in the completion of treatment is rehabilitation, involving the elimination of pain, waste, restoring mobility of meniscus, strengthening bundles and muscles. Physiotherapeutic procedures and massages help to establish a motor function in the knee. Full restoration of the meniscus function can take time from weeks to 3 months.

Fractures in the area of \u200b\u200bthe knee joint

The complexity of the trigger fractures is that it consists of 4 bones, during the injury of each of them there is a complete or partial fracture of the whole joint.

Forming the knee joint thigh, tibial, small-terber bone and a patella. Fractures of the first two bones occur due to sudden muscle contractions, as a result of which bone protrusions (sodes), on which the muscles are fixed, break. The injury of the patellands ends with a cup of cup.

Fractures are classified and as embracing (only bones are damaged) and intra-articular (the synovial bag covers the joint outside) is also injured.

Symptoms

For all 4 species of such fractures are:

• Acute painful manifestations during the wellness of the joint or with any movements in its area;
• The gradual appearance of the ethnicity in the area of \u200b\u200bthe Knee Sustav;
• Blooders manifested in the place of damage;
• Restricting the functions of bending and extension in the knee.

The reasons

The main causes of the knee fractures are the impact on it with direct force or injury, which is most often occurring when falling on a bent knee.

The patella breaks not so often, even a straight blow does not always end with a fracture. True, there is a danger to get injured without exposure to force, it comes due to the strong tension of the tendon, because of which the bone of the patella is possible, most often full.

Diagnostics

Clinical picture I. additional methods Studies allow you to put an objective diagnosis.

A good effect gives a radiographic examination method, which allows you to get a clear line of fracture or bone offset.

Diagnostics using the arthroscopy method, which implies the inspection of bone damage to the use of endoscopic installation, allowing to consider near possible cracks in cartilage tissue and define the nuances of the fracture.

Fracture of cartilage is determined more difficult, X-ray its show can, use the arthroscopy method.

Treatment

After clarifying the diagnosis, it is necessary to begin to immediately be treated, which is carried out in a specialized institution and is in the phased organization of medical care.

It begins with urgent provision of the knee joints with the help of funds available to protect him from further injury. At this stage, pain relief was used to overcome pain shock.

Then it turns out the patient specialized help traumatologist.

It consists in an accurate comparison of bone fragments with their further fixation in the desired position, which will create good conditions For healing.

This can occur in two ways - closed and operational. When first, fragments are connected by manual admission. The operational intervention is carried out in an open way.

After any fracture, a gypsum bandage is superimposed to ensure fixedness of the connected fragments.

In the injury of the artician cartilage, it is necessary to use drugs that contribute to the restoration of cartilage tissue - chondroprotectors.

Anti-inflammatory tools are prescribed at the fracture of the silence of the knee.

At the last stage, the joint is rehabilitation, which includes physiotherapy procedures, medical gymnastics and massage that contribute to the restoration of its functions.

The competent medical support of the patient at all stages of treatment will lead to the complete restoration of the knee joint functions.

• The knee is part of the body, which is relatively most often involved.
• Among the types of knee injury are distinguished: tensile ligaments of the knee joint, the stretching of the tendons surrounding and fastening to the joint muscles, post-traumatic inflammation of the articular bag, dislocation, fractures, cracked meniscus, as well as multiple injury.
• The knee injury, as a rule, occurs as a result of twisting or excessive bending, as a result of a force applied to the knee area or direct impact, for example, during sports, falling from height or accident.
• To the risk factors, knee injury include excessive burden on the joint, incorrect training and training, osteoporosis and high degree During sports games, during which there may be sudden changes in the direction of movement.
• The main signs and symptoms of knee injury are pain and swelling.
• The knee injury is usually diagnosed on the basis of anamnesis of the disease and physical inspection. To clarify the nature of the damage and selection of treatment tactics in most cases, the diagnosis is used by the Radiography of the knee joint or magnetic resonance tomography (MRI).
• The choice of the treatment option of the knee injury depends on the type and severity of the injury obtained, and usually includes a complex of the so-called Rice therapy (REST - rest, ice - Ice, Compression - compression effect, elevation - elevated position), physiotherapy, immobilization, or if necessary Operations.
• Forecasts for recovery during injury knee depend on the type and severity of injury, the need for subsequent physiotherapy or the results of surgical intervention.
• The knee injury can be prevented due to training (for example, in sports), the use of proper protective equipment or ammunition and compliance with the safety rules during the game on the game field or at home, prevent falls.

