Trips & falls

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Consultant Knee Trauma Surgeon, Mr Chinmay Gupte discusses common knee injuries and the best treatment options available


Knee injuries caused by trips and falls are very common, with approximately 135,000 incidents in the UK each year.

Depending on the severity and cause of the injury, some people will head straight to their local A&E department, while others may wait for symptoms to develop before making an appointment with their GP.



Why do we fall?

The most frequent factors that can trigger a knee injury include: sports injuries, slipping on wet surfaces or steps, injuries at work and falls related to balance problems.

In general, knee conditions are divided into four categories:

• Damage to the knee ligaments (cruciate and collateral ligaments)

• Injuries of the shock-absorbing cartilages (medial and lateral menisci)

• Damage to the bones of the knee

• Injuries to the knee cap and its associated structures

Symptoms of knee injuries

The symptoms of a knee injury will vary between different people and are dependent on the nature and severity of the injury. Common signs that damage has been caused to the knee include: swelling, pain, limited range of movement and looseness when moving the knee in different directions or the knee giving way when bearing weight or turning sharply.

Testing and diagnosis

If a serious injury is suspected, or pain and instability persist for more than four weeks, an orthopaedic consultation is recommended. Your consultant will take a full history surrounding the injury and examine you. Most types of knee injuries are investigated with an MRI scan and sometimes an X-ray. These tests are analysed by a radiology doctor specialising in knee injuries, and the outcomes are discussed with the orthopaedic consultant to diagnose and advise a treatment plan.

Treatment of injuries

Following an assessment by a knee specialist, your treatment options will be discussed. Depending on the nature of the injury, this will vary from a simple support bandage to bracing, with some cases requiring an operation. The most common knee ligament injury is partial damage to the medial collateral ligament. Usually, this is treated by a period in a knee brace, physiotherapy and crutches, with no operation needed.

If the anterior cruciate ligament (ACL) is injured, immediate treatment of the injury should consist of rest, ice, compression, elevation (R.I.C.E), with support using a hinge knee brace. If a large swelling is present this can be aspirated with a needle into the knee to remove the blood that causes it. Surgery to reconstruct the ACL should be considered, especially if you intend to return to playing contact or twisting sports, or you have an associated meniscal injury.

If a meniscal injury is symptomatic for more than six weeks, a keyhole operation (arthroscopy) may be required. A torn meniscus can either be stitched back together or the torn segment removed. Recovery after removal of the torn portion of the meniscus is much quicker than if it is repaired.

Physiotherapy

Physiotherapy after a knee injury will initially consist of reducing the swelling of the knee, while gradually regaining the range of movement. Thigh and buttock muscle-strengthening is also important. The physiotherapist should work closely with your surgeon to assess progress and tailor rehabilitation according to your needs, so that you make a speedy and optimal recovery.

For further information, or if you would like to arrange an appointment at The Wellington Hospital Knee Unit, please call 020 7483 5043, or visit thewellingtonhospital.com