Cruciate and other ligaments of the knee: symptoms and treatment
First aid for torn ligament of the knee joint
The knee joint is one of the most complex in structure and functional loading in the human skeleton.
It not just bears the full weight of the body, but also provides shock absorption during walking and running (hitting the ground), protecting that spine.
According to various statistics, the frequency of damage of the knee joint is more than 7% of all injuries of the lower extremities. 1/5 part from them has damage to ligaments and menisci.
Successful treatment of such injuries provides warning of chronic inflammation (arthritis) or metabolic and degenerative changes (osteoarthritis) in the cartilage and contiguous bone surfaces.
The structure of the knee joint
The complex anatomy of the joint and the constant stress contribute to its vulnerability to mechanical damage, excessive wear of component surfaces.
Individual structures of the joint, as the body include:
The knee connects the lower end of femur, upper tibia, patella rounded («Cup»). On the sides of both bones form a hinge surface — Misaki.
Knee «Cup» is only held by the ligamentous apparatus. It covers the joint anteriorly and outside, during movement of the slides along the grooves in the bone tissue.
Between the bone surfaces is a cartilage layer thickness up to 6 mm. It is responsible for cushioning and providing good slip.
And in the connection area of the condyles forms a semicircular strip of the meniscus (inside and outside).
Ligaments presents a powerful internal cross-bands (front and rear) and lateral ligaments. They hold the bone connection and does not allow «fall out» from the area of the joint capsule forward, backward and sideways.
The fibers of the ligaments are elastic, in a healthy person they are stretched in length by 5%.
Muscles of the knee are divided into:
- the flexor (anterior) — quadriceps and Sartorius;
- extensors (back) — biceps, paliperidonesee and polosuhina;
- internal (leads) — a large and fine muscles.
This mass is a strong muscle formation is attached to the different sites connecting the bones with their tendons and abbreviations provides the necessary range of motion is not only flexion and extension, but also rotation.
Nerve impulses to the joint is received on the trunks of the sciatic bundle. Popliteal artery and vein pass close to the nerve.
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To break the dense tissue of the ligamentous apparatus requires application of force in a certain direction.
The mechanism of ligament damage looks like this:
- anterior cruciate — force should be directed at a bent joint from behind, to push the bone forward;
- posterior cruciate — leg sharply bent to the limit or impact is applied to the front bent knee;
- the outer side is damaged by the deviation of the tibia inwards at povertyline, unstable walking in shoes with high heels;
- the inner side of the lower leg should be out.
Scientists have proved the influence of hormones (progesterone, estrogen) on the elasticity of the ligaments. The higher their level, the less strong become the cords. This contributes to the gap.
Injury of a joint can include the simultaneous damage to several ligaments, rupture of blood vessels. This causes bleeding into the joint capsule (hemarthrosis) and complicates treatment.
Classification of types of injuries
In addition to specifying the localization of the rupture and identify the injured ligaments there are 3 degrees of damage:
- first — the overall integrity of the ligament is preserved, broken only a small portion of the fibers;
- the second damaged more than half the mass of the ligament, movement in the joint is limited;
- third — complete tear of the ligament, the joint has unusual mobility.
The most frequent mechanism of injury, sports injury, jumping on straight legs, the punches during the fight, an awkward fall on his knee, a sharp slowdown in women love for high heels.
To assume a rupture of ligaments of the knee joint is possible if the following symptoms:
- sharp intense pain;
- the increase in joint size due to swelling;
- the feeling of the victims of the crash in the joint at the time of injury;
- unusual dislocation of the tibia anteriorly or to the side;
- limited mobility, impaired function or pathologically enhanced range of motion;
- the mobility of the patella when pressed with the hand.
- the inability to stand on the injured limb.
Unlike sprains pain syndrome is intense and constant, there is a pathological limitations or mobility in the joint, it is possible to change the shape.
Peculiarities of damage to cruciate ligaments
Rupture of the anterior cruciate ligament of the knee occurs when a sharp blow to the back of the calf or thigh, in the fall back to fixed foot and lower leg.