What are the types of knee injury?

Since the knee is one of the most rolling, always active and protruding parts of the body, it is logical that when some predisposing factor appears, the probability of its damage is more than that of other joints. In most cases, the cause of knee injury becomes athletic injury, falling on the knee joint and damage as a result of road traffic accidents.

At the heart of the type of knee injury always lies the damaging mechanism and the anatomical area of \u200b\u200bthe knee joint.

The injury of the knee joint in the type of tension of the ligaments occurs when exposed to bundles, ensuring the stability of the knee joint and the dense contact of the articular surfaces. There are several such bundles. The front cruciform bunch and the rear cruciform bunch contribute to the knee stabilization when moving in front and intersect with each other in the middle of the knee joint. Medial (internal) collateral bunch and lateral (outer) Collateral bunch (LCL) are responsible for the lateral stability of the knee and prevents bone offset from side to side.

The degree of tension of the ligaments depends on the severity of the stretching or the presence of breaking the fibers of the ligaments, and how much causes the unstability of the knee joint. The tension of the ligaments is classified as follows:

Stretching of ligaments 1 degree: A bundle or ligaments stretch, which is accompanied by the appearance of the knee pain, but at the same time the fibers do not rush and there are no signs of the unstability of the joint.
Tensile ligaments 2 degrees: In case of injury, the knee occurs a partial break of the fibers, as a result of which the appearance of a light instability of the knee joint is possible.
Tensile ligaments 3 degrees: There is a complete break / rupture of the ligament fibers, as a result of which the knee loses its support and articular function.

Fig.1 Stretching / Rip Collateral (side) ligaments

The knee deformation occurs when the tendons or muscles surrounding the knee stretch, as a rule, when re-installing or polishing the knee. Such deformation can lead pain in the tissues surrounding the joint, and not in the joint itself, but at the same time cause limit the range of movements of the knee joint. Often the cause of the deformation of the knee joint becomes damage to the tendons fixed to the knee cup, which is the key anatomical element of the joint. Part of the tendon is especially traumatized, located between the lower part of the knee cup and the front surface of the tibia.

Fig.2 of the knee deformation mechanism

The frequent satellite of the knee injury is inflammation of the knee joint or bursitis. Bursitis It leads to the appearance of painful sensations, a knee joint, when progressing inflammation to the infection of the contents of the articular bag. Functionally an eye-cutting bag with the articular liquid contained in it acts as a shock absorber that limits the friction of the joint surfaces and the surrounding tissues of the joint. There are several of these bags in the knee joint, of which 2 mains are distinguished: one is behind the patella (with a browser), the other below the knee joint on the front surface of the leg bones.

Fig.3 Bursitis (inflammation) of a near-handing bag

Damage to the meniscus can occur during the injury of the inner surface of the knee or at a submaximal load on the joint when dislocation. Menisk is a semicircular cartilaginous gaskets placed between the large bones of the knee joint and serving a kind of bone airbags. Menisky may be damaged as a result of a serious traumatic impact or even with a slight load in the case of their anatomical dysfunction when aging or constant excessive use.

Fig.4 Damage to Meniska

The knee dislocation can occur only as a result of a severe mechanical injury of the knee, for example, during sports injury or traffic accident. This is one of the rarest kinds of knee injury, but it leads to serious damage to all the anatomical elements of the knee joint, often with integrity disorders. blood vessels and nerves. Such a knee injury, as a rule, requires emergency intervention or surgery.

A patella or knee cup is a seamovoid (added joint) bone, which under normal conditions is quite movable and well shifts relative to the joint plane when moving. The injury of the patella in the type of dislocation can be very painful, but in most cases it does not lead to a life-threatening complications and is good to treat with the right, immobilization (for example, concretion) and physiotherapy.

Bone fractures The knee occur as a result of applying direct bone impact. The fracture or crack of the patella arises when a man falls on the knee joint. One of the most common types of bone fractures during knee injury is a fracture of the value of the tibial bone arising due to the compression mechanism, especially in patients with such a predisposing factor as osteoporosis. Fractures of other bones of the knee joint rarely occur, and more often worn character.
One of the varieties of knee injury is the so-called palatlofemoral pain or knee syndrome, in which the degeneration of cartilage tissue (chondromalysis) of the articular surfaces of the knee joint occurs as a result of constant injury. Often it may be a congenital problem or appear as a result of irregular knee movement mechanics.

