Knee injuries aren't forever

For a few glorious seconds, you’re high in the air celebrating a volleyball spike, a slam dunk into the basketball hoop, or skiing over a mogul when suddenly you come crashing back to earth. You know immediately: This is a serious knee injury.

A knee injury is one of the most common joint injuries and often results from participation in sports such as soccer, football, basketball, skiing and gymnastics. It can also occur from a direct blow to the knee or a twisting movement that causes a violent force at the knee joint.

Often a “pop” is felt at the time of injury. Patients have also described a sliding feeling, like the upper and lower knee joint bones are moving in opposing directions.

With severe knee injuries, there is almost always a significant amount of pain and swelling. In minor injuries, on the other hand, pain and swelling may not be as pronounced. Regardless, a health professional should evaluate any knee sprain that results in swelling or difficulty in walking.

If left untreated, injured ligaments can put extra wear and tear on the surrounding cartilage in the knee joints, which can lead to a type of arthritis that can be more difficult to treat than the ligament injury itself.

What about treatment?

If you’ve suffered a knee injury resulting in a ligament tear, there are two basic treatment options depending on your age, the severity of the injury and your activity level. Not all knee injuries require surgery. Most often the two choices are either surgical reconstruction of the knee joint combined with physical therapy, or physical therapy alone. Most young and physically active persons choose surgical reconstruction so they can resume their normal lifestyles and activity levels. But patients may opt for physical therapy alone if the injury is not affecting their daily activities or recreation.

• Reconstruction through surgery: Surgery is usually delayed until three to four weeks after the injury occurs to allow the swelling to go down and some motion to be restored. It is almost always performed under a spinal or general anesthetic, and usually on an outpatient or day-surgery basis. Because the ligament cannot be directly repaired, it is replaced with tendon tissue taken from around the patient’s knee. In some cases, tendons from other areas or from a tissue bank can also be used. Any injuries to cartilage are treated at the same time as the reconstruction.

• Physical therapy: With or without surgery, a complete physical therapy program is very important for successful recovery from a ligament tear. Guided by a physical therapist, patients gradually increase knee motion and learn muscle-strengthening exercises that can be done at home to speed recovery. Because it takes up to nine months to fully heal and strengthen the new ligament and rehabilitate the muscles above and below the knee, your motivation and persistence is essential for good results.

While it may feel like the end of the world, a knee injury need not be the end of an active life if you’re willing to get good medical treatment and work hard at rehabilitation through physical therapy.

Dr. Gaston Deysine is a board-certified orthopedic surgeon at Virginia Mason Federal Way. He can be reached at 838-2400.

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