Speaking of the knee, most people mean the knee joint. Indeed, it is an important anatomical part, however, its functionality without muscles and tendons is impossible. When walking, running, playing sports, the specified area has a significant load, increasing the risk of damage. Let us consider in more detail the knee joint, ligaments, muscle system and problems that arise during the action of the traumatic factor.
Anatomy Features
Three bones participate in the formation of the joint: part of the femur, patella and part of the tibia. The patella is represented by the femoral-tibial and femoral-patellar joints. Anatomical features contribute to the simultaneous mutual movement of bones in several planes.
The menisci, represented by cartilage from the connective tissue, are the “pads” between the heads of the bones. Their function is to provide depreciation, distribution of pressure and load during movement. On both sides, the menisci are connected to the joint capsule using the coronary ligaments.
The following muscle groups are stabilizers of the joint, awareness of which is considered an important point during trauma:
- The quadriceps muscle occupies the front of the thigh. It is considered the strongest anatomical structure of the muscle apparatus of the specified area.
- The tailor muscle is the longest. It provides flexion of both the hips and lower legs, bypassing around the knee joint.
- The thin muscle extends behind and slightly to the side of the joint, allowing the hip to flex and bend the knee.
- The major adductor muscle is involved not only in the adduction of the thigh, but also in its extension or extension of the pelvis in relation to the hip.
- The biceps muscle of the thigh passes behind the transverse axis , allowing you to bend the lower leg, extend the thigh, and provide outward movement.
- A back tendon muscle extends behind and inside the joint, extending the thigh, bending the lower leg and providing circular rotation of the limb.
- The semi-membranous muscle performs functions similar to the sub-tendon .
- The triceps muscle of the lower leg bends the lower leg in the knee and foot in the ankle joint.
- The short and flat popliteal muscle is located on the back surface. The function is to bend and rotate the lower leg.
Knee function
The performance of the knee joint is important for the human body. In it, movement along the vertical and frontal axes is possible. Extension and bending occurs along the frontal axis, along the vertical - rotation of the limb.
Bending the joint allows a person’s leg to take a step forward, not hitting the limb on the ground, but carefully placing it. Otherwise, the person’s leg would be carried in the upper front direction by raising the thigh.
Ligamentous apparatus
The knee joint, the ligaments of which are represented by the five main groups, is considered an anatomically complex part of the body. Its composition includes the following types of ligaments:
- collateral (tibial, fibular);
- cruciform (front, back);
- transverse ligament of the knee;
- posterior (arched, popliteal, ligament of the patella, medial and lateral);
- coronary (meniscus-femoral, meniscus-tibial).
In injuries, especially sports injuries, the main load occurs on the cruciate ligaments of the knee joint. The terms of recovery and rehabilitation period depend on the nature of the injury and the damaging factor, the characteristics of the victim’s body, last from 4 to 6 months.
Cruciate ligaments and their functionality
The anterior ligament passes from the posterior upper part of the meniscus of the femur through the cavity of the knee joint, attaching to the tibia, which enters the articular conglomerate. Its function is to stabilize the knee joint, limiting the movement of the lower leg forward.
The posterior ligament continues from the front of the bone protrusion of the femur and, crossing the joint cavity, is attached to the tibia in the back. The ligament does not allow the tibia to move excessively backward.
Cruciate ligament injuries
Such injuries are considered the most complex and dangerous, requiring proper treatment. Improperly selected or untimely started therapy leads to the development of lameness and a persistent restriction of functioning. Most often, such injuries occur in professional athletes when skiing, skating, jumping, wrestling, arising from a strong blow or an unsuccessful turn, fall.
Severe piercing pain and a characteristic click, a sharp restriction of mobility may indicate that the ligament of the knee joint is torn. The injured person cannot move independently, only relying on someone.
Injury to the posterior ligament occurs when the knee is excessively strong or during an impact on the anterior surface of the lower leg. Damage to the anterior cruciate ligament of the knee joint is most common. Symptoms of this injury are part of the "Turner Triad" along with a rupture of the meniscus and external ligament.
Clinical picture
The knee joint, the ligaments of which have a partial tear, becomes hyperemic, swollen, painful to the touch and when trying to move. Blood accumulates in the articular cavity (hemarthrosis). Inflammation of the ligaments of the knee joint, which has a similar clinic, should not be confused with the symptoms of trauma that occurred several days ago.