Fig. 5 Options for Tibra Tibony Frame during knee injury

What are the causes of knee injury?

In most cases, the knee injury is associated with an external influence, which is based on a twisting or bending mechanism. To such variants of movement, the knee joint is anatomically not adapted. The overwhelming number of such injuries arises as a result of drops, sports or accidents. Injury with twisting mechanism can lead both damage to the ligaments and damage to the cartilage.

When the traumatic power, for example, as during sports injury and traffic accidents, there may be damage to several anatomical elements of the knee joint, as a result of which a multi-type injury may occur simultaneously.

What can be attributed to the risk factors knee injury?

Perhaps the most common risk factor for the knee injury is to participate in sports sports or sports, in which the knee joints have a serious physical activity, such as running, basketball, football, hockey, football, cycling, etc. . Very often, the injury of the knee joint occurs during weight athletics, when submaximal loads fall on the knee tissue and sharp changes in the direction of movement are possible.

Especially high risk, when rose is used during running, with which most of which most of the load is shifted to the knee joint as a result of fixing the ankle joint.

For the elderly, the problem of another character is peculiar, the knee injury may arise from them as a result of the fall or weakness of bone tissue due to osteoporosis.

For women, it is more characteristic of injury with damage to the anterior cruciform ligament and a knee cup. In many ways, this is due to the special anatomy of the hips of women and femur, as well as the angle of inclination of the knee joint. This leads to progressive chondromation of the patella, inflammation or irritation of the lower part of the knee.

Fig. 7 X-ray and MRI when the cruciform ligament (green arrow) and a tibia fracture (red arrow)

The traumatologist taking into account the mechanism of the injury obtained will conduct special tests using the bending and twisting of the knee, with the help of which the stability of the ligament apparatus will clarify and reveal the hidden damage to the meniscovers and cartilage tissue of the joint. These tests are also necessary for right choice It takes into the further immobilization of the knee joint.

Instrumental diagnosis in the amount of radiography, (CT) or MRI may be required to determine tactics and necessity surgical treatment. Since the knee damage is accompanied by inflammation of the articular bag (bursita) or even hemorrhage into the joint (in medical terminology it is called this condition gemarthrosis), can be quite informative ultrasound procedure (Ultrasound of the joint), special in cases where it may be necessary for the puncture of the complications of injury.

X-ray and CT is usually used to identify damage - fractures of bone structures, and magnetic resonance imaging - to assess damage to soft tissues (ligaments and cartilage).

What are the treatment options for knee injury usually use?

The treatment of knee injury usually depends on the damaged part of the knee and the degree of damage.

Some types of injury, such as simple stretching or sublifting, are quite well treatment with the use of Rice therapy (definition for example). For the period of this therapy, there is enough restrictions on physical exertion and sports. It is necessary to use the use of non-receptible forms of anti-inflammatory drugs, such as Ibuprofen (Advil - Advil, Motrin - Motrin) or Naproxen (Aleve-Aleva), which will make it easier to make the pain and phenomenon of inflammation of the knee joint.

Immobilization or knee shining will provide peace and restriction of movements, thereby reduce the likelihood of further damage. This will make it possible to stabilize the damaged knee in the event of a joint instability, for example, due to breaking bundles.

Fig.8 Immobilization of the knee

Chronic knee injury accompanied by inflammation and bursite is usually well treated with anti-inflammatory means. Often with pronounced inflammation and / or pain syndrome, the intra-articular introduction of cortisone (glucocorticosteroid - steroid with powerful anti-inflammatory effects) may be required.

Extensive injuries associated with tipping bundles, the instability of the knee joint, expressed swelling, the restriction of the movement range or the fracture always requires the consultation of the orthopedic traumatologist. With acute injuries, for the period of transportation of the patient in the injury pack or traumatological hospital, the optimal is considered to be the immediate execution of the Term Therapy (REST - Recreation, Ice - ICE, Compression - Compression Impact, Elevation - Elevated position). The use of supports such as crutches or a wheelchair providing additional peace is also welcomed.

Fig.9 Rice Therapy

Surgical intervention can be shown when breaking bundles or extensive damage to meniscus. Also, the operation may be required in the treatment of fractures or dislocations of the knee joint. Some acute injuries, accompanied by serious damage to the joint under the influence of powerful traumatic force or with the involvement of several parts of the knee joint, usually suggest an emergency surgery.

