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Pediatric Orthopedic Surgeons treating a torn and Sprained Knee

SPRAINED KNEE

The knee ligaments connect the leg bones and support the knee joint. A knee sprain occurs when a person tears or overstretches a ligament.

If your child needs surgery or casting, our Fracture Care Clinic opens every day and you do not need an appointment. Surgery rooms get scheduled every morning, so your child receives the care and attention they need right away.

Sprained Knee

Sprained KneeThe knee ligaments connect the leg bones and support the knee joint. A knee sprain occurs when a person tears or overstretches a ligament in the leg. The ligaments in the human knee are bands of tough, elastic connective tissue that connect the femur to the bones of the lower leg. In addition, ligaments also provide support and help limit joint movement. This article explains the types of ligament sprains that affect the knee, their causes, treatment options, and when your child should see a doctor.

There are four primary ligaments in the knee, and each one is crucial to maintaining stability and allowing for a complete range of motion. The two collateral ligaments govern the sideways movement of the knee, whereas the two cruciate ligaments control the knee’s back-and-forth motion. Depending on which ligament has been damaged, a person may be experiencing one of the following types of knee sprains:

Anterior Cruciate Ligament

Medical professionals commonly refer to this ligament as the ACL. Located inside the knee joint. Two cruciate ligaments control the fore-and-aft movement of the knee. Together they form an “X” shape. The anterior cruciate ligament in older children will get damaged in may sports.

Posterior Cruciate Ligament

The posterior cruciate ligament (PCL) is the anterior cruciate ligament equivalent in the back. The tibia, or shin bone, can only travel rearward via the PCL.

Medial Collateral Ligament

The ligament that provides stability to the inside knee is known as the MCL. The lateral ligaments are on the sides of the knee. Within the knee is the medial collateral ligament.

Lateral Collateral Ligament

This is a knee ligament that supports the knee’s outer surface. The lateral collateral ligament (LCL) is on the outside of the knee.

QUESTIONS AND ANSWERS

What are the common causes of knee sprains in children?
  • Sports and Physical Activities: Knee sprains often occur during sports that involve sudden changes in direction, jumping, or contact, such as soccer, basketball, and gymnastics.
  • Falls and Accidents: A child can sustain a knee sprain from a fall or collision, where the ligaments in the knee get stretched or torn.
  • Overuse: Repeatedly stressing the knee through activities like running or excessive jumping can lead to overuse injuries, including sprains.
How are knee sprains in children diagnosed?
  • Clinical Assessment: Healthcare providers start with a thorough clinical examination. They assess the child’s history, and the mechanism of injury, and conduct physical tests to evaluate knee stability, range of motion, and pain levels.
  • Imaging: In some cases, doctors use X-rays to rule out fractures, as fractures can mimic the symptoms of a sprain. MRI or ultrasound scans help doctors assess the severity of the sprain and any associated soft tissue damage.
What is the treatment for knee sprains in children?
  • RICE Protocol: Rest, Ice, Compression, and Elevation (RICE) provides a fundamental approach for managing knee sprains in children. This involves rest to prevent further strain, ice to reduce swelling, compression with an elastic bandage, and elevation to minimize inflammation.
  • Immobilization: Depending on the severity, doctors will use a brace or splint to immobilize the knee and promote healing.
  • Physical Therapy: Once the acute phase of healing is completed, physical therapy can help restore strength, flexibility, and joint stability.
  • Medication: Non-prescription pain relievers like acetaminophen or ibuprofen can help manage pain and reduce inflammation, but only when directed by your doctor.
  • Return to Activity: Children should only return to their usual activities and sports when their healthcare provider gives them the green light. Returning too soon can lead to re-injury.

It’s important to note that our doctors devise a treatment plan for knee sprains in children on an individualized basis based on the severity of the sprain and the specific needs of the child. Close communication with a healthcare provider, such as a pediatrician or pediatric orthopedic specialist, ensures proper diagnosis and appropriate management of the knee sprain.

