KNEE CONDITIONS & TREATMENTS > TRAUMA
LEARN ABOUT YOUR KNEE
Trauma
Injuries happen. Our goal is for you to return to full function, with no pain or chronic disability. However, some injuries are so severe that this is not possible, but we will always strive to get the best possible outcome. Depending on the injury, trauma can be managed with or without surgery. I will discuss your injury and treatment options with you, as well as your expected recovery and long term prognosis.
I treat a variety of different injuries such as soft tissue trauma and fractures (broken bones). My primary region of interest is knee and lower limb trauma.
Soft tissue injuries (other than internal ligament injuries such as ACL tears) around the knee can affect skin, muscle or tendons with treatment depending on the type and severity of the injury.
Fractures are common injuries that can vary significantly in their location, severity and complexity, requiring treatment tailored to each individual patient.
Seek emergency assessment for an open wound over a suspected fracture, obvious deformity, a cold or pale foot, or rapidly worsening pain and swelling. An inability to actively straighten the knee after injury also needs prompt assessment.
TENDONS
Tendon Ruptures
Tendons connect muscle to bone and allow movement of a joint.
The quadriceps tendon, above the kneecap, and patellar tendon, below it, connect the thigh muscles to the shinbone through the kneecap. Together, they allow you to straighten the knee and form ‘the extensor mechanism’.
A rupture may follow a fall, awkward landing or sudden forceful muscle contraction. Tears can be partial or complete.
Symptoms and Assessment
Symptoms are usually the result of some kind of trauma:
A sudden pop with pain and swelling
Bruising or a gap above or below the kneecap
Knee buckling
Difficulty straightening the knee or lifting the straight leg
These types of tendon ruptures can be diagnosed clinically by examining the knee and your ability to straighten your leg. X-rays can assess the kneecap position and assess for potential fractures. The diagnosis can be further confirmed with an ultrasound or MRI.
Treatment
Partial tears may be able to be managed without surgery provided there is no loss of function and the tear is small on imaging. I still recommend using a splint or brace to hold the leg straight so that the tendon heals at an appropriate length and the tear does not propagate.
Complete ruptures require surgery to ensure that the Quadriceps muscle can straighten the knee. The tendon is repaired back to the bone using strong sutures held to the patella with bone tunnels or anchors. Some chronic or complex tears require augmentation with a tendon graft (augmentation / reconstruction).
Early assessment is important as delayed repairs are surgically more difficult as the tendon retracts and becomes scarred to surrounding tissue.
Recovery and rehabilitation
In the early stages of recovery, a brace protects the tendon by holding the knee straight, with limits on bending and walking.
Recovery and return to normal activity takes several months. Running, jumping and demanding work require adequate healing and strength, with some patients needing a year or longer to fully recover.
FRACTURES
Fractures Around the Knee
Fractures are common injuries that can vary significantly in their location, severity and complexity, requiring treatment tailored to each individual patient. The bones around the knee are the patella, tibia and femur, all of which can be susceptible to injury.
Common fractures:
Patellar fractures: Breaks in the kneecap.
Tibial plateau fractures: Breaks in the upper shinbone involving the knee’s weight-bearing surface.
Distal femoral fractures: Breaks in the lower thighbone, sometimes extending into the joint.
Fractures may follow falls, sporting injuries or major accidents. Weakened bone can fracture after a relatively minor fall.
Symptoms and diagnosis
Pain, swelling, bruising and difficulty bearing weight are common. Some fractures cause deformity or prevent the knee from straightening.
X-rays are usually the first investigation. CT may be needed to define the fracture, particularly when the joint surface is involved. Assessment also checks the skin, circulation, nerves and associated soft-tissue injuries.
Treatment options
Treatment depends on the type and severity of the fracture, its alignment and stability, and the individual patient.
Where appropriate, fractures can be managed without surgery, while more complex or displaced fractures may require surgical fixation to restore alignment, stability and function, followed by rehabilitation.
Non-surgical treatment
Selected stable fractures with acceptable alignment can be managed with a brace or cast, walking aids and follow-up X-rays.
Weight-bearing and movement restrictions depend on the fracture. Being able to walk does not necessarily mean a fracture is safe to load.
When is surgery recommended?
Surgery may be needed when the fracture is displaced, unstable, disrupts the joint surface or prevents the knee from straightening.
The bones are realigned and held with screws, plates, wires or a nail, depending on the injury. Significant swelling or skin damage may require several surgeries to achieve a good outcome.
TRAUMA
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I treat a range of soft tissue injuries around the knee, including other tendon ruptures, muscle injuries, and traumatic wounds.
Treatment is tailored to the nature and severity of the injury, with a focus on restoring function and enabling a safe return to everyday activities and sport.
When surgery is required, this may involve repair or reconstruction of the injured tissue, followed by a structured rehabilitation program
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Ideally within a few days. Complete ruptures are easier to repair before the tendon retracts and scars.
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Possibly. When the surgery is performed I aim to position any implants so they will not need to be routinely removed. However, removal may be considered or required after the fracture heals if the implants cause problems.
Frequently Asked Questions (FAQ)
Surgical procedures I offer for soft tissue injuries or fractures, when clinically appropriate.
Quadriceps or Patellar tendon repairs
Other tendon & soft tissue repairs
Patella fracture fixation
Femoral fracture fixation
Tibial fracture fixation
HOW I CAN HELP
Surgical procedures I offer for soft tissue injuries or fractures, when clinically appropriate.
Quadriceps or Patellar tendon repairs
Other tendon & soft tissue repairs
Patella fracture fixation
Femoral fracture fixation
Tibial fracture fixation
