Presentation, examination, investigation and early treatment of acute knee injuries

Abstract

Acute knee injuries are common presentations that frequently occur during sporting activities and can result in permanent disability. However, they often result in a single visit, seldom receive surgical intervention and, in the main, are cared for entirely by General Practitioners or Emergency Department physicians. Thorough clinical assessment and appropriate early treatment at the primary presentation is vital in order to offer the best chance of maximal functional recovery and to minimize long-term disability. This requires a sound knowledge of basic knee anatomy, careful assessment of the mechanism of injury, detection and consideration of physical ndings and the results of adjunctive investigations. This article aims to give a comprehensive review of the examination, investigation and early treatment of acute knee injuries at the primary presentation. In addition, comments on important epidemiological and aetiological factors and a brief description of basic knee anatomy are also provided.

The use of early immobilization in the management of acute soft-tissue injuries of the knee: results of a survey of emergency physicians, sports medicine physicians and orthopedic surgeons

“…1 Accurate recognition and appropriate early treatment are critical in minimizing further injury and facilitating recovery. 1 The treatment of acute soft-tissue injuries of the knee is guided by knowledge of the phases of healing.…”

“…1 Accurate recognition and appropriate early treatment are critical in minimizing further injury and facilitating recovery. 1 The treatment of acute soft-tissue injuries of the knee is guided by knowledge of the phases of healing. [2][3][4][5][6] In order to protect injured tissues and alleviate pain, complete knee joint immobilization (using either a nonhinged knee brace or splint) is used by some physicians as part of the initial management of these injuries.…”

“…[11][12][13][14][15][16] Patellar dislocation is arguably an exception, as is the grossly unstable knee. 1,[17][18][19][20] Management of these patients is undertaken in different clinical environments by various health care providers. For many acute injuries, the initial presentation for medical care occurs in the emergency department (ED).…”

“…21 When managing acute soft-tissue knee injuries, many physicians are influenced by treatment principles that allow motion so long as further injury is avoided, which is evidenced by decreasing levels of pain and inflammation. [1][2][3][4][5][6][22][23][24][25][26][27] Unfortunately, clear guidelines regarding the use of immobilization for specific knee injuries do not currently exist. The purpose of this study was to explore the opinions and reported practice patterns of EPs, SMPs and OS with regards to the use of early immobilization in the management of acute soft-tissue injuries of the knee.…”

Posterior cruciate ligament injuries

“…The knee joint is the most common cause of longterm disability following musculoskeletal trauma (Hunt and Greaves, 2004). According to Atkinson and Atkinson (2000) approximately 10% of all the injuries recorded annually were low-severity injuries; however, 1 in 50 were serious non-fracture knee injuries such as ligament tears.…”