Dislocation of the knee: causes, symptoms, treatment, rehabilitation and consequences
Probably in the life of every person at least once there were various injuries. Some of them are quite serious, others do not bring too much discomfort. They can occur as a result of an accident, a fall, or improper exercise. And in order to correctly determine the seriousness of the injuries and correctly provide first aid to the victim, it is necessary to know all the features. Dislocation of the knee joint is considered one of the most common and severe injuries. According to ICD-10, the code of this pathology is S83.
Such an injury consists in displacing one bone in relation to the other. At the same time, disruptions in congruence also occur and ligaments and muscles are necessarily broken. However, the most serious factor is considered damage to the capsule in the cup itself.
It is known that the knee joints contribute with the largest surfaces - the bones of the lower leg and thighs. Such a contact is very important for the formation of a full support. These surfaces perfectly match each other. They are firmly enveloped by various ligaments, muscles and connective tissue, creating a kind of dense capsule. Huge efforts are required to damage this system. When a knee joint is dislocated, its capsule is always damaged. That is why the cause of such a trauma can not be a simple jump or some inaccurate movement.
It should be said that the damaged part is that part of the leg that is located farther than the joint. For this reason, very often such an injury is called a dislocation of the leg, since it is she who is not in her place. Damage may occur between the femur and the tibial or the patella.
As a rule, strong external effects of the mechanical type are prerequisites for the appearance of injury. The most common causes of dislocation of the knee are:
- powerful physical damage;
- congenital anomalies of bone and cartilage systems;
- pathologies provoking the destruction of bones - for example, arthritis, poliomyelitis, osteoporosis, tuberculosis, osteomyelitis.
The weakening of the joints is often observed against the background of general vitamin deficiency, reduced immunity, which often occurs after illness, severe stress, as well as in old age.
However, most often professional athletes are faced with a dislocation of the knee joint.
The signs of such an injury are completely dependent on the severity of the damage. At first, after the onset of dislocation, the symptoms of pathology are in many ways similar to other diseases. That is why if you suspect a knee injury, you should consult a specialist and go through all the stages of the necessary examination.
The main symptoms of dislocation of the knee joint include:
- acute pain appearing during injury, as well as during palpation and movement of the limb;
- in case of damage, you can often hear a typical click, which occurs due to the rupture of the patellar tendons or the joint capsule;
- the knee itself is deformed, and its shape, position and shape change;
- the site of damage swells in the background of traumatic synovitis, hemarthrosis and periarthritis;
- sometimes bruises, hemorrhages under the skin and hematomas are signs of pathology;
- the resulting injury prevents the execution of familiar actions - it is simply unrealistic to perform active movements, and with passive actions a certain limitation appears, resembling a spring;
- the dislocation is accompanied by a rupture of the knee arteries, as a result of which the pulsation disappears on the foot, the limb becomes numb and becomes cold;
- when injuring nerve fibers on the background of subluxation, physical activity is disturbed, and the sensitivity in the leg is slightly lower than the injury itself.
All described signs of injury are non-specific. In fact, the symptoms of dislocation of the knee joint differ depending on the type of damage. For example, a habitual injury has a slightly different clinical picture. It should be said that the treatment of such a pathology is based primarily on the classification of damage and its severity.
The severity of a dislocated knee is determined by its appearance. There are several types of damage, differing in exactly where the joints are displaced and whether congruence is lost. There are such types of pathology:
- full form - the articulation is shifted backward or forward, the contact of adjacent surfaces is completely lost;
- subluxation or incomplete type - the joint is displaced inward or to the outer side of the leg, while the contact between the surfaces of adjacent joints partially remains;
- habitual type - regularly repeating calyx shifts fall into this category, usually this pathology is explained by strong sprain;
- open and closed type is determined by the presence of a skin break.
Taking into account the cause of the knee dislocations are divided into several categories:
- traumatic - develops on the background of a powerful blow to the joint area during sports or due to the reduction of the femoral muscles;
- pathological - due to the presence in the body of diseases of the musculoskeletal system;
- congenital - an anomaly develops during the period of intrauterine fetal formation and affects the knee joint itself, changing its structure;
- obsolete - a neglected stage of blemish or simply illiterately cured obtained before dislocation.
