Stability of the knee joint is a condition in which the musculoskeletal system continues to function normally and perform basic tasks. The correct mobility of the joint is provided by the muscles and meniscus, which are combined with the bearing passive parts of the knee. They represent the posterior and anterior cruciate part of the ligamentous apparatus and the medial collateral and lateral or otibial tract. Correctly functioning muscles located near the joint bag give the knee good dynamic stability. It is important to establish the main causes of knee instability.
Defeat features
The knee includes many tendons, as well as intertwined ligaments, at the rupture of which the joint becomes unstable, which most often requires the installation of an endoprosthesis to improve the condition of the knee and the vital activity of the patient. If you do not start a comprehensive and proper treatment, as a result, a person may lose the ability to move.
To understand the causes of the lesion, it is important to understand what the ligaments are and how they differ. They are of the following types:
- back and front cruciform type;
- medial and lateral collateral type.
In most cases, instability of the knee joint occurs due to severe trauma or insufficient amount of useful components and minerals. This condition is common among the military, who serve in the army, especially in the northern regions of the country.
People who are professionally involved in sports are also particularly affected. They have to constantly heavily load their legs. Due to sudden movements, incorrect turns and jerks, a rupture of the ligaments of the joints occurs. Under the influence of these processes, athletes are faced with stretching of the medial and collateral ligaments when jumping.
The cause of knee edema and joint instability can be various bruises and injuries. Injury is often provoked by inaccurate, too sharp movements, as well as twisting. If you do not start complex therapy at the initial stage of the development of the lesion, then in the future a person will have to go for a surgical operation to install an endoprosthesis, without which he simply will not be able to live normally.
Also, bruises and injuries often result in abrupt abduction or adduction of the ankle. The posterior portion of the cruciate ligamentous apparatus can be damaged by sharp bending.
The most dangerous cause of knee edema and its instability is a concussion of the extensor part and the main four ligaments. If this happened, then it is important to immediately send the patient to the clinic, where the treating specialist will conduct an x-ray and identify the degree of damage and, based on this, prescribe the patient treatment with local drugs or surgery. The recovery time of the knee joint and the chance of movement without problems in the future will directly depend on the chosen therapy.
Symptoms of the disease
With joint instability, a person often has symptoms that, due to their variety, can easily confuse him and lead him to untimely seek help from a doctor, since he considers that the disease is not serious.
The main symptoms of knee instability:
- If the joint capsule is in a normal state, then balloting and smoothing of the contour occur in the patella. When the capsule ruptures, nothing of the kind arises.
- If the lateral collateral ligamentous section burst, then a pronounced bruising occurs on the inner popliteal side. This condition occurs, as a rule, with an average degree of injury.
- If the cruciate ligament ruptures, then the person feels an unpleasant pain syndrome, which can cause severe swelling and hematoma.
- If the injury affects the meniscus, then the knee moves and blocks, which leads to the appearance of acute pain. In this case, the patient cannot normally bend and extend the legs in the knee joint.
- If the cruciate ligament is damaged, the posterior capsule rupture additionally occurs and pronounced edema occurs in the popliteal region.
- If the anterior cruciate part of the ligamentous apparatus is damaged, the tibia changes its location, begins to move in the wrong direction, which provokes the rapid deformation of the meniscus and cartilage tissue. This type of injury is common among children with fast running or falling.
The degree of development of the disease
Doctors distinguish the following degrees of development of chronic instability of the knee joint:
- In the first degree, the tibia and femoral articular surface change their position and are displaced by 5 millimeters from each other. The capsule in this case remains in a normal state, the ligaments are relaxed. Such a process most often occurs in infants as a result of a congenital pathology or trauma in the process of natural labor.
- Instability of the knee joint 2 degrees. Between the articular surfaces there is a large distance (up to 10 millimeters). The injury is accompanied by severe deformation of the affected area of ​​the cruciate ligamentous apparatus. Most often, such a lesion occurs in athletes.
- Third degree. The tibia and femur articular bone are located in relation to each other at a distance of more than 10 millimeters. As a result of this condition, the posterior and anterior cruciate parts of the ligamentous apparatus break. To get rid of this type of damage is possible only through surgical intervention, installation of an endoprosthesis and a long course of treatment.
Degree Classification
All types of instability are classified in degrees:
- in the first stage of the lesion, instability reaches 5 degrees;
- in the second stage, the deviation ranges from 5 to 8 degrees;
- in severe stages of the lesion, a deviation from the norm exceeds 8 degrees.
Diagnostic event
To accurately determine the presence of problems with the condition of the knee joint, doctors carry out the following activities:
- First, a specialist carefully examines the leg, assesses the location of the ligaments and the appearance of the knee itself. After the measurement of the leg, as in the presence of a dislocation, its length can be significantly reduced. The information obtained will allow the specialist to determine exactly what should be done next and what diagnostics to carry out.
- If a hematoma suddenly occurs in a sick area, then the joint is anesthetized with an anesthetic, which helps not only to eliminate the pain, but also to cope with spasm. After the specialist carries out a puncture with further diagnosis.
- After an external examination of the legs, an MRI, computed tomography and x-ray are performed, in some cases arthroscopy is additionally prescribed.
