When talking about the knee, most people mean the knee joint. Indeed, it is an important anatomical part, however, its functionality is impossible without muscles and tendons. When walking, running, playing sports, this area has a significant load, which increases the risk of damage. Let's take a closer look at the knee joint, ligaments, muscular apparatus and problems that arise during the action of a traumatic factor.
Features of anatomy
Three bones take part in the formation of the joint: part of the femur, patella and part of the tibia. The patella is represented by the tibiofemoral and femoral-patellar joints. Anatomical features contribute to the simultaneous mutual movement of bones in several planes.
Menisci, represented by connective tissue cartilage, are"pads" between the heads of the bones. Their function is to provide shock absorption, distribution of pressure and load during movement. On both sides, the menisci are connected to the joint capsule by coronary ligaments.
The following muscle groups are the stabilizers of the joint, awareness of which is considered an important point in traumatization:
- The quadriceps muscle occupies the front surface of the thigh. It is considered the strongest anatomical structure of the muscular apparatus of this area.
- The tailor muscle is the longest. It provides flexion to both the hip and lower leg, bypassing around the knee joint.
- A thin muscle runs behind and slightly to the side of the joint, allowing hip adduction and knee flexion.
- The adductor magnus is involved not only in hip adduction, but also hip extension or extension of the pelvis in relation to the hip.
- Behind the transverse axis is the biceps femoris muscle, which allows you to bend the lower leg, unbend the thigh, and provide outward movement.
- Behind and inside the joint is the tendon muscle, which extends the thigh, flexes the lower leg and provides circular rotation of the limb.
- The semimembranosus muscle performs similar functions to the tendon.
- The triceps muscle of the lower leg flexes the lower leg at the knee and the foot at the ankle joint.
- The short and flat hamstring muscle is located on the back surface. The function is to bend and rotate the lower leg.
Functions of the knee
EfficiencyThe knee joint is important for the human body. It can move along the vertical and frontal axes. Extension and flexion occurs along the frontal axis, along the vertical - rotation of the limb.
Flexing the joint allows a person's leg to take a step forward without hitting the limb on the ground, but gently placing it. Otherwise, the person's leg would be extended in the upper front direction by raising the hip.
Ligament apparatus
The knee joint, whose ligaments are represented by five main groups, is considered an anatomically complex part of the body. Its composition includes the following types of ligaments:
- collateral (tibial, fibular);
- cruciform (front, back);
- transverse knee ligament;
- posterior (arcuate, popliteal, patellar ligament, medial and lateral);
- coronary (menisco-femoral, menisco-tibial).
When traumatized, especially sports injuries, the main load occurs on the cruciate ligaments of the knee joint. The terms of recovery and the rehabilitation period depend on the nature of the injury and the damaging factor, the characteristics of the victim's body, last from 4 to 6 months.
Cruciate ligaments and their functionality
The anterior ligament runs from the posterior superior part of the meniscus of the femur through the cavity of the knee joint, attaching to the tibia, which is part of the articular conglomerate. Its function isin stabilizing the knee joint by limiting forward movement of the lower leg.
The posterior ligament continues from the front of the bony prominence of the femur and, crossing the joint cavity, is attached to the tibia in the back. The ligament does not allow excessive shifting of the lower leg back.
Cruciate ligament injury
Such injuries are considered the most complex and dangerous, requiring full treatment. Incorrectly selected or untimely started therapy leads to the development of lameness and persistent limitation of functioning. Most often, such injuries occur in professional athletes when skiing, skating, jumping, wrestling, arising from a strong blow or an unsuccessful turn, fall.
Severe piercing pain and a characteristic click, a sharp limitation of mobility may indicate that the ligament of the knee joint is torn. The victim cannot move independently, only relying on someone.
Injury to the posterior ligament occurs when the knee is strongly overextended or during a blow to the anterior surface of the lower leg. Damage to the anterior cruciate ligament of the knee joint is the most common. The symptoms of this injury are included in the "Thurner's triad" along with a torn meniscus and an external ligament.
Clinical picture
The knee joint, the ligaments of which have a partial tear, becomes hyperemic, swollen, painful to the touch and when trying to move. accumulates in the joint cavityblood (hemarthrosis). You should not confuse inflammation of the ligaments of the knee joint, which has a similar clinic, with symptoms of an injury that occurred a few days ago.
