Subluxation of the knee joint is an injury that is characterized by a partial displacement of the bone articular surfaces forming the knee joint. It differs from a dislocation, since with the latter the articular surfaces lose contact with each other when displaced, while with a subluxation they do not lose contact, but not to the full extent.
In simple words, a subluxation of the knee joint is the so-called incomplete dislocation, which is characterized by a partial preservation of joint activity, while with a complete dislocation it loses its inherent motor active function.
Anatomical features
The anatomical structure of the knee is quite complex: the structure of the joint includes a lot of main and additional components that provide extensive motor functionality. In addition, the knee joint is the largest in the body. One of his duties is to support the weight of the human body. Despite such a complex structure, the knee can be injured.
Three bones enter the backbone of his joint:
The patella is a shield against numerous traumatic factors, protects a large number of fragile ligaments from shock. The areas of the femur that form the joint are called the condyles - medium-sized elevations covered with cartilaginous tissue. A little lower is the tibial plateau.
Cartilage
Soft and tight contact to the surfaces of the joints is ensured by the cartilage coating, whose thickness reaches 6 mm. In addition, cartilage fibers cover the back of the patella. This structure reduces the degree of friction between the components of the joint and provides cushioning.
Limiters and strengthening movements is the ligamentous articular apparatus. The cruciate ligaments, which are located directly in the center of the joint, limit the movement of the knee forward and backward. The cruciate ligament in front holds the tibia, while the posterior ligament does not allow it to go back.
Menisci
The articular menisci are directly located between the bones - also cartilaginous formations, however, they have some differences from the classic cartilage. Thanks to the menisci, an even weight distribution is created that presses on the knee from above. They sort of distribute all the pressure of the body on the surface of the bone, which is adjacent to the knee.
The sensitive area of the knee joint is provided by the sciatic and tibial nerve. Nerve fibers branch and go through all areas of the joint, including menisci. But knee innervation is not developed as well as in other joints, and therefore, with serious injuries, he experiences a shortage of supply of nerve impulses, and as a result, tissue dystrophy occurs.
Types of Dislocations
Dislocation refers to the complete displacement of the bones of the joints when they completely go beyond the castle formed by the contacting surfaces, losing the channel that guides them: the condyles of the pineal gland leave the deep plateau of the tibia, while the patellar leaves the anterior groove of the femur.
With incomplete displacement and partial preservation of the contact of the surfaces of the joints, such a dislocation will be called a subluxation of the knee joint, that is, incomplete.
Such injuries can be closed if the skin is not affected, and open when manifested in external damage.
A complicated dislocation is considered when combined with damage to the meniscus, bones, muscles, nerves and blood vessels.
What other types of knee dislocations are there? They are separated for the reasons that caused them:
- mechanical (accident, sudden sudden movement, strong blow);
- pathological - due to inflammatory, degenerative and dystrophic processes in the bones, as well as osteopathies: osteoporosis, osteoarthritis, arthrosis, etc.
- chronic (habitual) - occur due to the anatomical specificity of the human musculoskeletal system;
- congenital - due to pathologies of bone development;
- chronic - occur due to untreated primary injury.
Causes
Subluxation of the knee joint can be in both children and adults. It can provoke:
- deviations in the structure of the skeleton of the legs;
- weakened thigh muscles;
- previous knee injuries due to bumps, jumps, accidents, falls;
- surgical interventions on the patella;
- falling from height;
- sudden contraction of the femoral quadriceps.
After an injury, the usual subluxation may form in the body. Its characteristic feature is that it becomes a source of instability of the kneecap and, with minimal injuries or physical exertion, causes another development of the disease. This is a dangerous condition that can subsequently lead to the appearance of post-traumatic arthrosis.
What are the symptoms of subluxation of the knee?
Symptoms and treatment of knee subluxation in adults and children
In its manifestations, subluxation is quite similar to dislocation:
- the patient complains of pain in the affected joint; however, it happens that a person may not experience pain at all (such a difference is determined by an individual threshold of sensitivity);
- joint modification;
- edematous phenomena, there may be redness and heating of the joint; the victim can talk about a subjective feeling of heat in the knee;
- limited action and pain with passive.
In some cases, the symptoms of subluxation of the knee joint can be so insignificant that the victim does not know about the pathology on his own. It is detected during a random examination or visit to a doctor.
