Sports Related Injuries that Affect the Knee

Barry T. Bickley, MD
Board Certified Orthopedic Surgeon

Common sports-related knee injuries
Many knee injuries occur when an athlete has sudden changes in speed, performs side-to-side movements or bears weight on the knee and simultaneously rotates it. These actions can injure the meniscus, a wedge-shape structure made of cartilage, which acts as the knees' shock absorbers and stabilizer. Meniscus injuries are common among basketball and tennis players.

Many times a meniscal injury also involves a sever sprain to the anterior cruciate ligament, also known as the ACL. The ACL is one of four knee ligaments that connect the femur and tibia leg bones and gives the knee strength and stability. Similar to a meniscus injury, the ACL is often torn or stretched by a sudden twisting motion that points the feet and knees in opposite directions. Football players commonly experience ACL injuries.

Diagnosing a knee injury
During the initial exam, the orthopedist also will ask the patient to describe the injury and any associated symptoms. Typically, a meniscus tear will result in pain, swelling and may cause the knee to catch or lock. On the other hand, an ACL injury often produces a popping noise or a feeling of the knee giving out and is usually associated with immediate swelling.

An orthopedic surgeon diagnoses a meniscus or ACL injury by thoroughly examining the knee. A meniscus exam involves bending the leg, then rotating the leg outward and inward while the surgeon extends it. If the doctor hear an audible click or the patient experiences pain, a meniscus injury is highly likely. With an ACL injury, an orthopedic surgeon will test how the knee reacts when pressure is applied from different directions.

With both a meniscus and ACL injury, the surgeon may order an x-ray. If closer detail is needed, the doctor will order a diagnostic test called an MRI that provides a three-dimensional image inside the knee joint.

Treating a knee injury
In some cases, the orthopedic surgeon may opt to perform minimally invasive, outpatient surgery called arthroscopy to view tissue damage. Arthroscopy involves making a small incision in the knee, where the orthopedic surgeon inserts the arthroscope. The end of the scope has a tiny video camera, which is wired to an external monitor that displays the images inside the knee joint. These images allow the surgeon to identify and treat the injury. Specialty surgical instruments are introduced into the knee to either repair or remove damaged structures. In the case of an ACL injury, a new ligament is created either from redundant tendons around the knee or occasionally from donor tissue.

Most athletes who sustain a meniscus or ACL injury return to normal activity after an appropriate rehabilitation program.