It is worth noting that people suffering from the habitual form of injury should be extremely careful with any exercises that require a heavy load on the knees.
In addition to the described types of damage, you should be familiar with the symptoms of subluxation. This pathology develops in the area of the calyx in the background:
There are certain signs of subluxation:
- patella instability;
- the occurrence of acute pain at the time of extension and flexion of the damaged area;
- all movements are accompanied by characteristic clicks or crunch.
This pathology gradually makes the joint unstable, which causes knee injury, even at the slightest exertion.
What to do with dislocation of the knee
Treatment of injury should begin immediately after receiving damage. After all, on how quickly and competently the first aid will be provided for dislocation of the knee joint, the future prognosis and the duration of the rehabilitation period largely depend. That is why absolutely all people should be able to act correctly in such a situation, since absolutely no one is immune from getting such an injury.And for first aid, you must first know the symptoms of pathology and some rules.
There is a specific emergency treatment regimen.
- State of complete rest. In order not to inadvertently worsen the situation, it is strictly forbidden to make any movements with the injured leg.
- Fastening the knee. The cup should be immobilized to the maximum. To do this, you can use special orthoses, tires or tugor. It is strictly forbidden to fix the dislocation with your own hands at home or in the place of injury - so you can only hurt by damaging the neurovascular bundle in the area of the knee band. The cup can be put in place only in traumatology, since this manipulation is performed under local anesthesia.
- Cold compress. Often, symptoms of dislocation of the knee joint are puffiness and pain, therefore, to relieve the condition of the injured person, first aid also consists in attaching ice. Moreover, such a simple manipulation allows to narrow the vessels and reduce the likelihood of the occurrence or spread of an already existing hemorrhage into the joint cavity.Ice should be used every 2 hours for several days after injury.
- The use of compression bandages. This tool helps to fix the joint, reduce pain and get rid of swelling. The bandage can be made on the basis of a special bandage or elastic bandage.
- Anesthesia. If, in spite of all the measures taken, the pain has not diminished, then a painkiller with a non-narcotic composition can be taken before the arrival of the doctors.
- The elevation of the limb. The victim must be moved to a flat, solid place by placing a roller under the injured leg in order to slightly lift it. This is required to lower the blood supply to the limb, which helps reduce the risk of hemarthrosis.
Before treating a knee joint dislocation, a traumatologist should conduct a thorough examination of the injured leg and palpation. After that, the victim is sent for x-rays. This procedure is necessary to rule out the possibility of a fracture. The specialist then determines the integrity of the articulation using an arteriogram.
Through ultrasound, the doctor reveals whether the blood flow is full and whether hemarthrosis has not occurred. The specialist determines the vascular permeability by the presence of the pulse in the ankle area.
After all these procedures, a traumatologist can make a therapeutic scheme.
Therapy for dislocation of the knee involves several stages:
- replenishment - performed under local anesthesia immediately after injury;
- immobilization - fixation of the joint is a mandatory step;
It is necessary to observe absolutely all stages of treatment. After all, the injury can be quite serious, in some cases it is impossible to do without surgical intervention.
It is necessary to fix the damaged joint immediately after the damage. If this is not done for two weeks, then the muscles will be inhibited, as they are constantly contracting. At this place a tissue scar will gradually form, which will also interfere with reposition of the calyx to the normal place.
To assist the injured specialist uses an arthroscope. With its help, it is possible with a small damage to the tissues to puncture the joints, and then adjust the patella. Then there is a fixation of the limb.To do this, apply a special bandage, which should be worn at least 2-3 months.
For rehabilitation in case of dislocation of the knee joint are used:
- Exercise therapy;
- balanced diet;
Dislocation of the knee joint is considered quite a serious injury and the consequences can be very serious. That is why it is so important to consult a specialist in time and follow all his recommendations.
The later the victim resorts to medical care, the harder the consequences of the dislocation of the knee joint may be. Among the complications can be identified traumatic shock, which can even lead to the death of the patient. In the future, with late treatment, the likelihood of complete rehabilitation is extremely small.