12 February 2020
12 February 2020
Pain, swelling, limited or excessive leg movement - these are symptoms that should alarm skiers and snowboarders.
Although the weather is exceptionally mild this winter, it doesn't discourage winter sports enthusiasts. Thousands of Poles are looking for suitable place to practice their beloved sport - both on the domestic slopes and in foreign ski resorts. Although the weather is exceptionally mild this winter, it doesn't discourage winter sports enthusiasts. Thousands of Poles are looking for the best place to practice their favorite winter sports - both on the domestic slopes and in foreign ski resorts. And where physical activity is involved, injuries inevitably occur. The most common are knee injuries – they account for almost 45% of injuries suffered by winter sports enthusiasts..1
If within an hour of injury severe pain appears, the knee begins to swell, we cannot stand and later we cannot move the leg at all – we should definitely seek urgent help – says doctor Łukasz Luboiński, head physician at the clinic of orthopedics, rehabilitation and sports medicine Carolina Medical Center - The more serious the injury, the sooner the pain and swelling will appear. The abnormal range of leg mobility should also be worrying, i.e. its limitation or excessive movement.
Contrariwise, if the pain occurred a few days after the injury - e.g. when we have returned from vacation - it is worth observing the painful leg for some time, because it can indicate overload. It is different when exudates occur.
If after returning from vacation, during which we suffered an injury, our knee begins to swell and exudations appears, then we should report to an orthopedist – says doctor Łukasz Luboiński – The appearance of the fluid may indicate the type of injury. If the fluid is clear, serous - we may be dealing with overload changes - that is, those that occur when we were skiing too intensively. However, if fluid with an admixture of blood appears, it may indicate some kind of trauma we have underestimated - like damaged joint structures or intra-articular fractures. The latter may only hurt after a few days.
The most common knee injury in winter sports enthusiasts is anterior cruciate ligament ruptures - it is estimated that they account for as much as 80% of all knee injuries.
These injuries are associated with pain, swelling and joint dysfunction. Most often they require surgical reconstruction of the anterior cruciate ligament – explains lek. Łukasz Luboiński. – These operations are most often performed by arthroscopic technique - the operation itself lasts for about an hour, rehabilitation - up to 6 months. This is the most frequently executed reconstruction procedure within the knee - adds doctor Luboiński, who completed over 2,000 operations of this type.
Another 15% of injuries are strains and tears of the collateral ligament. These are treated conservatively - rehabilitation is recommended, not surgical treatment. 5% of injuries are tears of menisci, muscles and other ligaments.
The most serious injuries are the least common and these are fractures that require immediate help. In the case of such injuries, pain and swelling are so strong that the patient is taken from the slope by a team of rescuers – adds doctor Łukasz Luboiński.
X-RAY: Stabilization of the proximal end of the tibia fracture after an accident
Fractures most often affect children - these are mainly fractures in the area of connections between the ligament and the bone, and so-called avulsion fractures (when a bone fragment breaks off with a ligament or tendon attachment). Adults most often suffer from torsion injuries.
The basis of diagnostics in the case of injuries which fans of "winter sports frenzy" are subject to, is magnetic resonance imaging and X-ray. The most common injuries - i.e. anterior cruciate ligament injuries - require particularly good diagnosis and identification of possible accompanying injuries.
In most cases, patients undergo rehabilitation - until they achieve relatively good health and mobility. If surgery is necessary - anterior cruciate ligament reconstruction may be performed 6-8 weeks after the injury at the earliest. During this time, the bruises must heal, the swelling and exudate disappear. When deciding about surgery, the type of sport a patient wants to play in the future should be considered, because it affects the nature of the surgery and allows to choose the appropriate part of the body for transplant collection. In such cases, the lack of proper diagnosis or overlooking - sometimes subtle - damage may have an adverse effect on the return to full sport activity.
The best solution is arthroscopic surgery - performed through two small holes (without cutting the skin). A camera is placed in the knee joint that significantly enlarges the image, thanks to which the doctor can accurately assess and then repair the structures within the knee. The advantage of such a surgery is minimally invasive approach, which eliminates cutting the skin hence no scars.
1Knee Surgery – Noyes 2016 r.