An expert guide to knee injuries

Knee injuries are among the most common ailments affecting people of all ages, particularly athletes. The knee, being a complex and vital joint, is susceptible to a variety of injuries that can range from mild sprains and strains to severe ligament tears and fractures.

Here, Mr Jonathan Bird, renowned consultant orthopaedic surgeon, offers an expert insight into the most prevalent knee injuries, the immediate actions to take post-injury, as well as preventive measures to minimise the risk of future injuries.

What are the most common types of knee injuries?

Knee injuries can vary greatly in terms of severity and type. The most common types include:

ACL (anterior cruciate ligament) injuries

The ACL is a key ligament that helps stabilise the knee joint. ACL injuries often occur during activities that involve sudden stops, changes in direction, or jumping.

Symptoms of an ACL injury include:

• an audible "pop" noise at the moment of injury
• intense pain and the inability to carry on with activities
• loss of range of motion
• feeling of instability or the knee "giving way"

Meniscus tears

The menisci are two C-shaped pieces of cartilage that act as shock absorbers between the thigh bone (femur) and shin bone (tibia). Meniscus tears can occur due to twisting motions or direct impact.

Symptoms of a meniscus tear include:

• pain and swelling
• difficulty moving the knee or a feeling of being "stuck"
• a popping sensation
• knee stiffness

Patellar tendinitis

Patellar tendinitis, also known as jumper's knee, involves inflammation of the patellar tendon, which connects the kneecap (patella) to the shin bone (tibia). It’s common in athletes who engage in jumping activities.

Symptoms of a patellar tendinitis include:

• pain located at the bottom of the kneecap
• swelling
• discomfort during jumping, running, or walking
• tenderness around the patellar tendon

Knee dislocations

A knee dislocation occurs when the bones of the knee are out of place, usually due to high-impact trauma. This injury is uncommon but severe, typically involving multiple knee structures.

Symptoms of a knee dislocation include:

• inability to move the knee
• visible deformity
• severe pain
• swelling and bruising

What should I do immediately after a knee injury?

Experiencing a knee injury can be alarming, but taking prompt and appropriate action can significantly influence the outcome and speed of recovery. It’s important to:

• Rest: Refrain from placing weight on the injured knee to minimise further harm. Patients should cease all activities that could aggravate the injury and rest as much as possible.
• Ice: Apply ice packs to the injured knee for 20 minutes every 2-3 hours during the first 48 hours post-injury to reduce swelling and numb pain. Patients should wrap the ice pack in a cloth or towel before applying it.
• Compression: Use an elastic bandage or compression wrap to help control swelling and provide support. The wrap should be snug but not so tight that it restricts blood flow.
• Elevation: Keep the injured knee elevated above heart level whenever possible to help reduce swelling by allowing fluids to drain away from the knee. Pillows or cushions should also be used to support the leg.

When is surgery required for a knee injury?

Surgery for a knee injury is required when non-surgical treatments (such as rest, physical therapy, medications, or injections) fail to alleviate the symptoms or when the knee injury is severe.

Complete ACL tears typically require surgical reconstruction, especially in athletes, to restore knee stability. Similarly, surgery might also be required for meniscal tears that cause locking, significant pain, or instability, especially if they don’t heal with conservative treatment.

Recurrent knee dislocations or severe patellar fractures might need surgical intervention to realign or stabilise the kneecap.

How long does it take for knee injuries to heal?

Minor injuries, such as mild sprains, typically heal within a few weeks with proper rest and rehabilitation, while patellar tendinitis may span from several weeks to months, contingent upon the severity of the condition and the adherence to treatment protocols.

Moderate to severe injuries, such as partial ligament tears, may take 2-3 months to heal with non-surgical treatment, while meniscus tears can require several weeks to a few months for recovery depending on the treatment approach.

Recovering from surgery can vary depending on the type of knee injury and the treatment undergone. For example, ACL reconstruction typically demands 6-9 months of intensive rehabilitation before athletes can safely return to sports. Following meniscus surgery, recovery spans 3-6 months, contingent on whether the procedure involved repair or removal of the meniscus.

Are there any precautions I can take to minimise knee injuries in the future?

Preventing knee injuries involves several proactive measures:

• Warming-up and stretching: Always warm up before engaging in sports or physical activities, and include stretching exercises to improve flexibility.
• Strengthening exercises: Focus on strengthening the muscles around the knee, including the quadriceps, hamstrings, and calves, and incorporate exercises that improve balance and stability.
• Proper technique: Use proper techniques in sports and activities to reduce strain on the knees, and ensure gradual progression in intensity and duration of activities for optimal training and injury prevention.
• Appropriate footwear: When it comes to footwear, prioritise shoes that offer ample support and cushioning to protect the knees. Regularly replace worn-out shoes to maintain optimal support. If you have a history of knee injuries or participate in high-risk sports, consider using knee braces or supports for added stability and injury prevention.

To schedule an appointment with Mr Jonathan Bird, head on over to his Top Doctors profile today.