Currently, most knee operations can be done with the help of and arthroscopic technologies. This is due to the sufficiently large sizes of the scene and the possibility of using equipment for endoscopy. Such operations are performed through small skin punctures in the projection of the articular bag, through which endoscopic tools are injected there. Operation itself is carried out under visual control using a small chamber connected to one of the tools. All this allows you to fulfill the intervention in full and without the use of a large section. In case of acute injury, most operations are performed in a delayed order, after the phenomenon appears.

Fig.10 Arthroscopic technique for knee operations (Meniska resection)

Immediately after the operation or if there is no need for operation, physiotherapy aimed at strengthening the muscles and the ligament apparatus of the knee joint can be used as an alternative treatment. In addition, physiotherapy allows you to provide optimal mechanics of leg and knee joint movements to prevent repeated injuries in the future.

What exercises are recommended and what exercises should be avoided during the rehabilitation after the knee injury?

When conducting physiotherapy for rehabilitation of knee injury, depending on the type of injury injury for the patient, individual specific exercises will be developed to strengthen and stabilize the knee joint. The complex of such exercises usually includes exercises aimed at strengthening the anterior group of the thigh muscles (four-headed muscles), the rear groups of the muscles of the thigh (trambled tendons) and other muscles of the leg and hips.

It is very important to understand that at the beginning of therapy it is impossible to use exercises independently and uncontrollably, because with this approach you can only harm and slow down the restoration of the joint. Inexperienced athletes are trying to "download" damage themselves, which does not categorically do. During the rehabilitation period, the joint usually requires peace and minimum loads that take into account the anatomy of damage. And to develop a correct exercise program, a mandatory consultation of the traumaologist or physiotherapist is required, which exactly knowing the mechanics of the movement of the joint and capable of choosing the optimal exercises, and to work out before the patient's independent use.

If you have pain or discomfort in the joint or surrounding tissues during exercises, please inform your attending physician or physiotherapist.

• Low-most amplitude extension of the knee joint in the sitting position (with a roller under the knee)
• Straight leg lifts: lying on the stomach and / or back
• Burning the hips to the thigh under load
• Rises on socks
• "Bridge" without cliff blades
• Light squats with alternate shift of the legs

The American Academy of Orthopedic Surgeons (AAOS) for these purposes has developed a special manual, which describes each exercise with a detailed analysis and pictures. However, no less than the independent use of these exercises, it is necessary to obtain approval and consultation of the traumaologist.

Here are some of the exercises that will allow to avoid follow-up knee injuries:

• Full knee extension sitting on a chair
• Fucks ahead with the bending of the knee of the leading leg
• Deep squats (you can with a vulture for weightlifting)
• Stretching in a position sitting with taut and designated foot, and stretched stretched leg (barrier stretch)

With the help of these exercises, an easy additional load on already damaged knee joints is created, as a result of which the so-called "injection" of the joint occurs.

What time is usually required to recover after knee injury?

The breakdown time of the knee joint after injury usually depends on the type and severity of the injury. If the injury is serious, requires surgical intervention and / or long-term physiotherapy, the recovery time is stretched.

Restoration after simple dislocation or tension of ligaments can last from one to two weeks. More massive damage under which arthroscopic operations are performed can take from one to three months of rehabilitation.
Sometimes a complete program of rehabilitation and restoration of the knee function after injury may require about 1 year, and in most cases the timing of this restoration is purely individual.

When conducting a rehabilitation program, it is important to listen to the advice of the practitioner of the traumatologist, respect the recreation regime, to carry out the right immobilization and avoid exercises capable of provoking repeated injury.

An important role in rehabilitation lies with physiotherapeutic treatment. Usually, various physiotherapeutic effects and procedures can be used, such as massage, magnetotherapy, healing baths and jacuzzi, heating joint, etc. Of course, physiotherapeutic procedures should be performed under the close control of the specialist.

Chronic knee injuries will be episodically disturb the patient and manifest themselves repeated occurrence Bolshes in the joint, but, as a rule, with such states, there is enough physiotherapy, anti-inflammatory and painkillers, intra-articular administration of hormonal drugs.

What is the forecast for knee injury?

The forecast for knee injury, as well as the treatment results, are completely dependent on the type, gravity of injury and its occurrence.

The knee injury is rarely life-threatening, although severe injuries can be accompanied by severe pain syndrome and a shock condition with collapse phenomena. Serious deforming injury with violation of bone integrity may result in injury of vascular nerve formations and severe disability.

Most minor knee injuries (stretching, minor dislocations) are heal independently when used conservative treatment. Forecast for this type of injury is usually good.

