Demystifying knee injuries
Thankfully, injuries to the knee are better understood now than ever before.
Many treatments are available to help those who are injured get back on their feet and remain active. Orthopedist David Doman has found that educating patients about their knee condition helps decrease their anxiety. This information can be as important to them as the prescribed treatment.
Knee conditions can be organized into a few discreet categories based on anatomy. Injuries to the bones include fractures, dislocations and mal-alignment. Ligament and tendon conditions consist of many sports injuries, including ACL tears, quadriceps tendon ruptures and less acute conditions like patellar tendonitis. The meniscus is a structure unique to the knee and can often be implicated in knee problems when torn or displaced. Cartilage difficulties can be confined to one part of the knee, as with osteochondritis dissecans, or throughout the entire knee, as commonly seen in osteoarthritis.
As with any joint, the knee can be affected by infection, tumors or inflammatory conditions. There are also a few pain syndromes commonly diagnosed, despite no objective evidence of any structural damage to the joint. These conditions include patellofemoral syndrome or pain at the front of the knee cap.
History, physical examination and x-rays provide enough information to diagnose most knee injuries. In some cases, an MRI is helpful to confirm the diagnosis. While general practitioners can address many low-grade knee conditions, consultation with an orthopedic specialist can often clarify the diagnosis and better define the optimal treatment plan. Other than infections and fractures to the bone, most knee injuries benefit from rest, ice, anti-inflammatories, compression and a course of physical therapy. When necessary, surgical intervention can provide predictable results for many conditions. Surgeries can vary widely from simple arthroscopic procedures (performed through small incisions with a camera and specialized tools) to a complete knee replacement with metal and plastic parts.
An important consideration for knee injuries in the workplace is the question of preexisting knee osteoarthritis. As mentioned above, knee osteoarthritis is primarily a condition of damaged cartilage. Cartilage is the pearly white lining on the surfaces of our joints, and it can degrade over time due to a combination of factors, resulting in inflammation, stiffness, and pain. These factors include the patient’s age, weight, genetics and prior injuries to the knee.
While a severe knee fracture can directly cause posttraumatic arthritis several years later, this is a rare example of how arthritis could develop from an isolated injury. Normally, arthritis tends to develop and progress over many years, often without the patient even being aware of a problem. An injury more commonly could aggravate osteoarthritis and cause the patient to seek care for the first time. A well-documented visit with an orthopedic specialist and thorough patient education can go a long way to avoid conflicts in this common scenario.
Whatever the situation, many options exist to help those who are injured be restored to an active lifestyle, both at work and home.