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Can knee injuries be harmful?

Dr Shirish Kumar
Haematologist,
WHO,
Geneva

Q: I am a trainer. Earlier this year, I heard a snapping sound in my knee and had excruciating pain. X-ray was done and the initial diagnosis was tendonitis. But it did not settle down. Ultrasound scan of the knee and venous doppler examinations were also done but did not show any findings. Finally an MRI scan was done, which was suggestive of a chronic meniscus tear and was confirmed by the consultant surgeon. An arthroscopy was done but the surgeon could not find any tear. However, there was a tangle of growth and the lining of the knee was inflamed. The knee was reportedly cleaned and the tissue was sent for biopsy. The biopsy report said it was a case of chronic non-specific synovitis. I am now on anti-inflammatory drugs and doing low intensive exercises. I am worried about my knee. It remains swollen and there is restricted movement. Its been 11 days since the surgery was done. Please advise.

A:Soft tissue injuries of the knee are very common and cause pain, swelling etc. because of damage to one or more of the soft tissue structures that stabilize and cushion the knee joint, including the ligaments, muscles, tendons, and menisci.The injuries to knee could affect:

  • Bone: resulting in fractures (breaks) and dislocations.
  • Cartilage (support tissue for the joints): causing tears in or degeneration of cartilage and arthritis.
  • Ligaments (connections of bone to bone): leading to sprains.
  • Tendons (connections of muscle to bone): presenting as strains, ruptures, or inflammation.
  • Bursa (fluid-filled sacs for cushion during joint motion): giving rise to infection or inflammation.
  • Actual space within the joint: causing infection or inflammation.
The treatment of acute injury is RICE therapy for mild to moderately severe strains/sprains.R - Rest (walking on crutch with no weight bearing for 24-48 h)I - Ice (application of ice on injured region for 20 min of each waking hour during the initial 48 hours after injury)C - Compression (with knee brace or splint, if necessary)E - Elevation (above the level of the heart)Further management requires examination of the patient and can be decided only after a firm diagnosis is made.