Subluxation of the knee joint is an injury characterized by a partial displacement of the bony articular surfaces that form the knee joint. It differs from dislocation, since during the latter, the articular surfaces lose contact with each other during displacement, but with subluxation, they do not lose contact, but not completely.
In simple terms, subluxation of the knee joint is the so-called incomplete dislocation, which is characterized by a partial preservation of the activity of the joint, while with complete dislocation it loses its inherent motor active function.
Anatomical features
The anatomical structure of the knee is quite complex: the structure of the joint includes a lot of main and additional components that provide extensive motor functionality. In addition, the knee joint is the largest in the body. One of his duties is to support the weight of the human body. Despite such a complex structure, the knee is susceptible to injury.
The backbone of its articulation includes three bones:
- patella;
- femoral;
- tibial.
The kneecap is a shield against numerous traumatic factors, it protects a large number of fragile ligaments from blows. The parts of the femur that form the joint are called condyles - medium-sized hills covered with cartilage. A little lower is the plateau of the tibia.
Cartilage coating
Soft and tight contact to the surfaces of the joints is provided by a cartilaginous coating, whose thickness reaches 6 mm. In addition, cartilage fibers cover the surface of the patella at the back. This structure reduces the degree of friction between the component parts of the joint and provides cushioning.
Limiters and strengthenings of movements is the ligamentous articular apparatus. The cruciate ligaments, which are located directly in the center of the articulation, create a limitation in the forward and backward movements of the knee. The cruciate ligament anteriorly holds the tibia while the posterior ligament prevents it from coming out backwards.
Menisci
The articular menisci are directly located between the bones - also cartilaginous formations, but they have some differences from the classic cartilage. Thanks to the menisci, an even distribution of weight is created, which puts pressure on the knee from above. They seem to distribute all the pressure of the body over the surface of the bone, which is adjacent to the knee.
The sciatic and tibial nerves provide the sensitive area of the knee joint. Nerve fibers branch out and go through all areas of the articulation, including the menisci. But the innervation of the knee is not as well developed as in other joints, and therefore, in case of serious injuries, it experiences a lack of supply of nerve impulses, and as a result, tissue dystrophy occurs.
Types of dislocations
Dislocation is understood as a complete displacement of the bones of the joints, when they completely go beyond the lock formed by the contact surfaces, losing the channel that guides them: the condyles of the epiphysis leave the deepened plateau of the tibia, while the patella leaves the anterior groove of the femur bone.
With incomplete displacement and partial preservation of the contact of the surfaces of the joints, such a dislocation will be called a subluxation of the knee joint, that is, incomplete.
Such injuries can be closed if the skin is not affected, and open when they appear in external lesions.
Complicated dislocation is considered when combined with damage to the meniscus, bones, muscles, nerves and blood vessels.
What other types of knee dislocations are there? They are divided according to the reasons that caused them:
- mechanical (accident, sudden sudden movement, strong impact);
- pathological - caused by inflammatory, degenerative-dystrophic processes in the bones, as well as osteopathies: osteoporosis, osteoarthritis, arthrosis, etc.;
- chronic (habitual) - occur due to anatomicalspecifics of the human musculoskeletal system;
- congenital - due to abnormal bone development;
- old - due to untreated primary trauma.
Reasons
Subluxation of the knee can occur in both children and adults. They can provoke him:
- deviations in the structure of the leg skeleton;
- weakened thigh muscles;
- past knee injuries due to hits, jumps, accidents, falls;
- patella surgery;
- falling from a height;
- sudden contraction of the quadriceps femoris.
A habitual subluxation can form in the body after an injury. Its characteristic feature is that it becomes a source of instability of the knee cup and, with minimal trauma or physical exertion, causes the next development of the disease. This is a dangerous condition that can subsequently lead to post-traumatic arthrosis.
What are the symptoms of knee subluxation?
Symptoms and treatment of knee subluxation in adults and children
In its manifestations, subluxation is quite similar to dislocation:
- patient complains of pain in the affected joint; however, it happens that a person may not experience pain at all (such a difference is determined by the individual threshold of sensitivity);
- modification of the joint;
- edema, there may be redness and heating of the joint; injuredmay indicate a subjective feeling of heat in the knee area;
- limitation of active actions and pain in passive ones.
In some cases, the symptoms of subluxation of the knee joint can be so minor that the victim himself does not know about the pathology. It is discovered during a random examination or visit to a doctor.
