Knee Injuries Are Problematic
Knee injuries can be difficult to overcome. Unfortunately, they are commonly associated with car accidents. Most are the result of impact – with the steering column, dash, or door.
As the largest joint in the body, this pivotal hinge supports the body’s weight. The knee is not only very complicated, but is the joint most vulnerable to injury. Several varieties of knee injury can occur. Regardless of the type or severity of the knee injury, it will need to be repaired so that the patient can regain their ability to control their daily life.
Basic Knee Anatomy
Four principal bones join at the knee, creating a hinge. The femur is the thigh bone and it comes together with the tibia or shin bone. The bone on the outside of the leg is the fibula, which works hard to provide stability.
The kneecap, also known as the patella, exits to allow knee movement and weight-bearing. It brings to bear the joint and its system of muscles. The femoral condyles is located at the end of the femur. This reinforces the tibal plateau and allows for the lower part of the body to withstand the weight above it.
None of this would allow for us to walk, run or stand if it were not for the hard-working muscles that make this complex network run smoothly. The major muscles involved are the quadriceps and the hamstrings. The former, at the front of the thigh, allows for knee straightening and extending. The latter is at the back of the thigh. The hamstring muscles permit flexion (bending) at contraction. Both the quadriceps and the hamstrings meet around the knee joint and remain affixed to the tibia by the work of the tendons.
The patella is located within the quadriceps. Patients with a strong quadriceps can be expected to advance more quickly during treatment. Further strengthening the knee joint are four thick bands of thin, elastic tissue called ligaments. These strong, stabilizing features include the medial collateral ligament (MCL), the anterior cruciate ligament (ACL), the lateral collateral ligament (LCL) and the posterior cruciate ligament (PCL). The natural tendency of the knee to slip around is reined in by this cross-lattice of ligaments.
The knee relies on other parts which serve as shock absorbers. A single cartilage is known as a meniscus. These lie on the fibia, at the surface. Reduction in friction is provided by the femoral condyle, which is attached to the tibial surface. Were it not for this, tremendous friction would be generated.
Arthritis is a real problem with aging, because the menisci (multiple meniscus) get worn down; suppleness is lost. The cushioning that the knee requires is enhanced by sacs filled with fluid, known as bursas. The important prepatellar bursa is located at the front of the knee joint, just under the skin.
The Most Common Knee Injuries Sustained From Car Accidents
When a person is riding in a car, their knees are usually bent. This natural posture exposes the knee in such a way that they are extremely vulnerable when a collision occurs. Below are some examples of common knee injuries that result from collisions:
- Torn meniscus – The meniscus is also known as cartilage. It’s a rubbery substance that’s attached to the ligaments inside the knee. They only partly divide the joint space. When the meniscus tears, it results in a higher degree of friction in the knee joint. This creates extreme pain and lack of range of motion.
- ACL tear – This is the most severe knee injury of all, because the ACL is the most interior ligament. It holds the entire knee joint in place, and offers stability to prevent the inter-connected bones from rotating excessively. Any injury to the ACL has significant consequences. Sometimes the ACL tear is not apparent in the immediate aftermath of an accident. However it can become exquisitely painful with time. The recovery for ACL tears can be long and demoralizing.
- MCL tear – The medial collateral ligament is another ligament in the knee. It assists in promoting basic stability. When it works properly, it also helps with joint flexibility. However when there is trauma to this area, both stability and flexibility are compromised. Standing and walking are painful.
- PCL tear – The posterior cruciate ligament runs along the back of the knee joint. This also gives overall stability. Trauma here causes it to tear either slightly or completely. When that stability is lost, swelling results and the pain can be incapacitating.
The Long Road Back to a Healthy Knee
The specific knee symptoms will dictate the modalities of treatment. The common symptoms are weakness and instability, inability to straighten the knee (known as “locking”), popping or grinding sounds, stiffness and redness.
Orthopedists have various modalities available for the treatment of knee injuries. When more than one ligament is involved the treatment plan can be more complicated. Patience is needed because months often must pass before discernible improvement is realized.
If the tear is more than slight, be prepared to undergo corrective surgery. Fortunately new, promising surgical techniques are being developed, according to a recent article in the Journal of American Academy of Orthopedic Surgeons.
Beyond that, expect several months of visits to the physical therapist’s office. The therapeutic regimen will address the inability to bear weight on the knee, which is usually accompanied by swelling. Over weeks or months, there should be increasing ability to either extend (straighten) the knee or create flexion (bending).
The most serious problem is the knee which gives out. Falling is often the result, and this leads to supplemental injuries and, later, osteoarthritis.
Eventually the knee hinge should regain most or all of its function. The hope is that it will return to its simple purpose of being able to allow for standing and mobility. If there is permanent compromise, a claim should be asserted to cover the victim’s loss of enjoyment of life.