- On the X-ray image obtained, it is possible to examine the condition of the joint well and accurately evaluate it, and then establish a diagnosis based on the classification of the instability of the knee joint. Instability can be of the following types: lateral, posterior, medial, anterior, combined. The course of treatment will directly depend on how badly the affected area was damaged.
- After the doctor determines the presence of all degenerative changes, reveals the state of bone tissue. If surgical intervention is prescribed to install the orthosis on the knee joint with hinges, then the doctor first assesses the installation site and selects the type of prosthesis.
Only after the attending specialist receives all the information about the condition of the knee joint, examines all the symptoms and reviews the test results, he will be able to prescribe an effective and efficient treatment, as well as preventive measures that will need to be followed after recovery.
During treatment, it is important to strictly follow all the advice and recommendations of a doctor so that the knee joint is more likely to recover and not lose its performance.
Treatment features
After classifying the instability and identifying the exact cause, the doctor prescribes an effective course of treatment that helps to restore the working capacity and normal condition of the joint. The duration of treatment will directly depend on the degree of defects, a person’s lifestyle and his age. Most often, for a full recovery, you need to wait from several weeks to several months.
Therapeutic measures should be aimed at restoring the mobility of the knee department without surgical intervention, if this, of course, is possible.
But in the event that the knee regularly changes its location, damages the ligaments, then without installing an orthosis with joints on the knee joint, it will be impossible to cope. Recovery after surgery continues for 6 months.
Therapeutic measures
If the traumatologist determines 1 or 2 degree of the disease, then the patient will be prescribed the following treatment:
- Laying a tire on a sore leg.
- To fix the joint in a certain position, a splint or bandage is used.
- Therapy may include taking non-steroidal drugs.
- The specialist prescribes physiotherapy, which includes electrophoresis based on restorative and tonic agents. This treatment is used if there are problems with the child’s joints as a result of recent illnesses. The congenital form of the lesion is treated with other methods.
- Appointment of special ointments for the knees.
- In addition, the doctor can prescribe massages that will help improve metabolic processes, restore blood circulation.
- To restore mobility and strengthen muscles, you should begin to perform a set of exercises for instability of the knee joint, an orthopedist will prescribe it.
If conservative treatment has not yielded any results, then the specialist suggests surgery. Surgery for joint instability is also performed when the ligamentous apparatus is torn. It is called arthroscopy in medicine. During the operation, the specialist performs an incision through which damaged tissue is sutured.
After surgery, the specialist prescribes a knee ointment, massage and simple exercises to the patient. After a 6-month rehabilitation, most often the patient's condition is restored and the previous normal mobility returns to him.
Endoprosthetics
In some patients, instability of the knee joint after endoprosthetics appears, which is accompanied by an increase in body temperature, severe pain, crunch in the knee and other unpleasant symptoms.
Pain can indicate an infection, contracture, synovitis, joint instability, and other serious complications.
At the beginning of a purulent-inflammatory process, a person experiences severe pain in the head, a feeling of malaise, chills and fever. He also has unpleasant sensations in his knee, and the skin around him becomes hot. The pain is distinguished by its bursting nature, and anesthesia with tablets and ointments does not give a positive result.
Knee instability is considered the most critical complication. The reason for this condition is a violation of the full sliding of the patella in the frontal plane, which occurs due to improper installation of the implant. During the first year after surgery, instabilities of this nature are diagnosed in 1.5% of patients.
The appearance of a complication does not depend on the experience of the surgeon and the type of prosthesis. To eliminate instability, the patient is undergoing endoprosthetics. When conducting repeated surgery, the doctor eliminates the error in the approximate part of the installed implant. Together with this, surface prosthetics are performed.
Hyaluronic Acid Injections
Doctors often prescribe injections of hyaluronic acid in the joints to improve the general condition and mobility of the patient. This method is the only one that gives a full effect. Injections are done with a syringe, in which all the medicines prescribed by the doctor are located. The procedure is carried out according to the proven method, problems can arise only when injecting into the hip joint, but they are not considered dangerous, as the patient’s state is controlled by x-rays.
But it is important to remember that prices for injections of hyaluronic acid in the knee joint do not always guarantee the quality of the product used.
Medicines with hyaluronic acid in the composition are produced in three forms: capsules, ointments and injection. Such funds are created in Russia, as well as in foreign countries. All of them are very different from each other in their formula and value. Prices for injections of hyaluronic acid in the knee joint can be different:
- Domestic funds - from 2500 to 3,500 rubles.
- From manufacturers from Austria and Germany - from 5,200 to 22,000 rubles.
- USA - from 9 900 to 23 000 rubles.
- Italy - from 4,000 to 6,600 thousand rubles.
Preventive actions
Each patient knows that it is much easier to prevent the disease than to undergo a long complex treatment, as well as surgical intervention. The following preventative measures should be followed:
- apply orthopedic insoles or wear special shoes;
- wear high-quality shoes of normal size, which should fix the foot well in the correct position;
- when playing sports and performing exercises, it is important to wear a special bandage;
- limit running and start swimming or doing yoga;
- eat properly;
- if people involved in sports have serious joint problems, then they should stop exercising.
It is important to remember that such a disease is not a sentence; at the initial stage of development, it is quickly eliminated. In this case, it is important to consult a doctor in a timely manner, who will choose the rational treatment and help to avoid complications that can lead to surgery.