The involvement of the ligament apparatus of the joint is fraught with dysfunction or the instability of the knee joint, which may require the fulfillment of operational treatment. Such injuries are well treated surgically, especially using arthroscopic technology, and the patient returns to a complete or almost complete range of movements, as before injury.

Some knee injuries lead to chronic and irreversible knee damage and subsequent long-term dysfunction. That is why the patient is preferably preferably during the first few hours or days (depending on nature) after injury to seek the help of a traumatologist so that he figured out the clinical situation and provided timely help.

Is it possible to prevent knee injuries?

Below are the main events or exercises that will significantly reduce the likelihood of injury and reduce the severity of its symptoms:

• It is necessary to constantly train and maintain physical shape, especially the lower parts of the body.
• It is necessary to monitor its weight and timely hold its correction.
• When classes, use specialized sports shoes
• The nature of training exercises must correspond to the sport type and it is recommended to avoid overvoltage
• Preparation and maintenance of the game surface for sports in optimal condition
• Avoid getting on slippery or uneven surface
• Avoid hitting a free turf or gravel
• Be sure to wear knee pads and pads, if necessary to protect during sports
• Be sure to perform all recommended rehabilitation exercises at the previous injury
• It is necessary to be examined for osteoporosis and conduct its treatment.

In medical practice, knee injury is found quite often. Are subject to such damage often people of old age and those who lead an active lifestyle, doing various species Sports activities, or people who love extreme. In case such an incident occurred urgent urgent Care victim to prevent development possible complicationsAnd for its correct provision you need to know what is the injuries of the knee and how to behave in one way or another.

In medicine there are several types of knee injury:

• bruises;
• breaks and damage to meniscovs;
• bleeding into the hollow of the joint;
• trauma of the patella;
• damage to the knee bundles;
• articular fractures.

Causes of occurrence

There are a lot of factors and situations that lead to the injury of the knee, but most often they occur for such reasons:

• mechanical strikes in the knee area;
• drops from elevations;
• the incident of natural origin;
• classes of active or extreme activities;
• road transport catastrophe;
• adverse weather conditions;
• retirement age and deterioration of sustainability;
• classes of martial arts.

Ears

The most secure injury that is characterized only by damage to the top layer of the epidermis. Most often, such knee injuries occur during falling and rarely accompanied by unpleasant consequences.

First symptoms:

• severe pain in the area of \u200b\u200bthe bruise;
• education of bruises, abrasion and hematoma;
• possible manifestation of swelling of soft tissues at the injection site;
• the manifestations of pain when trying to move the kneaded leg.

Diagnostics are carried out in a specialized institution under the supervision of an experienced physician. The first thing is a patient poll, injury to the injury, and then study using radiography, which is carried out to eliminate the presence of fractures and other more serious damage.

Treat the knee injury of this type is easy. The doctor recommends that pharmacy preparations (ointments and gels), which will contribute to the speedy restoration of the knee and prescribe the processing of manifested RAS using antibacterial agents. During the recovery period, the leg requires as much rest. Also, to prevent the enhancing infection in the wound, it is necessary to turn the knee using a bandage or bandage.

Bleeding in the articular region (hemartrosis)

When injuring the knee joint of this type, the blood enters the body cavity, which leads to the beginning of the inflammatory reaction of the synovial shell. This damage occurs as a result of the disorder of the integrity of one of the parts of the knee joint.

First signs:

• acute pain syndrome;
• visual deformation of the injured joint;
• deterioration of the workability of the affected limb;
• increase body temperature.

In order to confirm hemarthritis, it is necessary to carry out a full examination using the following diagnostic procedures:

• knee puncture;
• x-ray;
• arthroscopy.

After the doctor confirms the presence of hemarrosis, the necessary tactics of treatment of the knee injury will be immediately appointed. The first thing is to remove blood from the knee cavity. After that, arthroscopy is very helpful for thorough washing. Next, the injured limb is fixed for two weeks using a gypsum dressing or orthosis. For the sixth day, after the incident, physiotherapy procedures are prescribed, which help to restore the knee joint:

• magnetic therapy;
• UHF and microwave therapy;
• electrophoresis;
• phonophoresis.

Injury Menishov

The most common type of knee injuries. Internal meniscus is influenced by damage. And in the case of an external injury - the usual functionality of the joint often deteriorates.

