Dr Sanjiv, I had twisted my knee while playing futsal and sustained a ligament tear on the inner knee? Am I at risk of getting osteoarthritis if I don’t do surgery?

Dr Rampal, is surgery the only method in dealing with a sports injury?

Prof, how many per cent of patients progress to get arthritis if surgery is not done?

 Sports injuries of the knee are relatively common when there is a fall or excessive force exerted on specific locations of the knee. These are common in patients of all ages who are active in physical sports especially physical contact sports like futsal, basketball and sepak takraw.Common ligamentous injury would include injury to Anterior Cruciate Ligament(ACL), Posterior cruciate ligament, Meniscus and collateral ligament tears.

   ACL ligament which prevents excessive forward migration and rotation of thigh long bone (Femur) onto Tibia is the commonest injury of the knee. The extent of injury would dictate the severity of symptoms and complications associated. Complete tears of any of the ligaments stated above would lead to abnormal weight-bearing, joint strain and accelerate joint degeneration. This consequently would lead to pain, reduction of quality of life and eventual reduction of range of movement and stiffness of the knee at the accelerated time frame.

        Similarly neglected ACL injuries are associated with accelerated joint degradation and an increase in likeliness of injury to surrounding meniscus and cartilage if left untreated.        Appropriate management of these injuries would depend greatly on a few characteristics which include the patient’s level of physical activity, body mass index, the extend of injury and coincidental injury of other ligaments in the knee.

These would entail a thorough physical examination by trained medical personal and imaging which would include radiograph(X-ray) and MRI (Magnetic Resonance Imaging).

       Sequence of knee knee arthritis injury

injury

pain and reduced function

missed school or work,sport

Flare up

activity withdrawal

inactivity

obesity

osteoarthritis

Certain injuries of the knee for example complete tears of multiple ligaments of the knee, inner meniscus and significant chondral injury in an overweight recreational basketball or futsal player would significantly be associated with reduced quality of life and accelerated arthritis(Joint Inflamation ) if left untreated. The percentage of progression to arthritis would depend greatly on the extent of the injury and other structures that are damaged.

What to do when you do have injury

monitor your knee and act early

Feed your cartilage

Build your muscle

Control your weight

All information given here is for patient education and should not be a substitute for diagnosis or detail examination by a trained medical officer.

Dr Sanjiv Rampal is an orthopaedic consultant that specialises in the treatment of injuries of the knee and joints . For further information on joint preservation and care, follow Dr Sanjiv Orthopaedic Surgeon on Facebook, Instagram, Twitter and website http://www.rampalsurgery.com

Ligamentous Injury of knee- Injuries to structures in the knee

Ligament meaning structures in the body that connects muscle to its origin bone

Arthritis- Inflamation of the joint that causes pain and reduction of joint function

References

1.Simon D, Mascarenhas R, Saltzman BM, Rollins M, Bach BR Jr, MacDonald P. The Relationship between Anterior Cruciate Ligament Injury and Osteoarthritis of the Knee. Adv Orthop. 2015;2015:928301. doi: 10.1155/2015/928301. Epub 2015 Apr 19. PMID: 25954533; PMCID: PMC4410751.

2.Driban JB, Harkey MS, Barbe MF, Ward RJ, MacKay JW, Davis JE, Lu B, Price LL, Eaton CB, Lo GH, McAlindon TE. Risk factors and the natural history of accelerated knee osteoarthritis: a narrative review. BMC Musculoskelet Disord. 2020 May 29;21(1):332. doi: 10.1186/s12891-020-03367-2. PMID: 32471412; PMCID: PMC7260785.