Treatment methods for inflammation of the knee ligaments, prevention

Knee-joint

The knee is a joint that allows the leg to bend, provides stability to the body and supports all of its weight.
Thanks to the knee, activities such as walking, running, turning, jumping and squatting are possible. This work is ensured by several components:

• bones;
• cartilage tissue;
• muscles and ligaments;
• tendons.

No. 1. Injuries

Acute or chronic injury is a common cause of knee pain. According to some studies, the knee is the joint most often subject to injury. The very anatomical structure of the knee and its functions predispose to the development of injuries, which can disrupt its functioning and, accordingly, cause pain.

The appearance of such symptoms indicates damage to one of three ligaments:

• anterior and posterior cruciate;
• medial collateral.

Such injuries occur in athletes, especially track and field athletes. But this does not mean that non-professional athletes are out of the risk zone. Incorrect running technique is one of the causes of ligament damage and joint pain, which is typical for non-professional athletes.

Football and other contact sports with a ball can cause injuries such as direct blows to the knee. Some injuries may be so severe that they require surgery.

Despite the fact that this injury is serious, it is, unfortunately, not uncommon. Pain can occur not only in the acute period, but also persist in the future.

A fracture can affect several bones, including the kneecap. At risk are older patients and those suffering from degenerative diseases. In this case, a fracture can form even with minor injuries and everyday activities.

No. 2. Bursitis

This is an inflammation of the joint capsule of the joint. Anatomically, they are designed to soften the work of the joint and allow the ligaments to easily slide over the component parts of the joint.

Sudden impacts, chronic injuries and irritations can damage this joint capsule, which leads to inflammation.

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Characteristic symptoms of inflammation will be: swelling, pain, stiffness of movement, and the knee becomes hot to the touch.

Treatment is prescribed individually, but more often it comes down to taking anti-inflammatory medications; rest for the knee and the absence of a traumatic agent are also necessary.

No. 3. Dislocations

Patella dislocations are also common, which is accompanied by severe and acute pain. When seeking medical help, the doctor can easily return the patella to its place, however, visual examination methods are mandatory.

Radiography allows you to identify possible fractures and, based on this, develop treatment tactics. In severe cases, surgery may be required to prevent further dislocations.

No. 4. Degenerative changes in tissues

Osteoarthritis is a common problem and degenerative tissue disorder. A decrease in the volume of cartilage and surrounding tissues is the cause of pain, stiffness of movement and dysfunction of the joint.

Such changes are more associated with the aging process: it occurs in 10% of men and 13% of women aged 55-65 years.

No. 5. Rheumatoid diseases

These are inflammatory autoimmune diseases in which the target organ is the joints. Their own immune system perceives them as enemies and attacks.

Characteristic symptoms of the disease include: swelling, severe pain in the joints; if left untreated, bone erosion and joint deformation may occur.

There is no specific treatment for rheumatoid arthritis, but depending on the clinical picture, the doctor may prescribe a number of medications:

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• anti-inflammatory drugs;
• corticosteroids;
• biological agents and antirheumatic drugs;
• painkillers and others.

This is a very painful form of arthritis. Characteristic symptoms include: severe swelling, stiffness of movement, severe pain, etc. Their appearance is associated with the accumulation of uric acid in the joint; taking anti-inflammatory drugs or other treatments helps break down these chemicals.

No. 7. Infections

Even after a scratch in the knee area, the infection can spread to underlying structures, including the joint. The spread of infection can also occur through the blood and lymph flow. In weakened patients with immunodeficiency, this condition can be dangerous and pose a threat to the patient's health.

Tendinitis of the knee joint - the symptoms and treatment of this disease have certain characteristics. Inflammation of the anterior cruciate and medial ligaments (internal epicondylitis) occurs as a result of injury or under the influence of prolonged stress. Often the pathology is diagnosed in older people and athletes. Considering the specificity of the symptoms, the disease requires differential diagnosis, which will allow effective treatment and complete restoration of the function of the joint and limb.

Causes

Inflammation of the ligaments of the knee joint (ICD code – 10:M76) is inflammatory-degenerative in nature. Often the lesion is localized at the site of attachment of a ligament or tendon to the bone. Subsequently, as a result of the development of the disease, the process spreads and affects the knee, adjacent muscles and periarticular tissues.