In the knee joint, a subluxation can determine the x-ray. An indicator of a healthy knee joint in a direct projection is the uniform thickness of the joint gap throughout the interval between the bones and the parallelism of the lines connecting the vertical edges of both bones. In the lateral projection, you can examine the shape of the condyles of the femur, the condition of the patella, and also the physiological space of the knee joint (diamond-shaped space). Ligaments of the knee joint (cruciate, patellar ligaments ), which are injured quite often, can only be examined using MRI.
First Aid: Procedure
First aid must be provided as early as possible while the joint is still in a “fresh" state. How quickly attention will be paid to it will determine the number of consequences before and immediately after treatment.
If a subluxation of the knee joint is suspected in a child, then in no case should you try to correct it yourself, as this can cause even more significant joint damage.
First you need to immobilize and securely fix the injured place. This requires the use of improvised means, for example, thin linens, clothes, solid oblong objects (twigs, plywood, sticks). In the absence of solid material, a healthy leg can be attached to the injured leg.
The next step is cooling. You need to apply cold to the knee. Ice is a great option, but it must be wrapped in a dense cloth and only then applied. Thanks to this action, tissue frostbite is prevented. Also, instead of ice, you can use cold water poured into a bottle or heating pad.
It is important to remember that only a competent specialist, a doctor who practices in the field of orthopedics and traumatology, can set the knee subluxation. Incorrect movement of a person without experience will cause complications in the joint, and as a result, a subluxation will develop into an ordinary dislocation.
How to treat knee subluxation?
Treatment features
The main treatment method for subluxation of the knee joint becomes reduction. The specialist will first of all evaluate the local condition of the knee. In some cases, additional diagnostics are required - arthroscopy or radiography, but the need for such an instrument is usually infrequent: as a rule, subluxation is diagnosed simply and does not present difficulties for a practicing traumatologist. Then the doctor makes manipulations that are aimed at reducing the pathology.
You can also treat knee subluxation at home.
Actions at home
Sometimes, due to various circumstances, it is not always possible to send the victim to a medical facility. In this case, home therapeutic methods will come to the rescue. Primary care is the same as for regular care. Then you need to leave a subluxation of the knee in a calm state for a long period.
To improve blood circulation it is very important to put the lower part of the damaged limb on the roller. And further care of the joint consists in daily lubrication with ointments, which have strengthening and warming properties.
Treatment of subluxation of the knee should be timely.
Recovery period: features of rehabilitation
The victim after any treatment needs to undergo a rehabilitation course. After the joint is repaired, the patient is referred to a doctor competent in the field of rehabilitation. The duration of recovery after subluxation of the knee joint, on average, is from two weeks to two months: the knee apparatus is provided with a large number of structures, and each of them requires restoration. The rehabilitation course includes the following activities:
- treatment with ointments and, if necessary, painkillers;
- physiotherapeutic procedures, which include therapeutic massage, bathtubs, self-massage, restorative activities, visiting pools;
- a rational and balanced menu with such specific dishes as jelly, it contains a large number of substances that are useful for restoring joint components; jellied meat is especially useful for tendons and ligaments;
- Exercise therapy and exercises.
At first, it is necessary to limit the number of loads, gradually return the motor function to the knee. After completing the rehabilitation course, it is advisable for the patient to continue to do gymnastics and simple physical education.
To prevent the formation of subluxation of the knee joint in a child, you need to train the muscles, walk more often, add work to the joint, eat foods containing minerals and vitamins. One of the most common recommendations for avoiding subluxation of the knee joint in children is to avoid situations fraught with injuries.
Dog joint problem
Dislocation and subluxation of the knee joint in dogs of small breeds is a frequent problem, which can eventually cause severe lameness in the animal, requires contacting a veterinarian in a timely manner. The following breeds are most often predisposed to it: dwarf poodle, chihuahua, Yorkshire terrier, toy terrier and their crosses.
To determine the cause of subluxation of the kneecap, in addition to examination, a special study of the limb with pathology is required - an x-ray. Conservative treatment in this case is the use of anti-inflammatory and analgesics. It makes sense for small violations to maintain the animal.
Since this problem is mechanical in nature, the stabilization of the joint by surgery is a priority treatment method. Her method is determined by pathological changes in the patella. In some cases, a combination of several methods is required, since a subluxation can be caused by a number of factors.