Stability of the knee joint is a state in which the musculoskeletal system continues to function normally and perform basic tasks. Proper mobility of the joint is provided by the muscles and meniscus, which are combined with the bearing passive parts of the knee. They represent the posterior and anterior cruciate part of the ligamentous apparatus and the medial collateral and lateral iliotibial tracts. Properly functioning muscles, which are located near the joint bag, give the knee good dynamic stability. It is important to identify the underlying causes of knee instability.
Features of defeat
The knee includes many tendons, as well as intertwined ligaments, when ruptured, the joint becomes unstable, which most often requires the installation of an endoprosthesis to improve the condition of the knee and the patient's life. If you do not start a comprehensive and correct treatment, then as a result a person may lose the ability to move around.
To understand the causes of defeat, it is important to understand what thelinks and how they differ. They are of the following types:
- rear and front cross type;
- medial and lateral collateral type.
In most cases, instability of the knee joint occurs due to severe injury or an insufficient amount of useful components and minerals. This condition is common among the military who serve in the army, especially in the northern regions of the country.
Also, people professionally involved in sports are especially prone to such damage. They have to constantly put heavy loads on their legs. Due to sudden movements, incorrect turns and jerks, a rupture of the ligaments of the joints occurs. Under the influence of these processes, athletes face sprains of the medial and collateral ligaments when jumping.
Swelling of the knee and instability of the joint can be caused by various bruises and injuries. Injury is often provoked by inaccurate, too abrupt movements, as well as twisting. If you do not start complex therapy at the initial stage of the development of the lesion, then in the future a person will have to undergo a surgical operation to install an endoprosthesis, without which he simply cannot live normally.
Also, sharp abduction or adduction of the ankle often leads to bruises and injuries. The posterior cruciate ligament can be damaged by sudden flexion.
The most dangerous cause of knee swelling and instability is the contusion of the extensor part and the main four ligaments. If this happens, then it is important to immediately send the patient to the clinic,where the attending specialist will take an x-ray and identify the degree of damage and, based on this, prescribe the patient treatment with local medicines or surgery. The recovery time of the knee joint and the chance of movement without problems in the future will directly depend on the chosen therapy.
Disease symptoms
With joint instability, a person often has symptoms that, due to their variety, can easily confuse him and lead him to seek help from a doctor in an untimely manner, as he considers that the disease is not serious.
Main symptoms of knee instability:
- If the articular capsule is in a normal state, then balloting and smoothing of the contour occurs in the patella. Nothing like this happens when the capsule breaks.
- If the lateral collateral ligamentous area burst, then a pronounced bruise occurs on the inner popliteal side. This condition occurs, as a rule, with an average degree of injury.
- If there is a rupture of the cruciate ligament, then the person feels an unpleasant pain syndrome, which can cause severe swelling and hematoma.
- If the injury affects the meniscus, then the knee is displaced and blocked, which leads to acute pain. In this case, the patient cannot normally bend and unbend the legs at the knee joint.
- When the cruciate ligament is damaged, the posterior capsular section is additionally ruptured and a pronouncedswelling in the popliteal area.
- When the anterior cruciate part of the ligamentous apparatus is damaged, the lower leg changes its location, starts moving in the wrong direction, which provokes a rapid deformation of the meniscus and cartilaginous tissue. This type of injury is common among children when running fast or falling.
Degrees of development of the disease
Doctors distinguish the following degrees of development of chronic instability of the knee joint:
- In the first degree, the tibial and femoral articular surfaces change their position and move 5 millimeters apart. The capsule in this case remains in a normal state, the ligaments are relaxed. This process most often occurs in infants as a result of congenital pathology or trauma during natural labor.
- Stage 2 knee instability. Between the articular surfaces there is a large distance (up to 10 millimeters). The injury is accompanied by severe deformation of the diseased area of the cruciate ligamentous apparatus. Most often, such a lesion occurs in athletes.
- Third degree. The tibia and femur articular bones are located at a distance of more than 10 millimeters in relation to each other. As a result of this condition, a rupture of the posterior and anterior cruciate parts of the ligamentous apparatus occurs. To get rid of damage of this type is possible only through surgery, the installation of an endoprosthesis and a long course of treatment.
Classification by degrees
All types of instability are classified in degrees:
- at the first stage of the lesion, instability reaches 5 degrees;
- at the second stage, the deviation ranges from 5 to 8 degrees;
- with a severe stage of the lesion, the deviation from the norm exceeds 8 degrees.
Diagnostic measure
To accurately determine the presence of problems with the state of the knee joint, doctors carry out the following activities:
- First, the specialist carefully examines the leg, evaluates the location of the ligaments and the appearance of the knee itself. After that, the leg is measured, since in the presence of a dislocation, its length can be significantly reduced. The information received will allow the specialist to determine exactly what should be done next and what diagnostics to conduct.
- If a hematoma suddenly appeared in the diseased area, then the joint is anesthetized with an anesthetic, which helps not only eliminate pain, but also cope with spasm. After the specialist performs a puncture with further diagnostics.
- After an external examination of the legs, MRI, computed tomography and X-rays are performed, in some cases, arthroscopy is additionally prescribed.