Tendinitis often occurs as a result of injury

Often, tendinitis or rupture of the patellar ligament occurs in athletes who play professional football, basketball, tennis and other sports. This phenomenon is due to the fact that they are more susceptible to injury and physical overload, which are the main causes of pathology. In addition, the disease develops against the background of such factors:

• excess weight;
• wearing uncomfortable shoes;
• knee injury;
• abuse of antibacterial agents;
• bacterial and fungal infections;
• scoliosis and chronic periarthritis;
• post-traumatic syndrome;
• immunodeficiency and others.

When diagnosing a disease, a doctor needs to know the causes of its occurrence. This will allow you to choose the appropriate treatment.

Important! Often, injuries occur on the leading side: for a right-handed person - on the right, and for a left-handed person - on the left.

Damage to the collateral ligaments of the knee

Grade 1 and 2 medial collateral ligament injuries rarely require surgical treatment. If you have injured only one lateral collateral ligament, then treatment will be similar to treatment for an isolated injury to the medial collateral ligament, however, if the injury to the lateral collateral ligament is combined with damage to other structures of the knee joint (cruciate ligaments or menisci), treatment should be aimed at restoring these too anatomical formations.

Conservative treatment

Ice . Local cooling is an important component of the healing process. For this purpose, it is recommended to use crushed ice, which is applied for 15-20 minutes with intervals between applications of at least 1 hour. Chemical cooling agents ("blue" ice) should not be applied directly to the skin and are not as effective.

Immobilization . The knee should be protected from lateral movements that have caused damage to your ligaments. To avoid possible risks, you may have to modify your daily activities. To protect damaged ligaments, your doctor may recommend wearing a brace. A brace (orthosis) fixes the leg in a position of full extension in the knee joint. The brace must be worn for 3-4 weeks, during which time movements in the knee joint are completely prohibited. In addition, you may be advised to use crutches to relieve stress on the injured limb. Then, after 3-4 weeks, the patient begins to develop movements in the knee and gradually load the leg. As the patient begins to walk without limping, crutches can be discontinued.

Physiotherapy . Your doctor may recommend a special set of exercises aimed at restoring the function of the knee joint and strengthening the muscles surrounding and stabilizing the joint.

Return to sports . When normal mobility of your knee joint is restored and you can move without limping, your doctor will allow you to gradually increase the intensity of physical activity. This way you will gradually return to exercise.

If you play football, for example, your functional training may initially consist of only light jogging. Then it will be sprint runs, and then full running and ball training.

Depending on the severity of the injury, at first your doctor may recommend that you fix your knee joint with a brace when playing sports.

Surgery

Most isolated injuries of the collateral ligaments of the knee joint respond well to conservative treatment. Surgical treatment may be indicated in cases where the ligament is so damaged that its own repair is unlikely, or if its damage is combined with damage to other structures of the knee joint.

In all cases, an endoscopic examination is performed during surgery to detect and treat possible damage to the articular cartilage, cruciate ligaments and menisci.

For anatomical restoration when the collateral ligaments are torn from the bone, special anchors (anchors) or interference screws are required.

During surgery, an anchor is inserted at the site of the collateral ligament tear. Scraps of the collateral ligament are stitched with threads from the anchor. At the moment of tying knots on the threads, the ligament is pulled to the place of separation on the bone.

The best treatment for chronic collateral ligament injuries is anatomical reconstruction. Reconstruction refers to the replacement of a damaged collateral ligament with a graft from other tendons taken from the patient.

Symptoms

Inflammation of the knee tendons manifests itself as follows:

• sharp and intense joint pain in the right or left limb, especially during movement, which can radiate to the thigh;
• characteristic sound when the joint operates (crunching or creaking);
• restriction of connection movement;
• when pressing, pain worsens;
• increased discomfort when weather conditions change;
• inflammation of the ligament, which is accompanied by swelling and redness of the surface around the knee joint;
• temperature increase.

The disease is accompanied by pain in the knee.
In this case, external tendon tendinitis develops gradually. In this case, the manifestations are as follows:

• pain occurs only during severe physical exertion;
• sensations become aggravated even with minor loads;
• pain syndrome begins to manifest itself at rest;
• at an advanced stage, the collateral ligament ruptures, which is accompanied by severe pain and limitation of limb movements.

If the first signs of inflammation of the collateral ligaments occur, you should immediately consult a doctor. This will prevent complications from occurring.

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CAUSES OF PAIN IN THE KNEE JOINT

Osteoarthritis is a degenerative disease of the knee (can affect any joint) that is associated with general aging and usually occurs in people over 50 years of age. When the cartilage of the joint wears out, it no longer protects the bones of the joint from direct contact between the bones.

