knee injury
Introduction
Introduction to knee injury Knee joint injuries are common in contact or non-contact injuries in sports, including knee joint meniscus injury, knee ligament injury (both often combined), iliac dislocation tendon rupture and a series of injury diseases. More common in athletes and manual workers, more men than women. After the injury, the knee joint suffered from severe pain, stretched out, and swollen quickly, and there was blood in the joint. The diagnosis of knee meniscus rupture is clear. In the past, meniscectomy was performed. Although the symptoms disappeared after surgery, a triangular thin fiber plate was regenerated in the original meniscus within 3 months after surgery, but the knee joint of the meniscus was removed. It is easy to produce osteoarthritis, so it is not currently recommended to completely remove the meniscus. If there is a meniscus injury, it is currently advocated to perform surgery under arthroscopy. The semicircularly separated meniscus can be sutured, and the easily dissected ruptured meniscus flap can be partially removed, and the conditional suture can also be repaired. The broken meniscus can also be removed under the mirror. Endoscopic surgery has a small wound, less interference to the joints, quick recovery after surgery, and can get up early, which has become a routine treatment. basic knowledge Sickness ratio: 0.05% Susceptible people: no special people Mode of infection: non-infectious Complications: joint pain
Cause
Cause of knee injury
The disease is a traumatic disease. Mostly caused by torsion external forces. When one leg is under load. The lower leg is fixed in the semi-buckling. When the booth is out. The body and thighs suddenly whirl. The medial meniscus is between the femoral condyle and the tibia. Subject to rotational pressure. And the meniscus tears. The greater the degree of flexion of the knee joint, such as a sprain. The lower the tearing part. The mechanism of lateral meniscus injury is the same. But the direction of the force is opposite. The ruptured meniscus slides partially into the joint. Mechanical damage to joint activity. Prevents joint flexion and extension activities. Form an "interlock".
Prevention
Knee joint injury prevention
There is no special prevention method, try to avoid trauma, and pay attention to cultivate good habits in life.
1. Appropriate exercise to enhance leg muscle strength.
2, pay attention to protect the joints during childhood, wear suitable sports shoes to cushion the impact caused by running and jumping.
3. Wear protective gear during skating and roller skating to avoid joint damage.
Complication
Complications of knee joint injury Complications, joint pain
The structure of the knee joint is complicated and the trauma is many. The damage is mostly combined injury. In particular, the complication of the collateral ligament injury is more than 73%, and the damage of the III injury combined with other structures is about 100%. Common injuries There are anterior cruciate ligament injury, posterior cruciate ligament injury, meniscus injury, bone contusion, fracture, joint effusion, soft tissue around the knee joint.
Symptom
Knee joint injury symptoms Common symptoms Knee joint swelling Knee joint pain Knee joint can not fully straighten the knee joint swelling blood stasis inside the knee joint ... Knee joint effusion soft leg knee joint weakness weak joint pain
Other injuries to the knee joint
Meniscus injury - symptoms
1. Most patients have no history of trauma, and gradually become swollen after injury, and the injured side is more significant.
2. Pain often occurs in a certain position in the movement, and the pain may disappear after the position changes. The pain site is in the joint space on both sides.
3. Walking can be, but it is weak, especially when going up and down the stairs, accompanied by pain or discomfort. In the elderly, the quadriceps will gradually shrink.
4. Interlocking symptoms. When in motion, the femoral condyle protrudes into the rupture of the meniscus and cannot be relieved, which can suddenly cause the knee joint's flexion and extension obstacles, forming an interlock. After relaxing the muscles, changing the position, and autonomously or passively rotating and flexing, the interlock can be relieved.
Knee ligament injury - symptoms:
Have a history of trauma. More common in adolescents, more men than women, athletes are most often seen when injured, sometimes can hear the sound of ligament rupture, and soon because of severe pain can not continue to exercise or work at the knee joint swelling, tenderness and effusion ( Blood), knee tendon, the patient does not dare to move the knee, the knee is in a forced position, or straight, or the fracture of the knee collateral ligament has obvious tender points, and sometimes the ligament is collapsed. end
Dislocation of the humerus - main symptoms and signs:
The patient felt a sudden pain in the knee joint and could have a dislocated feeling or weakness. After the knee joint is straightened, the tibia often resets itself, and the "click" sound is often heard during the reset. Then the knee joint is swollen. These symptoms can be confused with meniscus tears, but unlike meniscal tears, patients with dislocation of the patella can significantly affect swelling and pain at the medial edge of the patellofemoral joint, rather than the medial space of the knee joint.
Other symptoms of knee injury
(1) Knee fractures, such as intercondylar fractures of the femur, humeral condylar fractures, etc., should pay attention to the knee ligament, meniscus and neurovascular injury, knee dislocation should also be concerned. Care must be taken to avoid missed diagnosis.
(2) Traumatic dislocation of the knee without special abnormalities in the knee joint can cause severe soft tissue injury in the knee, especially the joint capsule with suture tear should be repaired in time to prevent habitual dislocation in the future.
(3) or quadriceps tendon rupture. Indirect violence caused by sports. Suffering from the pain of the lap (the quadriceps tendon rupture) or the knee (the sacral fracture), the sound of the tendon rupture can be heard. At the time of physical examination, the knee is swollen and cannot actively stretch the knee. The knee extension resistance test was positive. There is obvious tenderness above the tibia (fracture of the quadriceps tendon) or below ( fracture), local emptiness, and can reach the tendon of the tendon. Compared with the contralateral side, the humerus is moved down (femoral quadriceps tendon rupture) or upward ( rupture). Should be repaired in time.