It’s important to be able to go to doctors who specialize in children.  The doctors and surgeons at Medical City Children’s Orthopedics and Spine Specialists are experts in children and their knees.

Classification System

Any damage to a knee ligament is classified as a sprain by doctors, who grade the severity of the sprain using the following scale:

  • Grade I: A person overstretches the ligaments in a modest grade 1 sprain, but the ligaments are still able to stabilize the knee joint.
  • Grade II: A person with a moderate grade II sprain will have evidence of a partial ligament tear. When someone puts weight on the afflicted leg because the ligament is loose, the knee may feel unstable and different.
  • Grade III: The most serious kind of sprain is a grade III. The ligament has completely torn here. It has a major loss of function and range of motion as well as severe instability. The leg may be difficult or impossible to bear weight on due to excessive swelling and bruising.

Symptoms

Depending on whatever ligament a person has strained in their knee, the associated symptoms may change. Also, the knee may snap and buckle as a result of damage to one of the ligaments, which can hurt and swell. A popping sound is frequently audible when some ligaments are torn. As the individual tries to stand on the leg, it can possibly give way. Swelling may also happen, often within 24-36 hours. According to our doctors and surgeons, the interior of the knee will hurt if MCL damage develops. If the LCL is injured, the pain occurs on the outside of the knee. Multiple knee ligament sprains, sometimes known as the “unhappy trifecta,” can accompany ACL damage.

Causes of each Type of Sprain 

When the knee undergoes a forceful muscular contraction or makes direct contact with anything, it sprains. For instance, this injury might occur when a runner changes direction too rapidly or while participating in sports.

Cruciate Ligaments

The ACL is the knee ligament that sustains injuries the most frequently. When a person abruptly changes directions, usually while moving quickly, the ACL may be injured. Also, it can happen when the knee receives a blunt force, such as during a tackle in football. In instances where the front of the knee is directly contacted, such as in football, PCL injuries frequently occur.

Collateral Ligaments

These ligament injuries usually occur when a force pushes the knee sideways. When there is a direct blow to the outside of the knee, it can result in an MCL ligament injury. Also, MCL injuries can also occur with improper landings that put a “valgus” force on the knee. Furthermore, a blow to the inside of the knee can push the knee outward and damage the LCL. Lateral collateral ligament injuries are common in contact sports.

Sprained Knee Treatment

Depending on the extent of your child’s injury and the specific area of the knee that was hurt, your doctor will advise a course of therapy.

Pain medication

Our doctor may recommend over-the-counter pain relievers such as acetaminophen.

Rest

Avoid doing anything that puts too much strain on your child’s knee and puts him or her in danger of further injuring it. Playing sports should be avoided until the knee is healed.

While sitting or sleeping, parents can also prop your child’s leg up on pillows to get it higher than the heart to help reduce the swelling.

Ice for a knee sprain

In order to minimize swelling, apply an ice pack to the knee for 20 minutes every few hours (but check with our doctor first, especially if your child has diabetes). The ice might also halt any internal bleeding and reduce pain.

Compression

With caution, avoid wrapping your child’s knee too tightly with an elastic bandage, as this might prevent blood flow and cause additional swelling. Loosen the bandage if it causes swelling in the lower leg, knees to go numb, or the wrap causes more pain.

Immobilization of a knee sprain

Our doctor might suggest that you immobilize or stop your child from moving the knee for a short while. This gives your child’s body time to recover naturally and enables any swelling and soreness to go down. Our doctor might recommend wearing a brace over your child’s knee to support and protect the joint as it recovers. Additionally, most braces have moveable pieces and extend above and below the knee; their main function is to allow your child to walk and gently flex the knee while wearing them. Your child can’t move his or her knee from side to side or overextend the joint in any way while wearing the brace.