In the knee joint, subluxation can be determined by x-ray. An indicator of a he althy knee joint in direct projection is the uniform thickness of the joint space over the entire gap between the bones and the parallelism of the lines connecting the vertical edges of both bones. In the lateral projection, you can examine the shape of the condyles of the femur, the condition of the patella, as well as the physiological space of the knee joint (rhomboid space). Ligaments of the knee joint (cruciate, patella ligaments), which are quite often injured, can only be examined with an MRI.
First Aid Procedures
First aid should be provided as early as possible while the joint is still in a "fresh" state. How quickly attention is paid to it will determine the number of consequences before receiving treatment and immediately after it.
If subluxation of the knee joint is suspected in a child, then in no case should you try to set it yourself, as this can cause even more significant joint damage.
First you need to immobilize and securely fixinjured place. This requires the use of improvised means, for example, thin bedding, clothes, hard oblong objects (branches, plywood, sticks). If there is no solid material at hand, you can tie a he althy one to the injured leg.
The next step is cooling. You need to apply ice to the knee. Ice would be an excellent option, but it must be wrapped in a thick cloth and only then applied. Thanks to this action, tissue frostbite is prevented. Also, instead of ice, you can use cold water poured into a bottle or heating pad.
It is important to remember that knee subluxation can only be reduced by a competent specialist - a doctor who practices in the field of orthopedics and traumatology. The wrong movement of a person without experience will cause complications in the joint, and as a result, the subluxation will develop into an ordinary dislocation.
How to treat subluxation of the knee?
Features of treatment
The main treatment method for subluxation of the knee joint is reduction. The specialist will first assess the local condition of the knee. In some cases, additional diagnostics is required - arthroscopy or radiography, but the need for such an instrument is usually infrequent: as a rule, subluxation is diagnosed simply and does not present difficulties for a practicing traumatologist. Then the doctor makes manipulations that are aimed at reducing the pathology.
You can also treat knee subluxation at home.
Actions at home
Sometimes, due to various circumstances, it is not always possible to send the victim to a medical facility. In this case, home therapeutic methods will come to the rescue. Primary care is the same as for regular care. Then you need to leave the subluxation of the knee in a calm state for a long period.
It is very important to put the lower part of the injured limb on the roller to improve blood circulation. And further care of the joint consists in daily lubrication with ointments that have strengthening and warming properties.
Treatment of knee subluxation should be timely.
Recovery period: features of rehabilitation
A victim after any treatment needs to undergo a rehabilitation course. After the joint is repositioned, the patient is referred to a doctor competent in the field of rehabilitation. The duration of recovery after subluxation of the knee joint, on average, is from two weeks to two months: the knee apparatus is provided with a large number of structures, and each of them requires restoration. The rehabilitation course includes the following activities:
- treatment with ointments and, if necessary, painkillers;
- physiotherapy treatments that include therapeutic massage, bathing, self-massage, general strengthening activities, visits to swimming pools;
- a rational and balanced menu with such specific dishes as jelly, it containsa large number of substances that are useful for restoring joint components; jelly is especially good for tendons and ligaments;
- Exercise and exercise.
At first, it is necessary to limit the number of loads, gradually return the motor function to the knee. After completion of the rehabilitation course, it is advisable for the patient to continue doing gymnastics and simple physical education.
To prevent the formation of subluxation of the knee joint in a child, you need to train muscles, walk more often, add work to the joint, eat foods containing minerals and vitamins. One of the most common recommendations for avoiding subluxation of the knee in children is to avoid situations that are fraught with injury.
The problem with the joint in dogs
Dislocation and subluxation of the knee joint in small breed dogs is a common problem that can cause severe lameness in the animal over time or immediately, and requires contacting a veterinarian in a timely manner. The following breeds are most often predisposed to it: pygmy poodle, chihuahua, Yorkshire terrier, toy terrier and their crosses.
To determine the cause of subluxation of the kneecap, in addition to examination, a special examination of the limb with pathology is required - X-ray. Conservative treatment in this case is the use of anti-inflammatory and painkillers. It makes sense for small violations to maintain the animal.
Since this problem is mechanical in nature, the priority treatment issurgical stabilization of the joint. Her method is determined by pathological changes in the patella. In some cases, a combination of several methods is required, since subluxation can be caused by a number of factors.
