Knee twist? Learn which structures can be injured.

Knee sprain is a common injury mechanism during physical activity. It can occur in virtually any sport, but in activities involving frequent contact, such as soccer, sprains are more common. In addition to contact, advances in footwear and flooring technology ensure greater foot support during sports, which can often lead to sprain in the knee or other joints.

Athlete with knee pain.

After a sprain, it's important to seek help from an orthopedist. This type of trauma can cause damage to various structures in the knee. The doctor usually begins the consultation with a conversation to try to identify the exact mechanism of injury. This helps identify possible injuries. Afterward, a thorough physical examination is required. Patients with a sprained knee often present with an enlarged joint, with joint effusion or swelling. Bruising and redness can also be signs of injury. Furthermore, pain points should be identified. Considering possible ligament injuries, joint stability tests should be performed. Often, due to the pain and inflammation of the acute phase of the injury, a complete evaluation of this type is not possible immediately after the trauma. Therefore, a second consultation, after the inflammatory process has subsided, is necessary. During the physical examination, other specific maneuvers are performed to identify other possible injury sites.

Main Injury Sites

• Lateral or medial femoral condyle

• Lateral or medial tibial plateau

• Cartilage

• Medial or tibial collateral ligaments

• Lateral or fibular collateral ligament

• Posterolateral corner of the knee

• Anterior cruciate ligament

• Posterior cruciate ligament

• Medial patellofemoral ligament

• Lateral meniscus

• Medial meniscus

• Joint capsule

Tests that Aid Diagnosis

Some imaging tests aid in the diagnosis of sprains. A knee X-ray is the exam ordered in the acute phase, immediately after the trauma. It is used primarily to evaluate the bone, as fractures of the tibia, femur, or even the patella, the circumferential bone located in front of the knee, are possible. A computed tomography scan is another exam that can also be performed and is primarily used to identify fractures in greater detail. Magnetic resonance imaging (MRI) is a test usually performed in the days following the initial trauma and is very useful for evaluating injuries to ligaments, menisci, joint capsule, or cartilage.

Treatment

Initial treatment includes:

• Protection of the limb with immobilization devices;

• Rest of the limb, avoiding placing body weight on the affected knee if necessary;

• Medications to improve the acute condition, such as anti-inflammatories and analgesics;

• Ice placement on the knee;

• Elevation of the limb while resting;

• Physical therapy for analgesia and inflammation reduction.

After initial treatment, medical follow-up with an orthopedic surgeon is recommended for completing the treatment. Because injuries resulting from a torsional mechanism can be diverse, treatments also range from maintaining immobilization for a few days or weeks to the need for surgery to correct fractures or more serious ligament injuries, for example.