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Knee Injuries

Florida Knee Injury Lawyer

The knee joint is commonly injured in automobile, truck, motorcycle and trip, slip and fall injuries.  Although the knee may look like a simple joint, it is one of the largest and most complex joints in the body.  The knee joint is a pivotal hinge joint.  In medical speak it is called a mobile “trocho-ginglymus” joint.

Anatomy of the Knee Joint

The knee joins the upper leg with the lower leg.  The upper leg bone is called the femur and it runs from the hip to the top of the knee.  The lower leg bones are the tibia and fibula.  The tibia is the long bone that runs down the front of the lower leg; we may know it as the shin bone.   The fibula runs along the outside of the lower leg from the knee to the ankle.

The knee joint has two main motions; flexion and extension.  Think of extension as locking your knee out.  Think of flexion as bring your heel to your buttock.  The knee joint also allows for a slight twisting motion, which is called internal rotation and external rotation.

Most joints in the body have a number of components.  It is important to understand the components of a joint before you can understand how the joint is injured.   Joints are made up of bones.  Bones are the main structure of the body and give the body support.  Bones are held together by ligaments.  Most joints have a very tough band of ligaments around the joint called the capsule.  When two bones come together, the ends of bone have a smooth surface called cartilage which allows the bones to come together.  Muscles are attached to the bones.  These muscles move the joint.

Main Bones of the Knee

In the knee joint, the femur bone articulates with the tibia.  This is called the tibulofemoral component of the joint.  The femur also articulates with the knee cap (patella).  This is called the patellofemoral component of the joint.  The tibia has cartilage on the top, which allows articulation with the femur.  The cartilage is called the meniscus.  We have a medial meniscus and lateral meniscus.  The medial meniscus is located on the inside of your knee and the lateral meniscus is located towards the outside of the knee.

Main Ligaments in the Knee

Inside the knee, there are two main ligaments that can be injured.  These ligaments are called the anterior cruciate and posterior cruciate.  The cruciate ligaments attach from the femur to the tibia and they check front and back motion between the femur and the tibia.  Along the inside/medial side of the knee is the medial collateral ligament a/k/a tibiofemoral ligament.  Along the outside/lateral side of the knee is the lateral collateral ligament a/k/a fibulofemoral ligament.  The collateral ligaments check/restrict either medial or lateral movement of the femur on the tibia.

Major Muscles of the Knee Joint

  • Rectus Femoris Group:  In the front of the thigh is the quadriceps group of muscles.  These muscles allow for extension of the knee.
  • Biceps Femoris Group:  In the back of the thigh is the hamstrings group of muscles.  These muscles allow for flexion of the knee.
  • Popliteus muscle.  This is a muscle that attaches from the back of the femur to the tibia.  This muscle allows for some rotation of the knee.

Blood Vessels & Nerves of the Knee

There are two general classifications of blood vessels arteries and veins.  Arteries deliver blood from the heart to the structures around the Knee.  Veins carry blood from the knee area up towards the heart.  Nerves innervate the muscles around the joint and the joint itself allowing communication between the muscles and joint and the brain.

Mechanism of Knee Joint Injury

As you can see there are many structures in the knee that can be injured in car, truck, motorcycle or slip, trip and fall accidents.  The type of structure damaged will depend on the mechanism of injury.  For instance, in a motor vehicle collision the direction of the collision can dictate the type of injury.

Types of Injuries to the Knee

Bone Injuries

Injuries to the bone can range from a contusion (bruise) to a fracture (broken bone).  As we discussed above, any of the bones associated with the knee joint including the femur, patella, tibia and fibula can be fractured in a car, truck, motorcycle or slip, trip and fall injury.

The signs and symptoms of a fracture to the bones of the knee joint depend on whether the fracture is compound or displaced but can include the following:

  • Pain and swelling
  • Bruising or bleeding
  • Disruption of the skin
  • Inability to put weight on the affected leg
  • Inability to walk, climb or descend stairs, squat or kneel

Cartilage Injuries

Injuries to the medial and lateral menisci occur frequently when a person's foot is fixed (such as on the brake) and a rotational force travels through the knee.

The signs and symptoms of a torn cartilage in the knee include the following:

  • Pain and swelling in the knee
  • Difficulty bending the knee
  • Difficulty putting weight on your leg
  • Difficulty climbing stairs
  • A catch (locking) or giving away of the knee
  • Difficulty sitting or getting up from the sitting position
  • Difficulty squatting
  • Difficulty kneeling

Ligamentous Injuries

Medial Collateral Ligament Signs & Symptoms:  The medial collateral ligament is often injured when the knee takes a blow from the outside or lateral side of the knee.  Symptoms associated with MCL tears are as follows:

  • Pain and swelling to the medial side of the knee over the ligament
  • Bruising to the medial side of the knee over the ligament
  • A feeling of instability in the knee

When a MCL injury is suspected, the healthcare provider should also evaluate the medial meniscus and anterior cruciate ligament for injury.