(4) Osteophyseal osteophytes. Occurs in adolescents, history of trauma or strain, localized pain of the tibial tuberosity, swelling of soft tissue, dysfunction, and obvious pain during sputum. At the time of examination, the tibial tuberosity was raised (higher than the opposite side), not red, hard to touch, and touched with pressure. For knee extension resistance test, knee flexion and semi-squatting test, single leg support test, etc., pain can occur at the tibial tuberosity. Treatment consists of strict suspension of training and partial closure. If conservative treatment is not effective in June, sacral nodule drilling can be used.
(5) Chronic running knee. Long-term running, jumping and other exercises cause the tendon bundle and the femoral condyle to repeatedly rub, forming a local aseptic inflammation. There is local pain, swelling, tenderness, and increased activity. Knee varus deformity is most likely to occur. Treatment consists of raising the outer side of the sole, partially closing it, and taking anti-inflammatory analgesics as appropriate.
Examine
Knee joint injury examination
Physical examination
(1) Overextension test: When the knee joint is completely straightened and slightly overextended, the meniscus rupture is pulled or squeezed to cause severe pain.
(2) Overflexion test: The knee joint is extremely flexed, and the posterior horn of the rupture is stuck and causes severe pain.
(3) Meniscus rotation test: the patient is supine, the affected side of the hip and knee is fully flexed, the examiner puts one hand on the extra-articular space for palpation, the other hand holds the heel and makes the calf a large circular motion, the inner loop The lateral meniscus was tested, and the medial meniscus of the outer loop was tested. The knee joint was gradually extended to 90 degrees while maintaining the rotational position, paying attention to the joint angle at which the sound occurred. If the sound is heard under the full flexion of the joint, it means that the posterior horn of the meniscus is damaged, and the sound is generated when the joint reaches the degree of the joint. It is expressed as a body injury, and then gradually extends to the micro-flexion while maintaining the rotational position (MOUCHE test) ), at this time it sounds loud and indicates that there may be damage to the meniscus anterior horn.
(4) Grinding test (Apley test): The patient is prone, the knee flexes to 90 degrees, the examiner presses the calf down forcefully, and performs internal and external rotation to cause friction between the femur and the tibial articular surface. Spiral pain, suggesting lateral meniscus injury, after which the lower leg is lifted up, and the internal rotation and external rotation movement, such as external rotation caused pain, suggesting that the medial collateral ligament injury, this test in the examination of hip ankylosis patients half a month The board has certain practical significance.
(5) squat test: mainly used to check the posterior angle of the meniscus for damage, the method is as follows: patients squat down the duck steps, from time to time to change direction, or left or right, if the patient can do these exercises well, Except for the posterior horn injury of the meniscus, if the knee joint is not fully flexed due to pain, the sound of the knee and the pain of the knee are discomfort, which is a positive result. The rupture of the meniscus rupture case is very obvious when the rupture of the meniscus is ruined. It is only suitable for examining adolescent patients, especially for large-scale physical examination to check for meniscus injury.
Film degree exam:
X-ray plain film examination can not show the meniscus shape, mainly used to exclude other lesions and injuries of the knee joint, joint air angiography, iodine solution contrast, or air-iodine solution comparison should be a small auxiliary diagnosis method, but it has been Replaced by MRI, ultrasound is still in the experimental stage. The resolution of the MRI film can clearly show whether the meniscus is deformed or broken, and can also detect the damage of joint effusion and ligament, but its accuracy is not as good as arthroscopy. Arthroscopy is a new technology. In recent years, the extensive use of endoscopic techniques has further hindered the disorder of the knee joint. It can not only find the meniscus injury that is difficult to detect by imaging examination, but also find out whether there is a cross between the younger brothers. Articular cartilage and synovial lesions can be used not only for diagnosis but also for endoscopic surgery, such as biopsy and meniscal repair and partial resection.
Diagnosis
Diagnosis and diagnosis of knee joint injury
Most patients have a clear history of knee sprains. After the injury, the knee has severe pain, can not automatically straighten, and the joints are swollen. The tenderness at the knee joint is an important basis for meniscus injury.
1. Only some cases of acute injury have a history of trauma, and there is no clear history of trauma in chronic cases.
2, more common in athletes and manual workers, more men than women.
3, after the injury, the knee joint is very painful, stretched and not straight, and swollen quickly, the page has blood in the joint.
4. After the acute phase, it will be transferred to the chronic phase. At this time, the swelling is not obvious, the joint function has been restored, but the joint pain is always felt. There is a ringing during the activity. Sometimes, when the activity is suddenly heard, the joint can not be straightened, and the painful wave is a few calves. When you hear the "" sound joint, you can straighten it. This phenomenon is called joint interlocking. It can happen occasionally or frequently. Frequent seizures affect daily life and exercise.
5, the signs of chronic stage have joint space tenderness, bouncing, knee flexion contracture and femoral medial muscle weak, along the joint space squeaking, you can check the tender point, according to the tender point, you can check the tender point, according to tenderness At the point of the point, it can be roughly judged that the anterior horn, the body or the posterior horn is torn. The horizontal cleavage of the anterior horn can be seen when the knee joint is flexed and stretched, and the knee joint is bounced. It is difficult to unlock the plate under the femoral condyle for a long time, and the atrophy of the muscle in the femur is disuse, and the sign indicates that the internal result of the knee joint is disordered.
