Knee Evaluation: Understanding the Process and What to Expect

Knee joint injury is the disease with the highest incidence rate among bone and joint injuries. More than 1.08 million people go for Knee evaluation yearly due to knee joint problems. 

Visit an orthopedic surgeon.

For a good assessment, the anatomy of the knee joint should first be understood. The knee joint is one of the largest and most complex joints in the body, consisting of the femur, tibia, and patella. Cartilage covers it effectively, preventing mutual grinding. The surrounding ligaments and tendons mainly maintain the stability of the knee joint. The medial and lateral collateral ligaments protect the knee joint from varus and valgus. The quadriceps tendon is the portion of the muscle on the front of the thigh that extends to the surface of the patella and acts to extend the knee. Taking the medical history should be the first step in managing a knee injury because it provides the most important information, such as “What were you doing when you were injured?” Swelling, pain, loss of function, tearing sound, and passive flexion are often the main symptoms of knee injuries. The speed of the swelling will indicate the severity of your injury, for example: if swelling occurs 2-12 hours after the knee injury, this is most likely a hemarthrosis, but also very likely an injury to the anterior cruciate ligament, meniscus, Or both at the same time. If the joint capsule is torn, there will be no significant swelling because blood will flow into the surrounding tissue. This is why you should look carefully for swelling in your thighs and calves during your assessment. If the patient can pinpoint the most uncomfortable area, this can help you localize the injury. However, since pain is only an indication of the extent of the injury, it is not always reliable, and sometimes a grade 1 or minor injury can be more painful than a grade 3 or severe injury because the ligaments are still connected in minor injuries There is tension in the stretched and injured fibers.

In complete tears and tertiary injuries, fibrous tissue is torn apart to reduce the tension that produces pain. If people are injured and have to stop their actions, this is often a sign of a more serious injury. 80% of those with torn ACLs cannot continue their activities. Reports of data on the frequency with which tearing sounds are heard in severe injuries vary, but in general, 40%-60% of ACL injuries have tearing sounds that can be heard at the same time as the injury. In addition to ACL injuries, tearing sounds can be heard in patellar dislocations, meniscal tears, and osteochondral fractures. 90% of patients with anterior cruciate ligament injury claim that the knee joint has downward passive flexion at the time of injury. If the patient feels that the joint is out of control while injured, it often indicates a serious condition.

Be ware of the possibility of a knee fracture when there is a traumatic injury.

Remember to use RICE (rest, immobilize, compress, elevate Affected Limb) – Your preferred treatment principles for knee injuries.

Using the Pittsburgh decision rules for Knee evaluation has a sensitivity of 99% and a specificity of 60%. The Ottawa knee rules were 97% and 27%, respectively. In terms of treatment, if you have a patient with a knee injury that requires immobilization, unloading, compression, cooling, and elevating the affected Limb, you need to treat it after the orthopedic assessment to prevent mistakes. Knee fixators are commonly used in acute care and can also be immobilized with casted compression dressings, casts, fiberglass, and medial and lateral splints. Most acutely injured patients with significant exudate require observation for 7 days post-injury.

In short, knee joint injury is a common injury, understanding the knee joint anatomical knowledge, asking relevant questions when collecting medical history, and Appropriate physical examination items and problems discovered in time during the physical examination Questions will be of great help in the evaluation of patients with knee injuries. 

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