In traumatological practice, it is customary to call a sprain of the ligaments of the knee joint a pathology in which a variety of macro- or micro-fractures occur in the connective tissue and its fibers, fixing the integrity of the bone joints. As a result of this, a violation of the anatomical structure of this joint occurs, a change in its functionality develops. Timely seeking medical help at the same time avoids the negative consequences of such a pathology, and familiarization with the symptoms of this phenomenon - seek help on time. How to treat a knee sprain, we will consider in this article.
Features of the structure of the knee joint
The knee is the most difficult joint bone structure in the human body. It is formed by the largest bones - the femur (tubular), sesamoid (patella) and tibia. Special cartilaginous layers called menisci connect the surfaces of the bones under each other, and special fat bodies and synovial bags are present between the tendons of the muscles.
Ligamentous apparatus
This complex structure is fixed not only by the muscular system, but also directly by the ligamentous apparatus. It includes:
- Lateral (collateral) ligaments that connect the femoral tibia on both sides. Stretching of the lateral ligaments of the knee joint occurs very often.
- Cruciate ligaments localized in the synovial cavity, crossing his menisci between themselves.
- The ligament of the patella, which performs the function of connecting the tibia and the patella.
So, what leads to a sprain of the knee joint (ICD-10 - S83.4)?
Causes of occurrence
Damaging effects on the ligamentous apparatus of the knee are:
- Excessively intense bending of the legs.
- When a joint warmed up while running is made to stop abruptly.
- Improper lifting of heavy objects.
- Sharp jumps.
Type of injury
There are several types of injuries, depending on the type of ligament:
- In order for a pathological extension of the lateral ligaments to occur, it is necessary that the bones of the leg or thigh sharply shift to one side. This happens with side impacts on the knee.
- When the cruciate ligaments are stretched, the knee joint must be sharply bent or unbent. This, as a rule, occurs at the moment of falling onto the joint or receiving a blow to it, and the force vector of such a blow should be directed from behind.
- A specific patellar ligament is stretched in cases when a person falls on his knee or lands when jumping.
The most traumatic for knee ligaments are sports such as basketball, bodybuilding, intense running, football, ice skating or skiing, and hockey.
Symptomatology
Sprains of the knee joint are inherent in symptoms that are also observed with dislocations or subluxations of the joint, so you should pay attention to the main reason for the appearance of such an injury. The most important symptom that the patient complains of is a sharp and sharp pain that appears immediately. With a slight stretching of the ligamentous apparatus of the knee, the pain may appear a little later - after about half an hour. The pathogenesis of pain is caused by a large number of nerve endings located in the ligaments themselves. The pain can be aggravated by exertion and pressure, and there is also limited or no movement in case of damage to this articular apparatus.
Bruising
The next symptom of sprain of the knee joint is the appearance of bruises (hematomas), which is caused by the presence of blood vessels in them - hemorrhage under the skin from such vessels occurs when they are damaged or into the joint cavity (hemarthrosis). An increase in the knee joint in size is due to the accumulation of blood in it, if a violation of the integrity of the vessels still occurs.
With a sprain of the knee joint, a symptom of a “drawer” can also be observed when the lower leg is excessively shifted back or forward.
In addition, signs of elongation of the knee-ligamentous apparatus are all kinds of clicks, crunching and crackling, which occur, as a rule, with movements of the limb.
First aid
Immediately, with the development of the first symptoms of sprain of the knee joint, ice should be put on its area (by wrapping it in dry tissue). A similar procedure should be done as follows: apply ice every half hour for two hours, and then repeat every six hours for fifteen minutes.
The leg cannot be bent at the knee, it must be laid on a flat surface, slightly raised upward, and bandage the area from the middle third of the leg to the thigh with an elastic bandage.
Pain medication
The first aid procedure also includes taking painkillers (Ibuprofen, Analgin, Diclofenac) or applying local anti-inflammatory creams to the damaged area without a warming effect (Voltaren-Emulgel, Diclofenac-Gel, Ibuprofen-Gel " etc.).
Seeking help from specialists after trauma is mandatory, and this must be done in the coming hours.
If in time to make all the necessary medical manipulations with sprain of the knee joint (ICD-10 code - S83.4), then it happens:
- Normalization of venous outflow from a damaged ligamentous apparatus.
- Narrowing of the bringing blood vessels (i.e. hemorrhage into the tissue surrounding the joint or directly into its cavity will be significantly reduced).
- Reducing further trauma to patients ligaments.
Subsequent therapy depends on how high the degree of damage to the knee ligaments and which ligaments were injured. If a mild degree of such a pathological condition is diagnosed, then on the second day it is no longer necessary to apply ice, but the limb must still be in a fixed and elevated state.
Treatment for sprain of the knee should be comprehensive.
Therapeutic procedures
After a few days, the use of the following therapeutic manipulations begins:
- Thermal physiotherapy.