Removing Fluid from the joint to reduce swelling

If your child’s symptoms include swelling, warmth, or redness, your doctor may recommend a procedure called a joint aspiration to remove fluid from the joint. During a joint puncture, doctors first inject a small amount of a local anesthetic to numb the skin, then insert the needle into the fluid-filled joint space. Your doctor will remove the fluid through the needle. This often helps relieve knee pain.

Knee sprain workouts and physical therapy

Depending on the severity of your child’s injury and where your child is in healing, a doctor or physical therapist may advise the following exercises:

  • leg lifts
  • thigh strengthening
  • knee bending
  • raising up on toes
  • thigh and calf stretches
  • using the leg press and hamstring curl machines for weight training

Non-Surgical Treatments for a Knee Sprain

The majority of knee sprains are treatable with non-surgical methods that focus on restoring the knee’s full strength.

Physical therapy. After initial treatment to reduce pain, knee sprains are commonly treated with physical therapy. Physical therapy combines exercises to strengthen the knee with activities to increase flexibility and restore knee flexibility. His two main components of physical therapy are:

Weight training: The physical therapist will have the patient lift small amounts of weight in repetitive sets. This exercise may include resistance bands, weighted braces, or exercise equipment that affects the knee joint. Over time, increase the number of repetitions and the weight lifted in a controlled and progressive manner.

Stretching for flexibility. A therapist may want to periodically measure a particular athlete’s range of motion and offer stretches to increase the range of motion. A return to a fully normal range of motion and flexibility usually indicates that the athlete is almost ready to return to exercise training.

The length and form of your child’s physical therapy program will depend on several factors, including age, medical history, general health, and the degree of knee sprain.

Surgery for a Knee Sprain

Severe knee sprains may require surgery to repair damaged ligaments. Surgery is usually only recommended if the knee sprain is Grade III (complete ligament tear). Surgical repair of knee ligaments is usually performed arthroscopically, which is a minimally invasive approach. In arthroscopic surgery, a small incision (usually less than 1.2 cm his) is made in front or behind the knee, and a very small medical camera is inserted into the leg. The camera helps the doctor evaluate the degree of a knee injury. Once this is done, a small tool is also inserted into the knee to remove or repair damaged tissue.

Why Choose Medical City Children’s Orthopedics and Spine Specialists

Orthopedics is a specialty of the doctors and surgeons at Medical City Children’s Orthopedics and Spine Specialists. They understand your concerns, can answer your questions regarding your child’s condition, and know how to use their specialized knowledge and training to find a medical solution.  Richard Hostin, MD, Shyam Kishan, MD, and Kathryn Wiesman, MD, specialize in children and are considered to be the very best by many children’s doctors.

The following are just a few of the many reasons why patients might choose Medical City Children’s Orthopedics and Spine Specialists.

  • Expertise in the spine: The team of specialists are spine experts.  They specialize in the diagnosis and treatment of spinal conditions, ensuring the best possible care for their patients.
  • Cutting-edge technology: Our practice uses the latest technology and techniques to diagnose and treat a wide range of conditions.  In addition, we use minimally invasive procedures that reduce pain and promote faster recovery.
  • Comprehensive care: Our practice offers a full range of services, from diagnostic imaging and physical therapy to surgery.  We ensure that patients receive complete, seamless care for their spinal conditions.
  • Dedicated facilities: Medical City Children’s Orthopedics and Spine Specialists is dedicated to providing patients with a safe and comfortable environment.

Finally, our board-certified physicians and fellowship-trained orthopedic surgeons use the full range of treatments to treat their patients. Medical City Children’s Orthopedics and Spine Specialists are experts with offices in Arlington, Dallas, Flower Mound,  Frisco, and McKinney, TX,  and offer cutting-edge technology, full and expert care, and modern facilities to ensure the best possible care for their patients. Call today to make an appointment for your child.

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Footnote:

WebMD: Sprained Knee

Call 214-556-0590 to make an appointment.

Comprehensive services for children from birth through adolescence at five convenient locations: Arlington, Dallas, Flower Mound, Frisco and McKinney.