Symptoms:

• acute pain in the location of damage location;
• the occurrence of the swelling of soft tissues;
• deterioration;
• the appearance of hemarrosis;
• education of abrasion, bruises and scratches.

When reaching the cost of the joint cavity - puncture is carried out.

Diagnostic methods are considered:

• interview;
• x-ray;
• magnetic resonance therapy;
• arthroscopy procedure.

The injury of the knee joint of this species requires only conducting surgical intervention. During operation, the task of the doctors is: restore the cartilaginous plate and remove it dead particles. For the tenth day, the doctor is appointed rehabilitation after the injury of the knee joint, which is to perform the developing gymnastics, visiting massage and physiotherapy procedures.

Traumatting of the patella

Very often, the fracture of the patella is accompanied by a violation of the operation of the extension function and the presence of intra-articular injuries that have different character. There are several types of such fractures:

• damage only cartilage part of the patella;
• transverse;
• edges;
• tearful.

Characteristic symptoms of such injury are considered:

• severe pain;
• powder of soft tissues of the knee area;
• the appearance of hemarrosis;
• when driving or the palpation procedure, the pain is raised intensively;
• visual change of joint;
• detection of the motor function.

Diagnostic procedures are similar to the diagnosis in damage to meniscos. The first thing is puncture to remove the contents of the liquid in the joint cavity, and then survey, radiography, ultrasound, MRI and arthroscopy procedure.

The treatment of this knee injury is chosen by a qualified physician, based on the results of the survey and the diagnosis. After the puncture, the limb is fixed with gypsum for four months. And after his removal, the doctor is appointed rehabilitation after the knee injury. It lies in medicinal physical education, visiting the developing massage and physiotherapy procedures. The rehabilitation period is also appointed by the attending physician.

Damage to the articular capsule and knee bundles

In the case of this injury, the capsule, ligaments and tendons are very important are the full gaps of collateral and cruciform ligaments. The causes of such damage become excessively active types of sports activities.

Symptoms of injury:

• severe manifestations of pain;
• feeling of overvoltage in the muscular area;
• difficult motor activity;
• the formation of various damage to the skin (scratches, abrasions, redness, hematoma, etc.).

To confirm such a injury, diagnosis is needed by radiography, ultrasound examination, as well as MRI or CT.

In the presence of fluid inside the joint - perform the puncture procedure. It consists in removing blood from the kingdom of the knee. Next, an operation is carried out, the task of which is to restore the integrity of the articular capsule, ligaments and tendons. After the completion of the operational intervention, the doctor appoints a wedding orthosis for one and a half months. To speed up restorative process An occupation of the exercise of the LFC during injury and special massage and physiotherapy procedures are appointed.

At the end of the treatment of each of the above damage, it is necessary to restore after injuries. The period of rehabilitation and its technique is assigned individually for each victim, based on the results of the diagnosis and nature of the damage.

The knee joint, being the largest joint human organism, often injuries of varying degrees of complexity. Incorrect behavior in the first minutes and injury hours leads to quite difficult consequences.who are poorly treatable.

Photo 1. knee injuries are dangerous serious consequences. Source: Flickr (William Doherty).

Causes of injury

Damage knee is associated with long-term voltage or sharp blow, for example, when falling, with the pathological effects of high temperatures, chemicals. In addition, painful states have a traumatic factor, due to which the tissues become vulnerable, and may be injured even with minor influences:

• sharp damage - a blow, sharp bending or legged legs - often occurs when drops;
• injuries associated with excessive loads that are repeated with periodicity, while always worn intensive nature: running, jumping, cycling;
• drop from height and landing on straight legs;
• diseases accompanied by osteoarthritis, arthrosis, infectious diseases joints, infringement of the femoral nerve;
• syndrome long compressionoccurring during natural disasters;
• thermal I. chemical burnsIntroducing deeply and longly traumatic impacts.

Types of knee injury

The knee injuries include various violations of the function of the joint, ranging from insignificant pain when walking and ending with serious deformations and ankylosis, that is, the complete immobility of the knee.

Separate two types of knee injuries:

• openwhen the integrity of the skin is disturbed - wounds, fractures with external damage to soft tissues, burns;
• closedWhen skin covers are not disturbed - dislocations, bruises, stretching, or, damage to meniscus, closed fractures, breaking ligaments.

Note! Falling from a height and landing on straight legs is a special kind of injury at which a strong axial load with a vector is acting onto the knee, leading to bone fractures, intra-articular structures and breaking the knee bundles.