Lateral Collateral Ligament Signs & Symptoms:  The lateral collateral ligament is often injured when the knee takes a blow from the inside or medial side of the knee.  Symptoms associated with LCL tears are as follows:

  •  Pain and swelling to the lateral side of the knee over the ligament
  • Bruising to the lateral side of the knee over the ligament
  • A feeling of instability in the knee

When a LCL injury is suspected, the healthcare provider should also evaluate the lateral meniscus and posterior cruciate ligament for injury.

Anterior Cruciate Ligament

The ACL is usually injured when foot is planted and twisting force is applied to the knee.  ACL injuries are sometimes difficult to diagnose.  Patients with an ACL tear may have the following signs and symptoms:

  • Generalized pain in the knee
  • Feel or hear a pop in the knee
  • The knee gives out when you put pressure on the leg

Posterior Cruciate Ligament

The PCL is usually injured when the knee is forcefully extended or hyperextended (locked out).  PCL injuries are sometimes difficult to diagnose.  Patients with a PCL tear may have the following signs and symptoms:

  • Generalized pain in the knee
  • Feel or hear a pop in the knee
  • The knee gives out when you put pressure on the leg

Muscles, Nerves and Blood Vessels

With any type of trauma the muscles, blood vessels or nerves that supply function to the knee joint can be injured.  Muscle injuries can range from a strain to a complete avulsion of the muscle off of the bone.   Blood vessels can be injured with fractures.  When a blood vessel is injured the symptoms will depend on the area that the blood vessel supplies.

Nerves run along with blood vessels.  Nerve injury can range from a contusion of the nerve to the nerve being severe.  Depending on the nerve and the extent of the injury to the nerve, the patient may feel numbness, tingling, loss of feeling, loss of the ability to move the knee joint in certain positions, or paralysis.

Diagnosis of Injuries to the Knee Joint

  • Fractures are generally diagnosed through plain film x-ray.
  • Injuries to cartilage and ligaments are generally diagnosed based on examination and MRI findings.
  • Injuries to muscles are generally diagnosed through examination and MRI findings.
  • Injuries to nerves are generally diagnosed through examination and electrodiagnostic studies which may include nerve conduction velocity and electromyography studies.

Injuries to blood vessels are generally diagnosed through specialized studies such as Magnetic Resonance Angiography, angiograms, and Doppler studies.

Treatment of Knee Joint Injuries

The proper treatment of a knee joint injury is solely dependent on quick and accurate diagnosis of the injured tissue.

Fractures of the Knee joint bones are generally treated with immobilization or casting if they are non-displaced.  Certain types of fractures may require surgical intervention to put the pieces of bone together.  Sometimes orthopedic surgeons will use fixation devices to hold the bones into place so they can heal.  Sometimes these fixation devices can be left inside the body.  This is called internal fixation.  Other times, the fixation device is outside the body and this is called external fixation.

Treatment of injuries to the knee cartilage (meniscus) varies from the conservative to invasive as follows:

  • Rest, ice, compression and elevation
  • Anti-inflammatory medications
  • Physical therapy
  • Steroid injections
  • Arthroscopic surgery where the meniscal tear is repaired and the joint is cleaned out

Treatment of injuries to the knee joint ligaments can vary from conservative to aggressive as follows:

  • Rest, ice, compression and elevation
  • Anti-inflammatory medications
  • Physical therapy
  • Steroid injections
  • Surgical reconstruction of the ligament(s) anterior or posterior cruciate ligaments
  • Surgical repair of the medical and lateral collateral ligaments if the patient continues to show instability in the knee

Compensation for Knee Injuries

If you are able to show that the party who caused the car, truck, motorcycle or slip, trip and fall injury, was at fault for the accident, the injured person will be entitled to compensation for his/her knee injuries.  Compensation can include medical bills, hospital bills, lost wages, and the loss of ability to earn money in the future.  However, in a knee case, the injured person needs an attorney that truly understands the dynamics and complexities of the knee joint because the non-economic damage component of these types of cases including the loss of ability to function and/or enjoy life have be articulated to the at fault parties insurance company in a way that it can truly understand what the client has undergone and will undergo in the future with the injury.

If you have any questions about a knee injury after a Florida accident, call Guy S. DiMartino, DC, JD at (352) 267-9168 or fill out the Internet consultation form on the right.

What makes me Unique?

What distinguishes my firm from the many injury firms throughout the state is my background as a chiropractic physician treating injured patients for 17 years. This gives you the benefit of having someone fighting for you that understands the nature and extent of your injuries and your road to recovery.

We are Partners

If you are my client, we are partners in your road to recovery. You will always have direct access to me to have your questions answered.