Direct contact between bones causes pain and inflammation.

One of the first signs of osteoarthritis is loss of rotation ability of the knee joint. Symptoms include pain when moving, joint stiffness and lameness. The intensity of symptoms may vary, sometimes there is a feeling of complete recovery, and at times there is very pronounced impairment.

Osteoarthritis does not go away, but it is possible to limit the development of this disease and maximize your quality of life.

To do this, you need to take care of your weight, under the supervision of a physiotherapist, study and regularly do a set of exercises to strengthen the ligaments and muscles of the thigh, protect the knee joint from heavy loads, and also take anti-inflammatory and painkillers after consulting a doctor. In some cases, knee replacement surgery is necessary. Meniscus tears. Each knee has two menisci, crescent-shaped cartilaginous structures. Both menisci together form a kind of ring between the heads of the tibia and femur bones. In the front and back of the knee, the menisci are connected to each other by ligaments, which provide them with a small range of motion. Compared to the heads of the two massive bones of the leg, the tibia and femur, which form the knee joint, the meniscus is soft and fragile. Although the menisci anatomically follow and assist in knee movement, they sometimes deviate from a reliable path and can become severely pinched or torn between the ends of the knee bones during movement, resulting in a meniscal tear. The sensations caused by damage to the meniscus are characterized by pain, aching and pulling exactly where the meniscus is anatomically located - along the perimeter around the knee joint. After serious injuries to the meniscus, when a fragment of it is torn off, inflammation often occurs in the knee, which can cause more severe pain and swelling in the knee joint. Edema can be indicated not only by visually noticeable swelling, but also by a pressing, unpleasant sensation in the knee. If a meniscal tear is smooth and located within the body of the meniscus, it will likely not cause significant discomfort and can be tolerated. However, if a fragment of the meniscus is torn off and floating freely in the fluid in the knee joint, the injury will likely cause such severe discomfort or even restriction of knee motion that it will be necessary to seek help from an orthopedic traumatologist. Torn fragments are usually an indication for meniscus surgery. Injuries to the ligaments of the knee joint The knee joint is stabilized by several ligaments. Damage or tearing of the ligaments usually causes immediate pain that gets worse when you move the knee, jump, or walk. Types of damage and ligament ruptures:

• A cruciate ligament injury is the most common ligament injury in the knee. It causes a feeling of instability in the knee joint and rapidly progressive swelling. Cruciate ligament injuries are often treated with surgery.
• Injury to the medial collateral ligaments of the knee occurs as a result of trauma caused by inward movement of the knee joint. It can be caused, for example, by a mechanical blow to the outer part of the knee joint. This type of injury is usually treated without surgery.
• Injury to the posterior cruciate ligament of the knee is very rare. It can be caused, for example, by a strong blow to the front of the knee joint, directed towards the posterior ligaments. Damage can also occur if a person trips. As with visceral ligament injuries, injuries to the posterior cruciate ligaments cause rapidly progressive swelling and instability in the knee joint. Injury to the posterior cruciate ligament of the knee usually occurs at the same time as other injuries to the knee, such as anterior cruciate ligament injury. If only the posterior cruciate ligament of the knee is damaged, surgery is usually not required. However, if multiple parts of the knee joint are damaged, your doctor may recommend surgery.
• Injury to the lateral collateral ligament of the knee usually occurs as a result of serious trauma, such as a car accident. This damage is treated with surgery.

