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At least 19 recordsLinked to original sources
PubMed1997

Common athletic knee injuries.

Knee injuries continue to be an increasingly common and highly visible problem presenting to the sports medicine physician. The physicians who handle knee injuries will be challenged by patients, coaches, trainers, business agents, the press, and family members with an ever-increasing sophistication of medical knowledge. An understanding of the underlying structure and function of the commonly injured ligaments, menisci, and the patellofemoral joint is discussed. Diagnosis by physical examination is encouraged. Conservative and surgical treatment options are reviewed as are the considerations involved in deciding the time to return to sports.

Athletic Injuries↗
PubMed1984

Assessment of the acute knee injury.

Knee injuries are the main reason for premature retirement from contact and rotational sports in the young healthy individual. They cause significant interference with employment, particularly tradesmen or persons with labouring jobs. These injuries may cause persisting disability and predisposition to early degenerative changes, if not recognised and appropriate treatment commenced early.

Humans↗
PubMed2006

Biomechanical analysis of tibial torque and knee flexion angle: implications for understanding knee injury.

Knee injuries are common in sports activities. Understanding the mechanisms of injury allows for better treatment of these injuries and for the development of effective prevention programmes. Tibial torque and knee flexion angle have been associated with several mechanisms of injury in the knee. This article focuses on the injury to the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL) and the meniscus of the knee as they relate to knee flexion angle and tibial torque. Hyperflexion and hyperextension with the application of tibial torque have both been implicated in the mechanism of ACL injury. A combination of anterior tibial force and internal tibial torque near full extension puts the ACL at high risk for injury. Hyperflexion also increases ACL force; however, in this position, internal and external tibial torque only minimally increase ACL force. Several successful prevention programmes have been based on these biomechanical factors. Injury to the PCL typically occurs in a flexed or hyperflexed knee position. The effects of application of a tibial torque, both internally and externally, remains controversial. Biomechanical studies have shown an increase in PCL force with knee flexion and the application of internal tibial torque, while others have shown that PCL-deficient knees have greater external tibial rotation. The meniscus must endure greater compressive loads at higher flexion angles of the knee and, as a result, are more prone to injury in these positions. In addition, ACL deficiency puts the meniscus at greater risk for injury. Reducing the forces on the ACL, PCL and meniscus during athletic activity through training, the use of appropriate equipment and safe surfaces will help to reduce injury to these structures.

Anterior Cruciate Ligament Injuries↗
PubMedDate not supplied

Lower extremity flexibility patterns in classical ballet dancers and their correlation to lateral hip and knee injuries.

Knee and hip problems account for up to 40% of injuries in classical ballet. Despite apparent flexibility, many dancers appeared to have tight iliotibial bands that contributed to lower limb problems. Thirty senior female ballet dancers were contrasted with thirty age-matched active volunteers for hip and knee range of motion, and the information derived was correlated with their orthopaedic medical histories. Dancers spent a reasonable period of time warming up, but it was usually with an unbalanced routine that emphasized hip abduction and external rotation to the exclusion of adduction work. This was reflected in the significantly lower range of passive hip adduction and internal rotation compared to the controls. Furthermore, the older and more experienced the dancer, the more this trend was exaggerated. This unbalanced flexibility may play a role in the production of lateral knee pain (30% of the dancers) and anterior hip pain (33% of the dancers). It is suggested that more attention should be given to a balanced stretching regimen as part of the dancers' warmup in an effort to reduce the frequency of some of the chronic hip and knee complaints.

Adolescent↗
PubMed2005

Treatment of acute and chronic anterior cruciate ligament-posterior cruciate ligament-lateral side knee injuries.

Knee dislocations are rare but devastating injuries. The ACL-PCL-lateral side injury combination is representative of the challenges these injuries present. Early management is focused on vascular integrity. When possible, acute repair and reconstruction within 3 weeks from injury is preferred. Chronically deficient knees generally will require lateral side reconstruction rather than repair and may require limb realignment. Addressing all injured structures is imperative to afford the best chance at a reasonable outcome. Good results with surgery are possible, but some degree of persistent disability is to be expected.

Anterior Cruciate Ligament↗
PubMed1998

A retrospective review of the incidence and rehabilitation outcome of concomitant traumatic brain injury and ligamentous knee injury.