- Warm wet compresses by applying a clean cloth dipped in warm water or herbal infusions.
- Dry heat - by applying a warm heating pad.
- The use of anti-inflammatory gels and ointments.
- The use of warming ointments - Viprosal, Apizartron.
The prescribed ointment should be applied to a small area of the skin to observe the skin reaction: if there is no allergic reaction to this medication, it can also be applied to the affected area several times a day until the symptoms of the pathological condition disappear.
Means for improving blood microcirculation
In addition, traumatologists recommend the use of local medicines that improve blood microcirculation in damaged tissues and stimulate venous outflow from them. Very effective are drugs such as Lyoton and Troxevasin, which are used simultaneously, mixing ointments in the same proportions.
How to treat a sprain of the knee joint is interesting to many patients.
Medium to Severe Therapy
For moderate to severe sprains, the following therapy is used:
- The knee joint is immobilized with a plaster retainer for several weeks.
- Some anti-inflammatory drugs are used - Ibuprofen, Nimesil, Diclofenac, both in the form of medicines for topical use and for systemic therapy taken orally.
- Approximately on the fifth day, a thermal effect on the knee joint should begin, but not in the form of wet compresses or dry heat, but in the form of physiotherapy.
- To normalize the circulation in the vascular system of the knee ligaments, medications are used in the form of injections - “Clexan” and “Actovegin”.
- After the plaster cast is removed, it is necessary to carry out massages and carry out a specific set of therapeutic exercises, individually selected in each case.
Severe degree
Extremely severe degree of sprain of the knee joint is treated exclusively in an operative way. If the torn ligaments are not stitched, there is a high probability that further movements in the knee joint will be impossible.
After surgery, a special plaster cast is applied to this joint, which should be worn for about two months. At this time, the patient is also prescribed medication, which involves prem of the same drugs as with whiter than light degrees of stretching
Subsequently, a course of some rehabilitation measures is carried out: massage, exercise therapy, swimming, physiotherapy.
Lateral ligaments
Sprain of the lateral knee ligaments is treated, as a rule, by conservative methods. The damaged site is anesthetized with local injection of lidocaine. If blood is present in the joint, then it is removed with a needle and syringe. Subsequently, gypsum is applied to the limb. Even if the internal lateral ligaments are completely torn, the operation in this case is not carried out. However, if there was a rupture of the collateral external ligament, then an operation is necessary: this ligament is either sutured or a flap is removed from its own tendon, which connects its edges. What else is used in the treatment of sprain of the knee joint?
Physiotherapy
Physiotherapeutic procedures are aimed at achieving the effects of anesthetic effect. The following methods are used for this:
- Ultrasonic exposure.
- Phonophoresis with lidocaine or novocaine.
- Magnetic laser exposure.
- Pulse magnetotherapy.
- Decimeter therapy.
- Electrophoresis with medicines anti-inflammatory activity.
- Magnetotherapy.
- Laser Therapy
- Exposure to a low energy laser.
Such symptoms are not considered pathognomonic and may accompany some pathological disorders of the knee joint. Therefore, for the correct diagnosis of pathology, it is necessary to consult a doctor and conduct such instrumental methods as:
- X-ray of the knee.
- MRI
- Ultrasound of the knee
- Arthroscopy
- Video endoscopic apparatus.
Such a sprain is considered a very serious injury that occurs most often during sports and is manifested by pain, hematoma and swelling in this area.
Effectively treating knee sprain at home.
Alternative treatment methods
Treatment of this pathology without fail should be comprehensive. In this case, not only conservative methods of therapy are used, but also specific methods of traditional medicine. The emphasis is on compliance with the instructions of the traumatologist. If a professional approves thermal procedures, you can use knee warming with ordinary sand or salt, which is heated in the oven to a certain temperature. The mixture is poured into a tissue bag, which is placed on the injured knee and covered with a blanket. Such a procedure lasts at least 10 minutes and is repeated every hour on the second day after injury.
Subsequently, when stretching the ligaments of the knee joint (ICD-10 - S83.4), you can use all kinds of compresses:
- A milk compress is one of the best methods to speed up the restoration of ligaments. To do this, you need to warm the milk to 60 degrees, moisten it with tissue and apply it to the knee joint. It takes about two hours to hold such a compress.
- The use of egg white also gives very good results. To do this, you need five eggs of protein, which is applied to the tissue, superimposed on the affected area and covered with plastic wrap or paper on top.
- The use of grated raw potatoes. This mass is wrapped around the joint, covered with a bandage on all sides and left overnight.
In addition to the above recipes, you can apply a variety of vodka compresses and lozenges using mustard and other heating agents. However, when using such methods of therapy, one should carefully monitor the condition of the injured knee so as not to further aggravate the course of the disease. It is advisable to do this after the doctor's recommendations and under his supervision.
We examined knee sprain. An ICD-10 code has also been provided.