knee injury, traumatic
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Etiology
- common causes
- less common causes
- anterior cruciate ligament (ACL) sprain/tear
- medial meniscus tear (may be more common in elderly)
- subluxed or dislocated patella
- contusions
- traumatic bursitis
- uncommon causes
- rare cause
- muscle rupture
Clinical manifestations
- varus or valgus contact
- ligament sprains
- patellar subluxation
- meniscal tear
- fracture
- direct blow
- patellofemoral joint injuries
- posterior cruciate ligament (PCL) sprain
- fracture
- direct blow to the lateral knee
- hyperextension injury
- anterior cruciate ligament (ACL) sprain
- posterior cruciate ligament (PCL) sprain
- posterior capsule injury
- deceleration injury
- rotational injury
- dashboard injury
- pop or snap
- swelling
- how quickly swelling occurred after injury indicative of severity
- bloody effusion immediately after injury most likely anterior cruciate ligament (ACL) rupture
* also see physical examination of the knee
Radiology
- radiograph
- see Ottawa knee rule
- magnetic resonance imaging (MRI)
- excellent for meniscal & articular cartilage
- poorly demonstrates ligamentous injury
Management
- orthopedic surgery consult in nearly all cases of trauma
- physical therapy
- minimize loss of muscle strength & range of motion
- gradual remobilization
- dynamic stabiliation
- avoid long periods of inactivity
- arthroscopic surgery or physical therapy with the option of surgery have similar outcomes in patients with a meniscal tear & osteoarthritis[3]
- prevention
More general terms
More specific terms
- anterior cruciate ligament [ACL] tear
- lateral (fibrillar) collateral ligament sprain/tear
- medial collateral ligament (MCL) sprain/tear
- meniscal injury
- patella alta
- posterior cruciate ligament sprain/tear
Additional terms
References
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
- ↑ 2.0 2.1 Walden M et al. Prevention of acute knee injuries in adolescent female football players: Cluster randomised controlled trial. BMJ 2012 May 3; 344:e3042 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22556050
- ↑ 3.0 3.1 Katz JN et al Surgery versus Physical Therapy for a Meniscal Tear and Osteoarthritis. N Engl J Med. March 19, 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23506518 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1301408
Buchbinder R Meniscectomy in Patients with Knee Osteoarthritis and a Meniscal Tear? N Engl J Med. March 19, 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23506467 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMe1302696 - ↑ 4.0 4.1 Carek SM. Hip and Knee Injuries. Prim Care. 2020 Mar;47(1):115-131. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32014129 Review.