- On the obtained X-ray, you can clearly see the condition of the joint and accurately assess it, and then make a diagnosis based on the classification of knee instability. Instability can be of the following types: lateral, posterior, medial, anterior, combined. The course of treatment will directly depend on how badly the diseased area was damaged.
- Afterthe doctor determines the presence of all degenerative changes, reveals the state of the bone tissue. If surgery is prescribed to install an orthosis on the knee joint with hinges, then the doctor first evaluates the installation site and selects the type of prosthesis.
Only after the attending specialist receives all the information about the condition of the knee joint, examines all the symptoms and reviews the test results, he will be able to prescribe an effective and efficient treatment, as well as preventive measures that will need to be followed after recovery.
During treatment, it is important to strictly follow all the advice and recommendations of the doctor so that the knee joint recovers faster and does not lose its performance.
Features of treatment
After classifying the instability and identifying the exact cause, the doctor prescribes an effective course of treatment that helps to restore the working capacity and normal condition of the joint. The duration of therapeutic measures will directly depend on the degree of defects, the lifestyle of a person and his age. Most often, full recovery will take weeks to months.
Therapeutic measures should be aimed at restoring the mobility of the knee without surgery, if this, of course, is possible.
But in the event that the knee regularly changes its location, damages the ligaments, then without installing an orthosis with hinges on the knee joint it will be impossibledeal. Recovery after surgery continues for 6 months.
Treatment measures
If the traumatologist determines the 1st or 2nd degree of the disease, he will prescribe the following treatment to the patient:
- Splinting the affected leg.
- To fix the joint in a certain position, a splint or bandage is used.
- Therapy may include nonsteroidal medications.
- The specialist prescribes physiotherapy, which includes electrophoresis based on restorative and tonic agents. This treatment is used when there are problems with the joints of the child as a result of recent diseases. The congenital form of the lesion is treated by other methods.
- Prescribing special ointments for the knees.
- Additionally, the doctor may prescribe massages that will help improve metabolic processes and restore blood circulation.
- To restore mobility and strengthen muscles, you should begin to perform a set of exercises for instability of the knee joint, it will be prescribed by an orthopedist.
If conservative treatment has not yielded any results, the specialist suggests surgical intervention. Surgery for joint instability is also performed when the ligamentous apparatus is torn. It is called arthroscopy in medicine. During the operation, the specialist makes an incision through which the damaged tissues are stitched.
After surgery, the specialist prescribes an ointment for the knees, massage andsimple exercises. After 6 months of rehabilitation, most often the patient's condition is restored and the former normal mobility returns to him.
Arthroplasty
Some patients develop instability of the knee joint after arthroplasty, which is accompanied by fever, severe pain, crunching in the knee and other unpleasant symptoms.
Pain may indicate infection, contracture, synovitis, joint instability, and other serious complications.
At the onset of a purulent-inflammatory process, a person experiences severe pain in the head, a feeling of malaise, chills and fever. He also has discomfort in the knee, and the skin around becomes hot. The pain is distinguished by its arching character, and pain relief with pills and ointments does not give a positive result.
Instability of the knee joint is considered the most critical complication. The reason for this condition is a violation of the full sliding of the patella in the frontal plane, which occurs due to improper installation of the implant. During the first year after surgery, instability of this nature is diagnosed in 1.5% of patients.
The appearance of a complication does not depend on the experience of the surgeon and the type of prosthesis. To eliminate instability, the patient undergoes endoprosthetics. When performing a repeated surgical intervention, the doctor eliminates the error in the indicative partinstalled implant. Together with this, superficial prosthetics are carried out.
Hyaluronic acid injections
Often, doctors prescribe injections of hyaluronic acid into the joints to improve the general condition and mobility of the patient. This method is the only one that gives a full effect. Injections are made using a syringe, which contains all the drugs prescribed by the doctor. The procedure is carried out according to a well-established technique, problems can only occur when an injection is made into the hip joint, but they are not considered dangerous, since the patient's condition is monitored by X-ray.
But it is important to remember that the prices for hyaluronic acid injections into the knee joint do not always guarantee the quality of the product used.
Medicines with hyaluronic acid in the composition are produced in three forms: capsules, ointments and solution for injection. Such funds are created in Russia, as well as in foreign countries. All of them are very different from each other in their formula and cost. Prices for injections of hyaluronic acid into the knee joint may vary:
- Domestic funds - from 2500 to 3500 rubles.
- From manufacturers from Austria and Germany - from 5,200 to 22,000 rubles.
- USA - from 9,900 to 23,000 rubles.
- Italy - from 4000 to 6600 thousand rubles.
Prevention measures
Every patient knows that it is much easier to prevent a disease than after undergoing long-term complex treatment, as well as surgery. should be adhered tothe following preventive measures:
- use orthopedic insoles or wear special shoes;
- wear quality shoes in a normal size, which should fix the foot well in the correct position;
- when playing sports and exercising, it is important to wear a special bandage;
- should limit running and start swimming or doing yoga;
- eat right;
- if people involved in sports have serious joint problems, they should stop exercising.
It is important to remember that such a disease is not a sentence, at the initial stage of development it is quickly eliminated. In this case, it is important to consult a doctor in a timely manner, who will select a rational treatment and help avoid complications that may lead to surgery.