Classification of knee injuries

The knee injuries are classified depending on which an anatomical structure is damaged.

In addition, injuries shared By type of damage (Fracture, gap, stretching) and accompanying skin lesions. Most often there are bruises. As a rule, when proper treatment Fabrics are restored quickly enough, and the bruises rarely have serious consequences.

The most severe injuries of the knee are the intra-articular fractures of the tibial, femoral bone and a patella, bundles or damage to the meniscus.

Ears

it the most common household injury, It usually happens as a result of a strong impact or fall when the bulk is on the knee.

Accompanied by the development of bruise and abrasion, the function of the leg is usually disturbed slightly. With proper treatment passes within a week.

Dislocation

Dislocation is a sharp side displacement of the parts of the knee joint relative to each other or scrolling the joint under load with a fixed stop.

This injuryis extremely painful, completely disrupts the function of the limb and requires rapid medical intervention.

Menisk injuries

Meniscus injuries are in his couror donkey. The peculiarity of such injuries of the knee is that the meniska fabric is very difficult to restore, often requires surgery and plastic Operations. When traumating a meniscus, a characteristic click and even blocking the joint is distributed.

Damage to ligaments

Bond damage is very diverse, starting with lightweight stretching, to a complete break or separation from the articular surface. If a - This is a lighter type of injury.T. Ripples and tips of ligaments - very painfuli and difficult to treat injurywhich requires compulsory medical intervention.

Damage to the knee chash

A patella or knee cup, reacts to an injury by dislocation, crack or a fracture. He, as a shield, protects the knee joint, taking over the strength of the blow. And the cracks of the patella are more common than dislocation.

Symptoms of knee damage

In case of injuries, the knee is always present. pain syndrome Miscellaneous intensity and periodicity, amplifying during exercise, lifting on the stairs, squats. Because of the pain knee, it is impossible to be bent or dispersed.

According to the severity of pain, it is possible to judge the seriousness of the injury. Often marked feeling of numbness, crawling goosebumps In a sore limb, because during the injury knee, the vessels and nerves of different caliber suffer, microcirculation is disturbed and paresthesia appear.

But there are certain features of manifestations in various damage to the knee joint:

• Dislocationdetermine the deformation of the knee.
• Stretchingthe joint does not affect the mobility of the limb, but at the same time there is an enemy.
• Increasing the temperature of the skin on the site of the damaged knee joint says that in place of injury begins to develop blood stagnationand inflammatory infiltration.
• If the knee after injury very quickly swells and changes its shape, then it should be suspected that the hollow of the joint is filled with blood, and this requires urgent medical care
• Crunch and clicking while driving more characteristic menisk damage.
• Sustaving says about breaks of ligaments or damage to the patella.

First aid

Victim first need to be put provide peace damaged limbs and lift it at an angle of 20 - 25 degrees. It will be a good prevention of venous and lymphatic stoles in the leg, reduce swelling and pain.

Mandatory is applying coldor ice to the knee joint (through the cloth, so as not to get frostbite) for 10 to 20 minutes. This simple procedure will remove swelling and pain, will prevent fast development Hematoma.

It is necessary to exclude everything that can strengthen swelling (hot shower, bath procedures, warming compresses, alcohol) in the first two days.

It is possible to inspect the doctor to impose a dressing with an elastic bandage.

It is important! When you apply a dressing on the joint, it is important to draw attention to its condition: if there is a joint edema and there is blood flow into the articular slot, which necessarily causes its deformation - the bandage is prohibited, it will sharply strengthen the pain and edema of the limb.

Diagnostics of knee injuries

In case of easy injuries, it will be enough to see the doctor and fulfill its recommendations, but if suspicion of more serious pathology has arisen, special examination methods are needed:

• Radiographythe knee joint in several projections will reveal bone disorders and deformations.
• Ultrasound procedure knee joint. This is a viewing of all elements of the knee joint, including bundles and cartilage structures.
• Magnetic resonance imaging – best diagnosis The 21st century, when the entire knee joint is diagnosed in layers, however, due to the high cost of the procedure, it is extremely rare.
• Puncture of Sustav. This procedure is also applied as diagnostic, and as therapeutic - the pathological fluid is sued. Diagnosis is possible in a knee joint of drugs, if necessary.