At risk doctors include skiers, skiers, hockey players, volleyball players, football players.
Important in the diagnosis of simultaneous avulsion of the patella, the extension forwards of the bone components of the joint.
Unlike the front, the rear ligament is better protected. She explodes in a massive leg injuries during car accidents.
Patients complain of a feeling of «emptiness» in the knee. Other symptoms (pain, swelling) do not differ from ruptures of the lateral ligaments.
In the presence of these symptoms should contact emergency room or to the clinic to see the doctor the traumatologist.
The physician should carefully inquire about the mechanism of injury, inspect and test the damaged structure.
To confirm the diagnosis help:
- x-ray images in different projections;
- Ultrasound of the joint;
- magnetic resonance imaging.
It also checks for muscle damage, presence of broken bones, blood in the joint cavity.
How to give first aid?
In case of rupture of the knee ligaments must be taken first aid measures to a final medical diagnosis.
It is recommended:
- rest your foot, put under the knee a little cushion for maximum relaxation of the muscles;
- a cold compress on the sore spot, change 4 times per day in the first 24 hours after injury;
- to reduce aches you can take a pill Dipyrone, Phenylbutazone, Ibuprofen.
It is not recommended to apply any rubbing, warm compresses can be used only by the third day, try to lean or stand on the injured leg.
Transportation of patient should be carried out after immobilization of limbs tires, or giving the possibility to use crutches.
What is the treatment
The main goal of treatment of a rupture of ligaments is to return the knee joint all of its functions, prevent the development of arthritis, hemarthrosis, osteoarthritis.
For this show:
- adhering to a limitation of movement, rest for the limbs;
- cold compresses to reduce swelling, reduce blood vessels reducing internal bleeding;
- for limited freedom of movement applies pressure to the knee area with elastic bandaging, a special bandage, such devices as braces, tapes help to lock the knee joint;
- it is advisable to keep the leg in an elevated position to obstruct the flow of blood and relieve swelling;
- for pain used non-steroidal anti-inflammatory drugs (Ketorolac, Ibuprofen), they can be used in the form of ointments;
- heat treatments administered on the third or fifth day, they contribute to the fusion of tissues of ligaments, eliminate the inflammation in the joint.
When you need surgical treatment
To surgical methods of treatment have to resort when:
- combined injuries;
- complete tear of several ligaments, accompanied by bleeding into the joint;
- with ineffective conservative therapy.
Types of surgical interventions:
- the stitching of the damaged ligaments using microsurgery;
- replace damaged cords own autograft, which is taken from another joint;
- suturing of the donor ligament or an artificial tendon.
In major trauma centers, the surgery is performed through small incisions using endoscopic techniques. After the operation we recommend wearing the brace.
Treatment of folk remedies
Folk remedies can be applied during the recovery period, but not to replace their medical appointments.
To do this, the healers recommend:
- prepare the cream of clay and Apple cider vinegar and make it compresses at night;
- to lubricate the joint composition of crushed eucalyptus leaves and grated garlic in lard;
- compresses made of grated potatoes with onions.
Rehabilitation after injury
For recovery of damaged tissues are used:
- physiotherapy methods — paraffin baths, electrophoresis, diadynamic currents, UHF;
- recommended exercises for the muscles in the calf, thigh, exercise bikes, prescribed massage;
- mud baths and foot baths chamber is carried out in sanatoriums, they have a reparative effect its biological and natural activators;
- the use of acupuncture can be carried out according to doctor’s recommendation.
Recovery times vary depending on the extent of damage: in case of an incomplete gap of three months with extensive injuries and persistent treatment will need at least six months.
Trauma of the ligaments of the knee can cause chronic arthritis with pain, stiffness.
Impaired synovial fluid in consequence contributes to the development of osteoarthritis. In any case, athletes are not encouraged to continue loading.
If knee injuries you need to seek medical attention. The treatment is most effective in the first days after injury. This will help maintain activity at any age.