OBJECTIVES: To estimate the incidence of ligamentous knee injuries in patients with traumatic brain injury (TBI) involved in pedestrian versus motor vehicle collisions (PVMVC), to identify associated risk factors, and to compare rehabilitation outcomes and costs in TBI patients with and without ligamentous knee injury. DESIGN: Retrospective, case control. SETTING: An academic rehabilitation hospital with a large metropolitan referral base. PATIENTS: Twenty-three consecutive adolescent and adult subjects admitted for acute inpatient rehabilitation after a PVMVC from January 1, 1994, to January 1, 1996. RESULTS: Five subjects (22%) were found to have a ligamentous knee injury, one with bilateral injuries. Two of these six injuries were diagnosed only after presentation to the rehabilitation setting. The most common injury was an anterior cruciate ligament (ACL) disruption in 5 of 6 knees. A coupled ACL and medial collateral ligament injury was identified in 4 of 6 injured knees. The risk of ligamentous knee injury was most closely associated with the presence of a tibial plateau fracture (n=3) (chi2=12.420, p < .001). There was no statistical difference between groups with and without ligamentous knee injuries with respect to age, gender, inpatient acute or rehabilitation length of stay, admission, discharge, or change in motor Functional Independence Measure (FIM) interval measures, or rehabilitation costs. Four of the 5 patients with ligamentous knee injuries were successfully managed nonoperatively. A case illustrating longitudinal management is presented. CONCLUSIONS: TBI and ligamentous knee injuries, in particular ACL injuries, are common comorbidities after PVMVC. Physicians must maintain a high index of suspicion for ligamentous knee injuries in this population, particularly when a tibial plateau fracture is present. TBI patients with and without ligamentous knee injuries can have comparable functional outcomes when the ligament injuries are identified and appropriately managed, without incurring undue cost or length of inpatient rehabilitation.

Adolescent↗
PubMed2003

A cluster analysis of road traffic-related childhood knee injuries.

BACKGROUND: Knee injuries represent an important category of road traffic injuries among children, and they are heterogeneous in their aetiology. The aims of this study were to estimate the incidence of road traffic childhood knee injuries in Greece by age and gender, point out their time, place and person co-ordinates and identify clusters with distinct characteristics with a view to potential preventive interventions. METHODS: During a 3-year period, 305 children with knee injuries resulting from a road traffic accident were identified among the 66,870 children with injuries recorded in the Emergency Department Injury Surveillance System (EDISS) of Greece. Using previously derived sampling ratios and national data on childhood population, incidence data by age and gender were estimated. Hierarchical analysis was undertaken for cluster identification. RESULTS: The incidence of road traffic knee injuries was 97.5 per 100,000 children-years. The incidence increased with age and was higher among boys than among girls. Most childhood knee injuries (50.2%) occur among pedestrians, and the majority (90.9%) of the children or their guardians admitted responsibility in crossing the road. Of the 31 children injured as car passengers, the vast majority (87.1%) were unrestrained, and a large fraction (38.7%) were front seat passengers. Two clusters were identified: the first consisted of younger children who resided mostly in the Athens area and suffered less serious knee injuries as pedestrians or car passengers during the colder months; the second consisted of older children, frequently tourists, who suffered more serious injuries as cyclists while vacationing. CONCLUSIONS: Many of the children who suffered road traffic knee injuries as pedestrians admitted responsibility in road crossing, whereas a large proportion of children who were injured as car passengers were injured while improperly seated in the front and without seatbelt protection. Older children, frequently tourists, were at high risk of knee injuries while using motorcycles and bicycles.

Accidents, Traffic↗
PubMed2002

Diagnosis and treatment of posterolateral knee injuries.

Posterolateral knee injuries can be very debilitating. It is important to understand the complex anatomy and pertinent diagnostic tests to properly treat posterolateral knee injuries. The fibular collateral ligament, popliteus tendon, and the popliteofibular ligament are the main static stabilizers against abnormal varus and posterolateral translational moments. Important radiographic imaging studies for the posterolateral knee include full length anteroposterior radiographs, taken with the patient standing, to assess for varus alignment in patients with chronic injuries and high field (1.5 tesla or higher) magnetic resonance imaging with specific posterolateral knee sectioning. A physical examination that includes the external rotation recurvation test, varus stress test at 30 degrees, dial test at 30 degrees and 90 degrees, posterolateral drawer test, reverse pivot shift, and an assessment for a varus thrust gait are essential to properly diagnose a posterolateral knee injury. Patients with acute (< 3 weeks) anatomic repairs of Grade III posterolateral knee injuries have the best functional outcome. Although various surgical reconstruction techniques have been developed to treat chronic or irreparable acute posterolateral knee injuries, these techniques have not achieved outcomes comparable with the treatment of other ligament injuries of the knee. Techniques for anatomic reconstructions of these structures are just being developed. Improved education of clinicians as to the proper diagnosis of posterolateral knee injuries is necessary because a large number of these injuries still are missed on initial examinations. In addition, additional research into the most optimal posterolateral knee reconstruction techniques and outcome studies are needed to improve the treatment of this debilitating knee injury.

