KIMS consultant Simon Ellis looks at the options available to people suffering with knee injuries.
At this time of year many people will have either had their ski holiday or be looking forward to one. Skiing is very hard on your knees and is very difficult or painful if you are suffering with a knee injury. In addition, taking a fall on the slopes can also cause a knee injury – such as anterior cruciate ligament or meniscal damage, which if not treated promptly, could potentially rule out your enjoyment of skiing in the future.
Many people delay diagnosis when they experience pain in their knees, perhaps putting it down to ageing or an old sporting injury, and not wanting to take time out from activities, but you shouldn’t let a knee injury prevent you from enjoying your life. A visit to a consultant knee surgeon will ensure not only a correct diagnosis and treatment, but can help you return to sport more quickly.
It isn’t just skiing that causes knee injuries. A common problem with the knee is a meniscal tear. The meniscus is a piece of cartilage that provides a cushion between the thigh and shin bones in the knee. There are two menisci in each knee and these can be torn or damaged by many sporting activities. Damage can also be caused by other daily activities such as moving from a squatting position too quickly or twisting on a bent knee.
When a meniscus tear takes place you may hear a popping sound around the knee joint and it can be painful and swollen. It will also be difficult to move the knee fully and it may feel like it will give way. An MRI scan is needed and usually provides a clear diagnosis but is not always conclusive.
To treat your knee your surgeon may need to carry out a procedure called arthroscopy. This is a day case procedure that is usually carried out under general anesthetic. During the procedure your surgeon will look inside your knee joint with a special telescope that allows direct vision of the joint surfaces, ligaments and menisci but most importantly allows problems inside the knee such as meniscal tears and anterior cruciate ligament injury to be treated at the same time. Arthroscopy is often referred to as keyhole surgery.
Arthroscopy offers many advantages over previous open surgery techniques including reduced pain and quicker healing time as well as reduced risk of complication. It is normally a day case procedure and you are up and walking the same day. Your knee may be swollen for a few weeks and walking can be uncomfortable. Regular exercise should help you to return to normal activities as soon as possible. You may benefit from seeing an outpatient physiotherapist to assist with your rehabilitation.
Anterior cruciate ligament (ACL) injury is a more serious injury often related to skiing as well as football and netball. Diagnosis of the injury can prove difficult in the early stages. The injury usually causes sudden swelling in the knee and loss of stability on twisting. If instability is a problem the torn ACL has to be surgically reconstructed which restores full function of the knee in around 80% of patients, with 90% pleased with the outcome. This procedure is also carried out arthroscopically in the same way as for a meniscal tear and a new ligament is generally fashioned from the hamstring muscles. The procedure is also carried out as a day case and the rehabilitation programme is an integral part of recovery and physiotherapy is essential. Return to sport is usually possible by 6 months but the knee improves for a year following surgery.
If you have an injury which prevents you from playing the sport you love, call us on 01622 237 726 or email enquiries@kims.org.uk