Sports Injury

 

Sports Injury of Knee

Introduction

Ligament and meniscus injuries in the Knee  are dreaded by professional and amateur athletes alike. They can be painful and debilitating. They can even permanently change lifestyle. But there is good news. While an ACL injury or other ligament and meniscus damage once ended the career of many an athlete, treatment has become much more successful.

Ligaments are tough bands of tissue that connect the bones in joints. There are four ligaments in the knee that are prone to injury. Two important ligaments in the knee, ACL (anterior cruciate ligament) and  PCL(posterior cruciate ligament)  connect the thigh bone(femur)  with the tibia, one of the two bones of the  leg. ACL injury  is a common cause of disability in the knee. The lateral collateral ligament (LCL) connects the thigh bone to the fibula, the smaller bone of the leg on the lateral or outer side of the knee. The medial collateral ligament (MCL) also connects the thigh bone to the leg bone on the medial or in side of the knee.

 

Meniscus is cartilage that cushions the space between the bones in the knee. Two meniscus( medial & lateral) in one knee transmit weight from thigh bone to leg bone and gives stability to knee.

Too much stress on these ligaments can cause them to stretch too far -- or even snap.

ACL injury and other ligament injuries can be caused by:

-Twisting of  knee with the foot planted.

-Jumping and landing on a flexed knee.

-Getting hit on the knee.

-Extending the knee too far.

-Stopping suddenly when running.

-Suddenly shifting weight  from one leg to the other.

-These injuries are common in soccer players, football players, volleyball players,   cricket players, basketball players, skiers, gymnasts, and other athletes.

Symptoms of a knee ligament injury are:

-Pain often sudden and severe

-A loud pop or snap during the injury

-Swelling

-A feeling of looseness in the joint

-Inability to put weight on the point without pain

 

When will you feel better after a knee ligament injury?

Recovery time depends on how severe your knee ligament injury is. People also heal at different  rates. In most cases, physical therapy can help after surgery to minimize complications and speed recovery.

While you recover -- If your medical team agrees -- you could take up a new activity that won't hurt your knee. For instance, runners could try  swimming.

Whatever you do, don't rush things. Don't try to return to your old level of physical activity until:

 -You can fully bend and straighten your knee without pain.

-You feel no pain in your knee when you walk, jog, sprint, or jump.

-Your knee is no longer swollen.

-Your injured knee is as strong as your uninjured knee.

-If you start using your knee before it's healed, you could cause permanent damage.

What is  the treatment for a knee ligament Injury?

 How Can you Prevent a Knee Ligament Injury?

Knee ligament injuries are hard to prevent since they are usually the result of an accident. But taking some precautions might lower the risks of ligament injury. One should:

-Keep  thigh muscles strong with regular stretching and strengthening.

-Warm up with light activities before taking part in more aggressive activities.

-Maintain flexibility.

-Never abruptly increase the intensity of your workout. Make changes slowly.

 

How knee Arthroscopic surgery is performed 

A number of methods can be used to reconstruct an anterior cruciate ligament (ACL). The most common method is to use a tendon from elsewhere in patient’s body to replace the  torn ACL. 

Patient will either have a general anaesthesia  or a spinal anaesthesia. The operation will take 1-1.5 hours and will usually require an overnight stay in hospital. 

Examining of injuried knee

After anaesthesia, the surgeon will carefully examine the inside of the injuried knee, usually with a medical instrument called an Arthroscope .

 

Surgeon will check that  ACL is torn and look for damage to other parts of the knee. If there is other damage, surgeon might repair it during the surgery or it may be treated after the operation.

After confirming that  ACL is torn,  surgeon will  harvest  the graft tissue ready for relocation.

Graft tissue

A number of different tissues can be used to replace torn ACL.Tissue taken from the patient’s own body is known as an autograft. Tissue taken from a donor is known as an allograft. Before  operation,  surgeon will discuss the best option with patient. Tissues that could be used to replace torn ACL are listed below.

 

Patellar tendon – this is the tendon running from the bottom of the kneecap (patella) to the top of the shin bone (tibia) at the front of the knee.

Hamstring tendons – these run from the back of the knee on the inner side all the way up to the thigh.

Quadriceps tendon – this is the tendon that attaches the patella to the quadriceps muscle, which is the large muscle on the front of the thigh.

An allograft (donor tissue) – this could be the patellar tendon or Achilles tendon (the tendon that attaches the back of the heel to the calf muscle) from a donor.

A synthetic graft – this is a tubular structure designed to replace a torn ligament.  

 

The most commonly used autograft tissues are the patellar tendon and the hamstring tendons. Both have been found to be equally successful.

Allograft tissue may be the preferred option for people who are not going to be playing high-demand sports, such as basketball or football, as these tendons are slightly weaker. Synthetic (man-made) tissues are currently used in certain situations, such as revision surgery and multi-ligament injuries.The graft tissue will be removed and cut to the correct size. It will then be positioned in the knee and fixed to the femur (thigh bone) and tibia (shin bone) with biodegradable screws.