Arthroscopy↗
PubMedDate not supplied

Application of the Ottawa Knee Rules in assessing acute knee injuries.

The Ottawa Knee Rules (OKR) were established to identify which adults with acute knee injuries require knee x-rays as part of their assessment. This study evaluates the compliance of non-consultant hospital doctors (NCHDs), working in an Irish Emergency Dept., with these guidelines and assesses the impact of raising the profile of these rules on their implementation. Emergency Dept. (ED) notes of all adults who presented with an acute knee injury in a 3-month period were analysed retrospectively and compliance with the OKR was assessed. ED NCHDs were then educated on the details and value of these guidelines. In the subsequent three months, the improvement in compliance with the OKR was audited. In the initial audit, according to the Ottawa criteria, 65.5% of all x-rays of acute knee injuries were performed unnecessarily. In the second audit, performed after increasing awareness of the OKR, this figure had dropped to 39.1%. The NCHDs involved in this project cited 'patient expectation' for an x-ray as the primary reason why full compliance was not achieved. This study highlights a lack of awareness of and compliance with the OKR in the assessment of acute knee injuries in adults. It shows how the implementation of simple measures, which raised the profile of the OKR among ED staff, significantly improved compliance with the rules, thus cutting patient waiting times and cutting hospital costs. Futhermore, this study revealed that patients, when injured, expect to get x-rayed and ofter doctors comply with these expectations even if no indication exists.

Education, Medical, Continuing↗
PubMedDate not supplied

[The significance of arthroscopy in the diagnosis of acute knee injuries].

Acute knee injuries were arthroscopically diagnosed in 32 patients from July 1988, to November 1989. Aiming to compare diagnostic reliability, knees were clinically examined before and after anesthesia had been induced, and arthroscopically. Arthroscopy revealed that ligaments were the most frequently injured. These injuries were diagnosed as dominant ones in 26 (79%) cases. Correct diagnosis was made in 10 (30%) injured, and by examination under anesthesia in 18 (55%) ones.

Acute Disease↗
PubMed1980

Mechanisms of selected knee injuries.

Mechanisms of knee injury are very complex and depend on multiple factors. The purpose of this article was to describe mechanisms of knee injury. Causes of knee injury include microtrauma and macrotrauma. For microtrauma, mention was made of the accumulation of inflammatory reactions that eventually produces clinical signs and symptoms. For macrotrauma, particular emphasis was placed upon immediate injuries resulting in straight one-plane instabilities and transverse plane rotatory instabilities.

Athletic Injuries↗
PubMed2002

History of acute knee injury and osteoarthritis of the knee: a prospective epidemiological assessment. The Clearwater Osteoarthritis Study.

OBJECTIVE: To evaluate the association between acute joint injury to the knee and knee osteoarthritis (OA). DESIGN: Prospective cohort. Sample size = 1,436. Men and women aged 40 years and older participating in the population-based Clearwater Osteoarthritis Study (1988-current) with biennial physical exams including serial radiographs. Radiologically confirmed knee OA = 27%; self-reported knee injury = 11%. Lawrence and Kellgren ordinal scale was used to determine radiological evidence of the study outcome, knee OA. Self-reported history of knee injury was used to determine the study exposure. RESULTS: Individuals with a history of knee injury were 7.4 (95% C.I. 5.9-9.4) times as likely to develop knee OA than were those individuals who did not have a history of knee injury. CONCLUSION: Acute knee joint injury appears to be a risk factor for the development of knee OA. Prevention strategies for OA should be targeted to those individuals with a history of acute knee injury.

Acute Disease↗
PubMed1996

Diagnosis and treatment of common knee injuries in athletes.

Knee injuries are an all too common occurrence in athletes. Prompt diagnosis, aggressive treatment and rehabilitation is necessary to minimize time away from athletic activity and to maximize function at a competitive level. This article reviews the latest trends in diagnosing and treating common knee injuries in athletes, including ligamentous and meniscal injuries.

Athletic Injuries↗
PubMed1985

Primary evaluation and management of knee injuries.

In summary, knee injuries may be difficult to evaluate, but a systematic approach can lead one to an accurate, precise diagnosis. Certain injuries require higher priority management, and more expedient care and recognition of these is critical.

Exudates and Transudates↗