Treatments For Knee Sprain

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Hi, I’m Ava and currently I’m pursuing Masters in Biochemistry and Molecular Biology. According to our today’s project here I’m trying to suggest some treatments which is suitable for Dr. Stoddart’s knee sprain.

What is knee sprain!

A knee sprain is an injury in one of the ligaments around the knee joint by running, jumping, twisting or wrenching of knee.

The knee joint has four major ligaments:

major ligaments of knee
  1. Anterior cruciate ligament (ACL)
  2. Posterior cruciate ligament (PCL)
  3. Medial collateral ligament (MCL)
  4. Lateral collateral ligament (LCL)

There are three levels of severity for knee sprain:

Grade I Sprain (mild)

  • least severe
  • occurs when the ligament of the knee stretches,but does not tear
  • does not affect the stability of the knee
  • likely recover with rest and activity modifications over the course of 1-2 weeks
Grades of knee sprain

Grade II Sprain (moderate)

  • injured ligament of the knee is partially torn
  • resulting in swelling, pain, and difficulty moving the knee
  • require more limitations in activities and may take 4-6 weeks for recovery.

Grade III Sprain (severe)

  • injured ligament is completely torn,
  • causing knee to be very unstable and unable to bear weight.
  • depending on the ligament damaged, this may require either more prolonged rehabilitation or surgical intervention.

Diagnosis:

To recommend the specific treatment to a patient doctor should examine the knee sprain patient with following tests:

  • Test the ligaments by stressing the individual ligaments to see if there’s any instability or if the joint is stable and identify the specific ligament for the knee sprain.
  • Examine the knee, look for swelling and bruising, and ask to move it around to determine mobility and compare it with uninjured knee.
  • Taking the history weather the patient has heard any pop and how long it took to become painful.
  • Often specialized tests such as X-rays and MRIs will be performed if there is a concern of a more serious injury or if the diagnosis is unclear.

Treatment:

The treatment of knee sprain is depended on the severity of the injury and what part of the knee was damaged.

PRICE:

For any kind of knee sprain PRICE is the first line treatment to reduce the pain and swelling. The combination of protect rest ice compression elevation is especially appropriate for soft tissue injuries (muscle, ligament, tendon) and is considered more of a first-aid treatment than an end-all cure.

Fig 3.jpg
  • Protect: Aims to prevent any further injury to the joint e.g. with a brace or crutches
  • Rest: Resting the affected knee minimizes the risk of further injury or damage to the joint.
  • Ice: An ice pack wrapped in a towel or a cool compress can be applied to the affected knee in fifteen minute intervals, pausing between each session to avoid damaging the skin. Icing the joint helps to reduce any swelling that is present.
  • Compression: Wrapping an elasticized bandage around the knee can provide mild compression of the joint and help reduce localized inflammation but wrapping bandage tightly can cause pain or cuts off circulation so it should be done carefully.
  • Elevation: Raising the leg, preferably above the level of the heart also helps reduce knee swelling. This will prevent blood from pooling in the injured area and contributing to the swelling.

Medicine:

Non-steroidal anti-inflammatory, such as ibuprofen, may be given to the athlete in order to reduce swelling in the affected knee. Painkiller such as acetaminophen may be recommended for relief the pain.

Self Care:

In case of Grade I (PLC, MCL) sprain resting, icing, elevating, and putting compression on the injured knee is enough for recovery.

Knee sprain brace:

Fig 4.jpg

In knee sprain Grade I and Grade II(ACL, MCL) a basic knee brace will be sufficient and if patient need more support advance knee brace will work well. It will protect the knee and stabilize it while it heals. This will keep the injured knee from moving it too much or over-stretching it. In case of Grade III Sprain elite knee brace is recommended.

Physical Therapy:

Physical therapy is recommended for all type of ACL, PCL, MCL ligament sprain. Certified Physical Therapists work closely with doctors to create an individualized program to maximize healing and restore function, strength and mobility. Following an initial course of treatment for pain relief, it is typical for a knee sprain to be treated with physical therapy. Physical therapy will involve a mixture of exercises aimed at strengthening the knee and activities that increase and restore knee flexibility. Two primary components of physical therapy are:

  • Weight training: patient have to lift small amount of weight with in repetitive sets under the instruction of a therapist. This exercise may involve resistance bands, weighted braces or exercise equipment that involves the knee joint. The amount of repetition and the weight being lift will increase with time in a controlled and progressive manner.
  • Stretching for flexibility: By stretching exercise patient can increase the range of motion and return to a full normal range of motion which is guided by a therapist.

To see the procedure take a look here : https://www.youtube.com/watch?v=EVTORtOzu-g

Surgery:

Surgery may be necessary to repair the damaged ligaments. Surgery is only recommended for Grade III (full ligament tear) knee sprain. Depending on the severity and type of ligament injury there are different types of surgery.

Grade III ACL or PCL sprain: Arthroscopic or open surgery is done using a graft(allograft or autograft) to replace the damaged ligament for ACL  or PCL Grade III injury.   
Arthroscopy
  1. In this method a small incision (typically less than half an inch) is made on the front or back of the knee and a miniature camera is inserted into the leg.
  2. Using the camera the extent of the damage to the knee is assessed.
  3. After that a small tools will also be inserted into the knee in order to remove or repair the damaged tissue.
Grade III MCL sprain: RICE , NSAIDs (such as ibuprofen) and physical therapy and sometimes it need surgery to treat this kind of sprain .
Grade III LCL sprain: only in the severe cases surgery is used to treat. 

Acupuncture:

It is an ancient Chinese technique where a sharp, thin needle is use to change the flow of energy within the body. It helps to relieve pain for a short time and it has less risk factor.

Acupuncture

Prolotherapy:

Here dextrose solution (an irritant solution) is injected in ligament to increase blood flow and supply of nutrient and stimulate the healing process by irritating tissue.

Prolotherapy

Stem cell treatment:

In this process bone marrow stem cell is use to regenerate cartilage tissue in the knee. It helps to reduce the pain and improve function but doesn’t re growth cartilage.(It is not yet a part of medical practice).

Conclusion:

As the doctor only says that Dr. Stoddart has knee sprain, it doesn’t clarify which ligament is injured and how badly the ligament is injured, so it difficult to say specifically that which treatment Dr. Stoddart should have . But considering his age and the suggestions of doctor we can assume that he might have suffering from Grade III knee sprain, as in the older age ligament became weak and can be tear by a sudden twist. For the Grade III sprain surgery is an obvious choice but it is not convenient for aged people so I suggest he should try non surgical process including time, rest, anti-inflammatory medicines, ice packs and physical therapy first.

Written by : https://coolinventor.com/profile/Ava01

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