The wobbling knee or the unstable knee is dreaded by every sportsperson as it can effectively put paid to their
dreams of becoming a sports star .. especially players involved in contact sports.
Why the knee becomes unstable?.. To answer this query one need to know the anatomy of the knee. the knee is the biggest joint in the human body but inherently unstable without its intelligently and strategically placed ligaments…the important being the anterior and posterior cruciate ligaments and the medial and lateral collateral ligaments,they all function as a single unit. Any rotational force acting on the knee with lateral or medial bending of knee which can happen during tackling in football, or a jumping shot in volley ball or basket ball, or in any high violence injury for that matter, can produce tear of these ligaments.. and thereby produce instability.
There may or may not be an associated fracture,if there is a fracture then that needs to be treated first,but
usually there is no fracture. The typical complaint will be a sense of the knee giving way, or a feeling as if the knee is wobbling…your doctor might prescribe a knee support which might support your knee temporarily.
You may have to do an MRI to assess the severity of the anterior cruciate ligament tear[ACL]. Generally for complete tear you may have to undergo arthroscopic reconstruction of the ligament. This is now a very safe procedure which can keep your dreams alive.
Generally the procedure is done around the third week after injury, followed by a stringent post operative protocol,this protocol being more important than the surgery itself.
The most important thing you should remember is, do not neglect any injury around the knee .. just because the xray is normal doesn’t mean everything is normal,a torn ACL is never visible in an xray. Its always better to get a expert opinion.
Dr.Elangovan MS,MCh,orth
How long it takes for healing of ligament tear? Sir
The average time taken for a ligament to heal is 6 to 8 weeks , more than the time taken for a pediatric
fracture to unite.It must be remembered that the healing of the ligament is by fibrotic healing and rarely it
regains its original strength.. But a fractured bone after complete union can regain its original strength over
a period of time.
Sir in this case the procedure can done after 3 weeks of injury..till that what should be the management for this case..
Till then its managed like any other injury… in acute phase Rest,Ice pack,Compression and Elevation [RICE]
can be followed.. usually the patient is given a knee support or an immobilizer and allowed to walk with a
walking frame..partial weight bearing is advised, These patients usually develop a tense hematoma inside the
knee which may have to be aspirated to relieve pain.
Why this procedure takes 3weeks to perform sir…???
Generally it not done immediately because of the following reasons ..
1.Usually because of the fact that there is a hematoma inside which might preclude proper vision
so we wait for 3 weeks till the hematoma gets organised.
2.Its not a life threatening emergency
3.There is usually an increased pain perception post operatively if done immediately.
Sir,Why arthroscopic reconstruction is done at third week after the injury?
I have already answered this query elsewhere … please go through it.
Sir,why it should be done around the third week of injury.And till that how to manage the condition ,and after this procedure is there any changes when compared to before in their sports activities.
As to the management and why its done in the third week i have already answered elsewhere,
..as far as returning back to sports activities, it is very much possible, but needs a proper surgery and a
strict post operative physio protocol,if that criteria is satisfied there will not be any change.
Sir,what type of injuries and all should be performed around the third week of injury. And what’s reason
Reason i have given elsewhere,… as far as other reasons are concerned, surgery may be postponed
if the skin condition is not healthy, if not necessarily for 3 weeks at least for 4 or 5 days in case
of a fracture.
Hi Sir, Thanks for the great article it is very use full for me. What causes an unstable kneecap
Thanks for the appreciation, an unstable kneecap is a problem of young individuals where there is a muscle imbalance between the medial and lateral group of muscles or there is bony hypoplasia.