Damage to the cartilage of the knee joint Hyaline cartilage is a very smooth and strong structure that is located between the surfaces of the bones of any joint and protects them from friction and damage. Damage to the cartilage of the knee joint occurs as a consequence of trauma, degenerative wear and tear of the joint surface (for example, as a result of osteoarthritis), and also as a result of other joint diseases. There are no nerves or blood vessels in cartilage, so cartilage cannot repair itself. The damage may go undetected until the cartilage wears down significantly and can no longer protect the bones of the joint from direct contact with each other. This causes pain and inflammation. The joint bones are sensitive, and the acute pain that occurs in such situations is caused by irritation of the nerve endings of the bones. Teared pieces of damaged cartilage that move freely in the knee joint capsule can also cause pain, swelling, a “caught” feeling, and sharp, sharp pain. When treating knee joint cartilage damage, both non-surgical and surgical treatment methods are used, depending on the severity of the damage and the disorders caused. Knee tendonitis (inflammation of the muscle tendon) . Often the cause of inflammation is degenerative processes in the tendon itself, which loses its natural elasticity as a result of aging. Inflammation can also be caused by injury or repeated injury. In certain diseases, such as rheumatoid arthritis, gout, psoriatic arthritis or diabetes, inflammation in the tendons of the knee joint can occur without previous injury. Tendon inflammation is usually felt as a burning pain in a specific area of ​​the knee joint. The pain intensifies with movement. Symptoms can usually be effectively managed by reducing stress on the knee and using physical therapy. Protein injection - the injection of platelet-rich plasma into the injured joint - is recognized worldwide as an effective treatment for inflammation of the knee tendon. In rare cases, the inflamed tissue is surgically removed from the knee. A knee dislocation is a rare but serious injury to the knee that can occur after a car accident, fall from height, or sports injury. At the moment of dislocation, the ends of the bones of the knee joint momentarily touch and are incorrectly positioned relative to each other. Excessively strained knee ligaments. Depending on the force with which the movement occurs, part of the ligaments (usually the anterior and posterior cruciate ligaments) are torn. In everyday life, this injury is called a dislocation. In medicine, it is called damage to the ligaments of the knee joint. A knee dislocation can damage the meniscus and cartilage. Large nerves and blood vessels may also be affected. If the damage is significant, it is treated surgically, reconstructing the damaged tissue. Dislocations of the knee joint can be confused with a dislocation of the patella, so when diagnosing and treating such rare injuries of the knee joint, it is important to entrust your health to the experienced orthopedic traumatologists gathered at the ORTO clinic. A luxated patella (kneecap) is a much more common and less traumatic injury to the knee joint than a luxated knee joint. When the knee bends, the kneecap slides up and down along the end of the femur, or groove. In some people, the movement of this cartilage is not stably fixed, so the kneecap may slip out anatomically incorrectly during movement. This may have no consequences, but it can cause the kneecap to luxate, where it slips completely out of the socket of the femur. Usually, after such a dislocation, the kneecap will return to its place on its own, however, after such an injury, it is important to undergo a course of physical therapy to strengthen the joint ligaments and muscles, protecting the knee from repeated dislocation of the kneecap. In some cases, surgical intervention is required. Knee bursitis is an inflammation that occurs in the knee joint bursa (bursa). Signs of inflammation: pain, swelling, limited movement in the knee joint and pain when moving. Symptoms are worse when squatting or when going up or down stairs. Inflammation can occur after a knee injury, overload while running, jumping, or after standing for a long time. Bursitis can be caused by poor posture. Often, after an injury, fluid rapidly accumulates in the knee joint along with the inflammation process, which doctors remove with a syringe. To treat inflammation of the knee joint, non-steroidal anti-inflammatory drugs and painkillers are used, as well as injections of corticosteroids and growth factor into the knee joint. Corticosteroid injections quickly reduce pain and swelling, so they are often given in cases where non-steroidal anti-inflammatory drugs do not work or the person is intolerant to these drugs. Injections of growth factor in case of inflammation of the knee joint help reduce inflammation and restore tissue. After consulting an orthopedic traumatologist, it is recommended to attend physical therapy to strengthen the ligaments and muscles of the knee joint and reduce the likelihood of re-inflammation.

Diagnostics

After visiting a medical facility, the patient undergoes a comprehensive examination, which includes the following methods:

1. External examination and palpation. The disease occurs with obvious symptoms that are visible to the naked eye (redness, swelling and increase in size). On palpation the patient feels pain.
2. Lab tests. As pathology develops, test results change. The exception is tendonitis caused by injury.
3. Instrumental examination. Patients undergo ultrasound examination, x-ray, CT and MRI.

Important! Differential diagnosis allows you to determine the nature and complexity of the damage. Against this background, the correct treatment is prescribed.

An ultrasound examination is performed for diagnosis.

Treatment

As the disease develops, the patient feels pain, and the mobility of the joint is limited. As a result, the quality of life decreases. To eliminate the problem, the patient is prescribed treatment. Depending on the complexity of the case, therapy is carried out using various methods.

Conservative treatment

The technique is selected depending on the nature of the lesion and the cause of the disease, but there is a list of actions that need to be carried out for any etiology:

1. Cold compresses. Use immediately after injury. Cooling reduces blood supply to the affected area. In some cases, such manipulations are prohibited.
2. Immobilization of a limb. Depending on the nature and etiology, doctors recommend reducing the load on the leg or completely immobilizing it.
3. Drug therapy. The mainstay of treatment for tendinitis is taking anti-inflammatory drugs. Antibiotic drugs are used in cases where the cause of the disease is infection. Since the drugs negatively affect the gastrointestinal mucosa, the course of therapy lasts no more than 14 days. In addition, various gels, ointments and creams are used that have an anti-inflammatory effect.
4. Physiotherapy. To increase the effectiveness of treatment, the patient is prescribed a course of laser therapy, magnetic therapy, electrophoresis and others. The duration of physiotherapeutic treatment is prescribed by the doctor depending on the indications and dynamics.
5. Massage, taping and exercise therapy. Massaging and performing the exercise allows you to improve blood flow, strengthen muscles and restore joint mobility.