Complete rupture of the cruciate ligaments causes excessive mobility of the lower leg in the anteroposterior plane. Checking such a symptom is carried out by two specialists at the same time. The first holds the back of the thigh and bends the painless limb at the knee at a right angle. The second doctor checks the movement of the lower leg forward and backward. When stretched or torn, such a sign will be negative.
A sprain means a slight tear of the fibers, accompanied by moderate soreness, slight swelling, and the absence of hemorrhage. The restriction of motor function occurs to a small extent.
Diagnosis
Determining the mechanism of injury allows you to find out possible damage to the anatomical structures. Before examining an injured knee, the doctor examines a he althy one to find out the structural features. The state of internal structures is assessed using ultrasound and MRI.
Differential diagnosis allows to exclude fractures of bones, patella, meniscus rupture. With a dislocation, the bones are displaced relative to each other, there is no possibility of motor function, there is a springy resistance when trying to passive movements. For damage to the ligaments, the complete absence of movement is not typical, it is limited due to the pain syndrome. There is also no springy resistance.
The fracture is accompanied by deformity, crepitus and pathological mobility. However, there are fractures that do not have such signs. In this case, confirmation of the diagnosis requires an X-ray examination, ultrasound or MRI.
Principles of treatment
In case of partial injuries (stretching, tearing), assistance is provided in the emergency room. The limb should be in an elevated position, the first few days - bed rest. The first day after the injury requires the application of cold to the damaged area. The joint is fixed with a tight elastic bandage, which allows you to maintain the physiological position of the limb during movement. It is impossible to leave a bandage at night, so that there is no circulatory disturbance. Pain relief requires the use of analgesics ("Ketanov", "Ketalong", "Nalbuphine").
The knee joint, whose ligaments require not only conservative therapy, but also surgical treatment, needs a long rehabilitation period. After all the same measures as with partial injuries, physiotherapeutic measures are used, including massage, physiotherapy exercises, electrophoresis with medications.
Quite often, surgery is required when there is a torn cruciate ligament of the knee joint. The operation to restore the integrity of the anatomical structures is necessary for normal functioning. Surgery is performed throughsix months after a joint injury.
The ideal candidate is considered to be a young athlete who needs to perform jerky movements of the limbs in his sport. Older people who do not have much physical activity are more suitable for conservative therapy and exercise therapy.
Acruciate ligament repair of the knee requires the use of a graft taken from the patellar ligament or hamstring (autograft). It is also possible to use synthetic prostheses, however, their use may be rejected by the patient's body.
Suturing synthetic grafts is a common procedure when the lateral knee ligament is torn. Treatment with surgical measures is considered the method of choice in such a case.
Surgical practice has shown that simple suturing of injured structures practically does not restore functionality.
What are the complications of a knee injury?
Among the common complications of knee injuries are the following:
- The development of arthritis is possible 2-3 weeks after joint damage. An inflammatory reaction occurs as a result of circulatory disorders and the entry of pathological microorganisms into the injury zone. It is characterized by pain syndrome, the appearance of swelling, hyperemia, limitation of mobility due to pain.
- The appearance of degenerative changes in the form of arthrosisaccompanied by the formation of osteophytes, thinning of cartilaginous tissues.
Forecast
After an injury, most of the victims are interested in: "Rupture of the ligaments of the knee joint, how long does it heal?" This question is considered in each clinical case individually. Depending on the nature of the injury and the characteristics of the body, full performance may return in six months, or maybe in a few months.
The mechanism of damage itself is important and how the victim received a rupture of the ligaments of the knee joint. How long the injury heals also depends on the exact observance of the advice of the treating specialist. Early initiation of therapy, taking the necessary medications and adherence to the regimen allows you to speed up the healing process and prevent the development of complications.
Prevention
The list of preventive measures used to minimize joint damage is as follows:
- adequate physical activity;
- inflammation of the ligaments of the knee joint should be treated in a timely manner;
- balanced diet;
- rejection of alcohol and tobacco abuse;
- avoiding hypothermia;
- control of the minimum stay of limbs in static poses;
- the right choice of shoes, the rejection of high heels.
Injury to the knee joint is preventable, which is one of the simpler measures than restoring its functionality due todamage.
