вт, 12/06/2011

Knee injuries: how to cure and avoid them

They are designed ingeniously: Without our knees, we could not run, jump, do not climb stairs. One usually only comes aware of it when the knees make problems. The reasons are as varied as the knee is complicated: torn ligaments, broken meniscus, frayed cartilage or joint bones.

The German Sunday tabloid Bild am Sonntag asked doctors from Berlin about the knee. Among them Dr. Karsten Holland from Waldkrankenhaus Hospital in Berlin-Spandau

How do you know that a knee can become a problem?

"Typically is pain, especially if it occurs while bending or twisting the knee", the orthopedic surgeon and sports medicine specialist Dr. Karsten Holland says. "If the motion of the knee is limited or even blocked, you should find out why. Other symptoms include swelling or redness. A crackling in the knee which often is perceived as disturbing, is usually harmless, unless of course it is accompanied by pain."

What damage can there be in the knee?

Dr. Holland: "With young people most commonly are the side bands and the two crescent-shaped cartilage wedges in the joint, the menisci, affected, followed by injuries of the anterior cruciate ligament. This often happens during sports. Injuries caused by extreme use also are irritation of the patellar tendon and problems around the kneecap. With increasing age wearing off of the articular cartilage - arthritis – becomes more common. "

How can we protect the knee better?

Dr. Holland: "If the 13 muscles that work on the knee, are well trained, the knee is stable and offers little problems. Here, the excellent cooperation of muscle groups at different positions of the joint is critical. The cartilage in the knee is well nourished, when the knee is alternately loaded and unloaded as it is the case while riding a bike. "

Should we do more squats?

"Probably not," says Dr. Alexander Putzo, a physician for orthopedic and sports medicine, "deep knee bends are too onerous for untrained. Better suited are exercises where the knee and cartilage in the knee will be charged only slightly. A good daily exercise is to bend your knee easily when brushing your teeth and to balance on one leg. While compensating the movements to stay straight the muscles around the knee get strengthened."

What do knees not like at all?

Dr. Putzo: "Long intervals of standing, walking or kneeling. When sitting in the office you should not bend your knees too much. The angle between the lower and upper leg should not be smaller than 90 degrees. Stretch your legs from time to time. Shoes can also strain the knees like continuous wearing of high-heeled shoes. "

How do you find out what shoes are good for the knees?

Dr. Putzo: "Soles that are worn off on one side are an indication of a bad position, the can put pressure on the knee. Before buying running shoes one should analysis the feet on a treadmill. If necessary an orthopedic technician can make a special sole that eliminates the position error."

How does the doctor determine what is wrong with the knee?

Dr. Holland: "He sees swelling, analyzes the flexibility, takes a look of the axial ratio of the leg to recognize evidence of damage inside knee. Also ultrasound, x-ray and magnetic resonance imaging (MRI) can give information about the state of the knee."

When is a knee mirroring necessary?

Dr. Holland: "An arthroscopy is done if damage in the knee is suspected, which is not visible from the outside. For this a camera is inserted into the knee joint. In the same work step, repairs can be performed already, for example, a smoothing of the cartilage or the removal of a crack in the meniscus."

What is osteoarthritis?

Dr. Putzo: "In this the layer of the cartilage in the knee is damaged by wear. First the cartilage frays, then it cracks. If the cartilage is completely worn down the bone is attacked. Typically for this is pain when getting up after sitting down for long."

What helps with arthritis?

Dr. Putzo: "If your are overweight it is important to lose weight, second strengthen your muscles. In the early stages anti-inflammatory ointments and tablets provide relief. In further course injecting cortisone or hyaluronic acid into the joint can help. There are some surgical procedures such as the correction of deformity or the use of cultured cartilage membranes, up to a complete resurfacing of the knee."

Who needs an artificial knee?

Dr. Holland: "People who have little or no more cartilage in the joint and, most importantly, have a high level of distress because of severe pain."

How fast can you run again with an artificial knee?

Dr. Masyar Rahmanzadeh, Joint Center Berlin: "On the first day after surgery, the patient can strain the knee using crutches. The following rehabilitation, he gains confidence in dealing with the new joint. After six months, patients usually do not think of their artificial joint anymore."

Must meniscus or knee ligament injuries always have an operation?

Dr. Putzo: "A tear of the meniscus does not heal by itself, because of its poor circulation. The torn part must be surgically removed or stitched together again. Cruciate ligament and lateral ligament tears can be repaired with autologous tendon. Torn ligaments heal by itself when the knee is calm or relieved by a cuff."