GENERAL INFORMATION
The knee injuries are perhaps the most frequent injuries in all the sportsmen, affecting soccer players, cyclists, alpine skiers, martial medical instructors of fight or arts, ... In the 10% of the cases they need surgical treatment. The popular kneepads, on the other hand, they have not demonstrated its utility in the prevention of the injuries of the ligaments of the knee.

TYPES
The more frequent injuries of knee in the sportsmen are:

DIAGNOSIS
The best moment to value the knee is immediately after the injury. Before passed one hour from the injury, muscular protector can exist spasm already. After 24 hours a spill degree can even exist so that prevents a satisfactory exploration.

When valuing the injuries of the knee it is necessary to compare the side affected with the healthy one. If a spill exists, it will be necessary to make x-rays to discard fractures.

His doctor will value in addition the neuro-vascular state to the leg and the foot.

INJURIES MENISCALES

The injuries of the meniscus happen because of a mechanism of torsion or rotation of the associated knee to intense flexion and hyperextension.

The symptoms consist of pain, I spill recurrent and noises, associated to a limitation of mobility. Sometimes the meniscales are catched in the cavity to articulate, with which the knee is blocked or “nailed”.

If being the knee flexion to about 90 degrees, it appears pain in the knee when is made an external rotation of the foot, it is sign of injury of the internal menisci (test of McMurray).

Treatment. After a menisci injury, the sportsman must follow the rule of all sport injury: rest, ice, compression and elevation. He is advisable to use mullets to avoid an overload of weight when walking while they have not sent to the pain and the swelling. In most of the cases the patient it must be derived to the trahumatologyst for the repair of the menisci injury by means of arthroscopic (inserted optical fiber tube in the knee under local or regional anesthesia).

The pursuit must be planned so that it allows to initiate a rehabilitation program and that the patient can soon resume (weeks) the sport activity.


INJURIES OF the INTERNAL LATERAL LIGAMENT OF the KNEE

The internal lateral ligament (LLI) is the one that provides stability to the internal region of the knee and usually is injured when to this one an excessive tension is applied to him in I am worth (twist towards outside). The tears of the external lateral ligament are much more rare and are caused by a traumatism towards inside (in I beach) directed towards the interior of the knee.

The tears of the LLI usually are associated to an injury of the internal menisci.

Diagnosis. Immediately after the injury, the sportsman usually is still able to walk a little supporting the affected leg. Normally, at the moment of the injury it feels pain in the internal zone of the knee, and later, when it tries to walk, note as if the knee “staggered”. The sportsman with a complete tear of the LII can paradoxical ally refer very little pain when making the maneuvers, but at the same time the doctor observes an important hiperlaxitud in absence of a definable diagnosis. The tumefaction or the spill to articulate usually appears after several hours of the injury.

Treatment. Esguince of first degree (it weighs) is dealt with rest, ice, compression and elevation. This injury usually is solved absolutely in 5-10 days, after which the doctor can allow him to resume the sport activity. The treatment of esguinces more serious must make it the trahumatologist.

INJURIES OF THE CROSSED LIGAMENT PREVIOUS OF THE KNEE

The injury of the crossed ligament previous (LCA) is the more frequent ligaments pathology and burdens of the knee. This injury usually happens after a direct traumatism; other times it takes place as a result of an associated torsion force to an injury by deceleration. The injuries are observed when a sportsman changes of direction when running and experiences a “blockade” abrupt of the knee.

The injuries of the crossed ligament later (LCP) are less frequent and serious than those of the LCA. They are caused by a direct traumatism in the anterosuperior region of the tibia. For example, when a kick to “karateka” in the region of the knee occurs while it has the firm foot in the ground.

Diagnosis
Frequently the sport one notices noise when injuring itself, an intense pain falls to the ground noticing and is incapable to follow the competition. In a 60% to 70% of the sportsmen it appears a hematic spill (of blood) before 24 hours. In order to value an injury of the LCA several maneuvers can be used, commonest of which it is the test of the previous drawer:

The test of the previous drawer is made with the flexion knee to 30 degrees. The explorer kneels down next to the external part of the affected leg, with a hand it stabilizes the thigh and, with the other, it makes a smooth traction, but it signs, on the proximal region of the tibia. If the tibia moves forwards, tear of the LCA exists.

Treatment. The initial treatment of the tears of the LCA consists of rest, ice, compression and elevation, along with strict immobilization or use of mullets. The rehabilitation demands the precocious beginning of exercises of contraction of the quadriceps to prevent the atrophy and to favor the muscular reinforcing. In some sportsmen the kneepads articulated or of protection are useful. The sportsman must go immediately to the trahumatologyst, mainly if radiological signs of fracture are observed or if latitude exists to articulate, in case a arthroscopic is precise. Sometimes the rehabilitation of an unstable knee by injury of the LCA can take months.

LUXACIÓN OF THE LOZENGE

The rotuliana happens as a result of a traumatism in the knee or when a sportsman changes soon of direction and it makes force in the leg. He is more frequent in the adolescents.

Treatment. If fracture signs do not exist, it can be tried to reduce the luxacion by means of the extension of the knee. Sometimes it turns out useful to give massages in muscles and to ask the sportsman whom relaxes, with which the lozenge must be reduced in minutes. If the explorer finds difficulties in the accomplishment of the maneuver, perhaps a fracture or a fragment of displaced cartilage exists, in which case it is necessary to place a rule and to derive to the patient to a service of urgencies to carry out a radiologic survey and the reduction. The treatment subsequent to the reduction consists of rest, ice, compression and elevation, along with the use of mullets if the patient cannot walk. The leg must be high while edema persists and exercises of reinforcing of the quadriceps will begin immediately (the previous muscle of the thigh) to prevent the atrophy.