If conservative treatment methods do not give the desired result, the doctor insists on surgery.

Cold compresses can reduce pain

Surgery

If, as a result of the development of pathology, a rupture or tear of the kneecap occurs, then surgical intervention is prescribed. During this process, the affected tissue is excised, as well as the functionality of the joint is restored. The operation is performed open or endoscopically. After this, a rehabilitation period is prescribed, during which the ligament heals.

Important! The operation is prescribed by the doctor in each case individually, based on the indications or contraindications for manipulation.

Traditional methods of treatment

Home treatment is carried out using compresses, ointments and applications. Among the popular recipes it is worth highlighting:

1. Ginger compress. For this, a mass is used, for the preparation of which you will need 1 tbsp. l. grated ginger, 4 drops of apricot oil, 1 tbsp. l. water. Mix everything well and apply to gauze. Apply externally to the affected area and cover with polyethylene. After 1 hour, remove.
2. Arnica ointment. Dry and chop the inflorescence. Add pork fat and bring to a boil. Leave for 15 minutes. The finished product is used as an ointment. Apply 2 times a day.
3. Aloe compress. Cut off the leaves and place in the refrigerator for a day. Squeeze out the juice and soak gauze in it. Apply a compress to the joint 5 times a day.

Folk remedies are used for minor injuries. With their help, symptoms are temporarily relieved.

Knee tendonitis

Treatment is usually conservative and carried out on an outpatient basis. Operations are rarely performed and are indicated when conservative measures are ineffective and ruptures of the affected tendon.

Conservative therapy

Completely stop training and carry out complex therapy, which includes:

• Protective mode
  . Patients are advised to rest and, if necessary, immobilize with a plaster or plastic splint.
• Medicines
  . Analgesics and anti-inflammatory drugs (naproxen, ibuprofen) are prescribed.
• Physiotherapy
  . After eliminating the symptoms of acute inflammation, patients are referred to exercise therapy, massage, electrophoresis with novocaine, iontophoresis, UHF and magnetic therapy.

In case of severe swelling, intense pain and fibrotic changes, radiotherapy is sometimes used or blockades with corticosteroid drugs are performed. The administration of hormonal drugs is carried out in short courses with an interval of at least six months, since frequent use of medications in this group can accelerate tendon degeneration. Shock wave therapy is an effective treatment for tendonitis and tendinosis.

The load on the joint should be increased smoothly, gradually. During the period of remission, patients are advised to unload the affected ligament using special tapes (tapes) or fixing the knee joint with an orthosis. In some cases, good results are achieved by targeted work with the technique and height of jumps (tendonitis has been found to develop more often in athletes who use a rigid landing strategy, make higher jumps and land with a deeper squat).

Surgery

Indications for surgical intervention are tears and ruptures of the tendon, as well as the lack of a positive effect from conservative therapy for 1.5-3 months. The operation is performed as planned in an orthopedic or traumatology department. The skin over the affected area is dissected, the ligamentous canal is opened, and pathologically altered tissue is removed.

Sometimes, to stimulate the recovery process, they resort to curettage of the lower part of the patella or perform multiple incisions on the tendon using traditional or minimally invasive endoscopic access. Cystic formations are excised openly. For large tears and ruptures, surgical reconstruction of the patellar ligament is performed.

In the postoperative period, antibiotics, analgesics, exercise therapy, physiotherapeutic procedures and massage are prescribed. You are allowed to start training only after completing rehabilitation measures.

Prevention

Since the disease often occurs as a result of increased load on the joints, experts recommend following the following preventive measures:

• Before playing sports, you need to do a proper warm-up;
• loads should be gradual;
• if pain occurs during exercise, then you should stop doing it;
• It is not recommended to constantly load the same joints;
• Pay special attention to the condition of the leg muscles, which protect the joint from overload.

Also, do not forget about such problems as excess weight and poor nutrition. Compliance with the basic rules of a healthy life will protect not only from tendinitis, but also other pathologies.