Knee Injury

Every organ in our body is important, in one way or another and I don’t think God did any mistake in that creation process (one way circumcision is trying to correct ‘God’s blunder’ by those who think they know about God and His ways better than the God himself!). The way our body works is just amazing. In fact the whole research that’s happening in the field of science and technology is trying to understand the know-how of God’s technologies, in one way or another, knowingly or unknowingly.

What about the knee then? I read an article by somebody (don’t remember his name, can be a doc coz it was technically a good article about the structure of the knee) where he said knee is a faulty design by the God. Knee is the most complicated joint in our body and one of the easily injured one too. For walking, running, standing, kicking, sitting…we need support from knee. We can lift a person of our weight (or more). It goes thru our knee. It can bend, twist and even has the ability to rotate limitedly.

The volume of Arthritis reported among the old and not- so- old and the number of knee replacement surgeries happening around us these days show how this joint can be overused. Injuries to the knee can be of different types. A muscle strain, tendonitis, bursitis , a runners knee …..and in the little more severe cases, it can be tear of ligaments and more.

There are many ligaments in our knee and the most injury prone ones are MCL (Medial Collateral Ligament), ACL (Anterior Cruciate Ligament) and PCL (Posterior Cruciate Ligament) and LCL (Lateral Collateral Ligament). The role of ligaments are to connect two bones.

What should one do when there is a knee injury? If you check the net for that purpose, almost every site will advise you to do RICE (Rest, Ice, Compression and Elevation). Is that all? Just be relaxed and take some rest with an ice pack?

Since I did not get the results I expected for my LCL tear, I decided to go for a second opinion with one of the best doc in my city. He was known to me and is a friend of my family doc. He was my son’s doc and at some point of time, my wife also had to consult him. Thus I had an idea about his approach. He always believed in going with the latest technology.

I briefed him about what happened to me and what I did. And then he said (he always speaks very loud):

“See, these days, our approach to knee injuries are very aggressive. The problem with knee injuries are that, if we don’t take care of it properly, it can lead into irreparable osteoarthritis especially in middle age people, in a very short period. When I started my practice about 25 years ago, we never had any equipment to asses the severity of these kind of injuries. If people were old, we used to suggest some pain killers, rehabilitation programme that included wearing a brace that you are wearing now or some exercises or life style change. And if they were young, we had to cut it open and see what it is. But as you know, science is growing fast. Now we have MRI and Arthroscopy to evaluate the injury. I suggest you to go for an MRI and then we will discuss. I don’t want you to end up with arthritis in five years time”

I did MRI and while lying down inside that machine, I was thinking about the reasons why it can lead into arthritis.

Its so simple. It is ligaments that keep the bones together and the joint intact. What happens when that’s torn? The joint becomes unstable and loose. That leads the joint to function in ‘not so normal’ way, which again giving a chance for bone to bone direct contact. Our joints are built in such a way that bone like hard stuffs won’t make direct contact with its counter part and when it happens, the wear and tear starts leading to osteoarthritis.

My MRI showed a chronic tear with wavy fibers to the LCL even after 3-4 months. Not just that, it showed the early symptoms of OA changes (welcome, osteoarthritis)in the patellofemoral. Is that all? Nope it showed Grade I injury to my Medial Meniscus. As per the X-ray I had done earlier, everything looked just normal and it didn’t even show any OA changes in the knee. Thus my old therapist and doc thought my knee cap pain was some radiating pain.(X-rays wont show ligament tear, since ligaments are made of soft tissues)

What does it all mean? Simple. When you end up in a knee injury, don’t take it lightly. Don’t listen to Tom ,Dick and Harry and let a doc examine your knee on day one itself (or next day). This is important coz, the damage due to the delay can not be repaired in many cases. It is always wise to learn from others experience than waiting for things happen to us. So learn from me. The biggest blunders I did with respect to this knee injury are:

Listening to “ I had many such falls. It pains a lot initially and then it goes by itself” from somebody close to me

Not following the RICE principle at all

Self medicating with pain killers/anti inflammatory drugs

Delay in seeing the doc

Meeting the nearest doc just for convenience and thus not getting the right treatment at the right time.

And the result?

(sigh....)