The knee is a complex
structure with many components that make it vulnerable to a variety of sports
injuries. Most people suffer a minor knee problem at one time or another. Knee
injuries often occur during sporting activities, too. In 2009, knee injuries were
the most common reason for visiting an orthopedic specialist.
Knee Anatomy and
Function
The knee joint is the
largest joint of the body and the one that is most easily injured. Two
cushioning discs call menisci separate the upper and lower bones of the knee.
The upper leg bone (the femur) and the bones of the lower legs are connected by
ligaments, tendons, and muscles. The surface of the bones is covered by
cartilage, a substance that absorbs shock and provides a smooth, gliding
surface. Knee injuries are the result of damage to one or more of these
structures. Of the four major ligaments found in the knee, the three that are
injured the most are the anterior cruciate ligament (ACL), the medial
collateral ligament (MCL), and the posterior cruciate ligament (PCL).
ACL Injury
The ACL is injured when
athletes are changing direction rapidly, slowing down when running, or landing
from a jump. Individuals who play basketball, football, and soccer and those
who ski are particularly at high risk for ACL injuries. If this structure is
damaged, you could require surgery to regain full function of your knee. This
will all depend on the severity of your injury and your activity level.
Most of the time ACL
tears are too severe to be stitched back together. The orthopedic surgeon will
have to surgically repair this structure by reconstructing the ligament. Most
of the time the doctor will use a tissue graft to repair the ligament. This
graft acts as scaffolding for new ligament to grow on. Most of the time grafts
are taken from the patellar tendon or the hamstring tendons.
MCL Injury
A direct blow to the
outer aspect of the knee commonly causes injuries to the MCL. Those athletes
who play football and soccer are at the highest risk. When the knee is forced
sideways, the MCL can tear and result in knee pain. Swelling will occur with a
MCL injury as well and the knee will become unstable and give way.
When the MCL is torn
severely and cannot heal correctly, surgery is necessary. This will involve
grafting a piece of tendon to allow the portions of the torn ligament to
connect to. Most of the time, however, these injuries can be treated without
surgical intervention.
PCL Injury
The PCL is most
commonly injured when an athlete receives a blow to the front of the knee. This
structure can also be torn or injured if the individual makes a simple misstep
on the playing field. Those who participate in football and soccer are at the
greatest risk for a PCL injury. This ligament is located in the back of the
knee and connects the femur to the shinbone (the tibia).
When an athlete suffers
a PCL tear or injury, the orthopedic specialist will most likely recommend
surgery. This is done to rebuild the ligament by replacing the torn structure
with a tissue graft. During the procedure the doctor will rebuild the PCL. A
tendon or other structure is used to replace the torn ligament.
Meniscus Injury
The menisci tear in
different ways. The orthopedic specialist depending on how they look, where
they occur, and how complex they are classes the tears. Common tears include
the parrot-beak, flap, bucket handle, longitudinal, and mixed/complex.
Sports-related tears of the meniscus often happen along with other knee injury.
Sudden tears can occur when the athlete squats or twists the knee. Direct
contact or a sharp blow can also cause meniscus injury.
When a meniscus tear is
serious and the symptoms persist with nonsurgical treatment, your doctor may
recommend an arthroscopic procedure of the knee. This is one of the most
commonly performed surgical procedures where the orthopedic specialist inserts
a miniature camera into the knee joint to trim and repair the tear to the
meniscus. While he is doing this surgery, other torn structures can be repaired
and treated as well.
Visit Dr. Watt's
website to learn more about him or to schedule an appointment. Dr. Watt
provides sports medicine, including arthroscopy to the Seattle area.
http://jmichaelwattmd.com/
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