Treatment

Light bruises can be treated at homeHowever, to make sure that there is no danger, it will be better to turn to the doctor, which after the examination will put an accurate diagnosis and eliminate possible problems. Cases requiring urgent doctor intervention:

• Signs of shock from cutting pain, loss or confusion of consciousness.
• Acute knee dislocation with offset.
• Long bleeding, if it lasts more than 15 minutes even when the wound is pushed.
• Cases of fragmentation of bones and sticking fragments from damaged tissues.

Note! Do not register the bone yourself - it will dramatically worsen the patient's condition and lead to traumatic shock!

Medications

Depending on the clinical picture Use:

• pick-pool- Non-steroidal anti-inflammatory agents - analgin, oxigan, ketanov and others;
• anti-shockpreparations - adrenaline, dexamethasone;
• bloodstandfunds;
• antibioticswith massive damage and burns;
• local medicinal products - ointment, creams for improving microcirculation in the knee;
• chondroprotectors, improving metabolism in cartilage tissue and contributing to its rapid recovery.

The injury of the knee joint - Damage to the soft tissues and bone structures forming the knee joint. Refers to the category of frequent injuries. It can be significantly different in terms of gravity - from light bruises to intra-articular fragmented and multi-diversified fractures. More often occurs when falling or hitting the knee. Accompanied by swelling, pain and restriction of movements. GEMARTRINA is usually observed. For diagnosis, X-ray, ultrasound joint, arthroscopy, CT, MRI and other studies are used. Therapeutic tactic depends on the type of damage.

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General

The injury of the knee joint is one of the most common damages, which is due to the high load on this segment and its anatomical features. Most injuries are light, arise in everyday life (for example, when falling on the street) and are subject to outpatient treatment in the trauma. In addition, the knee joint often suffers during the class of various sports, while the severity and nature of injuries can vary greatly.

In the radiographs of the knee joint, the unevenness of the articular gap is detected. On the MRI of the knee joint determines the violation of the integrity of the ligament. The most informative diagnostic method is an arthroscopic study that allows you to visually assess the condition of the ligament, and in some cases - and restore its integrity. Treatment of supervisors is usually conservative. Perform the joint puncture, apply the plaster for 3-4 weeks, if possible, rejecting the leg in the direction of the injured ligament. Subsequently prescribe LFK and massage. When ruptures usually required operational treatment - Stitching or plastic ligaments. After restoring the integrity of the ligament, physiotherapeutic procedures are prescribed, rehabilitation activities.

The breakdown of the tendon of the four-headed muscle and its own bundle of the patella occurs due to the impact of either a sharp bending of the tibia with the tense muscles of the thigh. There is intensive pain and a breakdown of gait, the patient's foot begins when walking. The patient cannot raise the straightened leg. Hemarthrosis is absent. Palpation of the injured area of \u200b\u200bpainful, signs of pathological mobility are absent, feeling of bone structures is painless.

The knee injury is diagnosed on the basis of clinical signs, if necessary, the patient is directed to MRI. In the overnights, immobilization is carried out for 3-4 weeks, then prescribed physiotherapy, massage, leaf and water procedures. When ruptures, surgical intervention - suture tendon or bundles. After the operation, analgesics, antibiotics and physiotherapy are prescribed. Be sure to conduct an exercise program for preventing the development of the contracture of the knee joint, the preservation of the tone and the strength of the muscles.

Damage to Menishov

Fractures in the area of \u200b\u200bthe knee joint

The fracture of the patella is formed when falling on the front of the knee. Accompanied by intense pain, swelling, hemarthrosis and inability to keep the raised straight leg. Support is difficult or impossible. When palpation of the patella can be determined by the "failure" - diastasis between fragments, which is formed due to the reduction of the four-headed muscle. The diagnosis is confirmed by the roentgenography of the knee joint. Treatment of fractures without displacement conservative - immobilization by 6-8 weeks. When fractures with displacement, surgery is shown, during which the fragments are tightened and combined with each other with a special wire. Then prescribe physiotherapy, massage, leaf and painkillers. The recovery period ranges from two to three months.

The fractures of the legs and hips are the most severe injuries of the knee joint. Food as a result of high-energy impact. Usually accompanied by damage to other structures (ligaments, meniscoves). Often observed in the composition of the combined injury. Manifests acute pain, significant edema, hemarthrosis and knee deformation. Movement is impossible. When palpation, crepitiation is sometimes determined. Treatment, as a rule, conservative: skeletal extract or gypsum. With a pronounced displacement, osteosynthesis of fragments with screws, plate or bolts-tie are carried out. Patients prescribe LFCs and physiotherapeutic procedures, rehabilitation measures are carried out in the recovery period.