Complete rupture of the cruciate ligaments causes excessive mobility of the lower leg in the anteroposterior plane. Verification of this symptom is carried out by two specialists at the same time. The first holds the back of the thigh and bends the anesthetized limb at the knee at a right angle. The second doctor checks the movement of the lower leg forward and backward. With stretching or tearing, a similar sign will be negative.
Sprain implies a slight tear of the fibers, accompanied by moderate soreness, slight swelling, and the absence of hemorrhage. Restriction of motor function occurs to a small extent.
Diagnostics
Determining the mechanism of injury allows you to find out possible damage to the anatomical structures. Before examining the injured knee, the doctor examines the healthy one to find out the structural features. The state of internal structures is assessed using ultrasound and MRI.
Differential diagnosis eliminates bone fractures, patella, meniscus rupture. With dislocation, the bones are displaced in relation to each other, there is no possibility of motor function, there is spring resistance when trying to passive movements. For damage to ligaments, a complete lack of movement is not characteristic, it is limited due to pain. Also there is no spring resistance.
Fracture is accompanied by deformation, the appearance of crepitus and pathological mobility. However, there are fractures that do not have such signs. In this case, confirmation of the diagnosis requires an X-ray examination, ultrasound or MRI.
Treatment principles
In case of partial injuries (sprain, tear), assistance is provided at the emergency room. The limb should be in an elevated position, the first few days - bed rest. The first day after the injury requires applying cold to the damaged area. The joint is fixed with a tight elastic bandage that allows you to maintain the physiological position of the limb during movement. You can’t leave the bandage overnight so that there is no circulatory disturbance. Relieving pain requires the use of analgesics (Ketanov, Ketalong, Nalbuphine).
The knee joint, the ligaments of which require not only conservative therapy, but also surgical treatment, needs a long rehabilitation period. After all the same measures as for partial injuries, physiotherapeutic measures are used, including massage, physiotherapy exercises, electrophoresis with medications.
Quite often, surgery is required when the cruciate ligament of the knee joint has been torn. The operation to restore the integrity of the anatomical structures is necessary for normal functioning. Surgical intervention is performed six months after injury to the joint.
An ideal candidate for holding is a young athlete who needs to perform jerky movements with his limbs in his sport. Older people who do not have a lot of physical activity are more suitable for conservative therapy and the use of physiotherapy exercises.
Plastic surgery of the cruciate ligament of the knee joint requires the use of a graft taken from the ligament of the patella or hamstring (autograft). The use of synthetic prostheses is also possible, however, their use may be rejected by the patient.
Suturing of synthetic grafts is a common procedure when the lateral ligament of the knee joint is torn. Treatment with surgical measures is considered the method of choice in such a case.
Surgical practice has shown that simply stitching injured structures practically does not provide restoration of functionality.
What are the complications of a knee injury?
Among the frequent complications of knee injuries, the following are distinguished:
- The development of arthritis is possible 2-3 weeks after damage to the joint. An inflammatory reaction occurs as a result of circulatory disorders and the entry of pathological microorganisms into the injury zone. It is characterized by pain, the appearance of swelling, hyperemia, limitation of mobility due to pain.
- The appearance of degenerative changes in the form of arthrosis is accompanied by the formation of osteophytes, thinning of cartilage.
Forecast
After receiving the injury, most victims are interested in: “How much does a knee joint rupture heal?” A similar question is considered in each clinical case individually. Depending on the nature of the injury and the characteristics of the body, full working capacity may return in six months, or maybe in a few months.
The damage mechanism itself is important and how the victim received a rupture of the ligaments of the knee joint. How much the injury heals also depends on the exact adherence to the advice of the attending specialist. The early start of therapy, taking the necessary medications and following the regimen can speed up the healing process and prevent the development of complications.
Prevention
The list of preventive measures used to minimize joint damage is reduced to the following measures:
- adequate physical activity;
- inflammation of the ligaments of the knee joint should be treated promptly;
- balanced diet;
- quitting alcohol abuse and smoking;
- avoidance of hypothermia;
- control of the minimum stay of limbs in static poses;
- the right choice of shoes, the rejection of high heels.
Injury to the knee joint can be prevented, which refers to simpler measures than restoring its functionality due to damage.