How a Knee Injury Is Treated

Knee injuries are relatively common and come in many different varieties. Whether it’s a tear to a ligament or tendon, damage to a bone or its cartilage, or subluxation of the joint itself, a wide array of structures can be involved. Because of this, an equally high number of treatments exist to address the subsequent symptoms of your knee injury.

From conservative and at-home options to more invasive procedures, each intervention has the potential to improve your condition in the right circumstances. To find out more, read about the details of each treatment in the sections below.

Home Remedies

Any time a knee injury occurs, it is best to be evaluated and diagnosed by a healthcare provider. That said, several at-home remedies can be administered early on to combat the symptoms of your condition.

R.I.C.E.

One home-based intervention that can help reduce the inflammation that sets in after an acute injury is the R.I.C.E. principle. This acronym, which stands for Rest-Ice-Compression-Elevation, represents a grouping of four treatments aimed at decreasing your pain and swelling.

To properly utilize this coupling of remedies:

1. Begin by resting your leg and refraining from any activities that lead to increased pain.
2. Apply ice to the affected leg for 10 to 20 minutes at a time. Doing so at least three times daily will help combat any inflammation that develops.
3. Apply a snug elastic or ACE bandage to help reduce any fluid around your knee. It is important that the dressing is not too tight.
4. Elevate your leg above your heart any time you are off of your feet to help combat swelling in the joint.

Bracing

Following an acute tear of one of your knee ligaments, your leg frequently feels unstable, and tasks like standing or walking can be unsafe. In these circumstances, wearing a stabilizing brace while you are on your feet can help improve the sturdiness of your leg and make daily activities safer.

In addition, a knee extension brace (one that keeps your knee completely straight as you walk) is typically recommended after a patellar (knee cap) fracture. This type of device helps reduce the forces placed on the injured bone in your daily activities.

Over-the-Counter (OTC) Therapies

The inflammation associated with most knee injuries can lead to pain and swelling, making it very uncomfortable to go about your day. With this in mind, several over-the-counter (OTC) medications can help to ease the discomfort in your leg and improve some of your symptoms.

NSAIDs

Nonsteroidal anti-inflammatory drugs (NSAIDs)—like ibuprofen or aspirin—are one of the most common classes of medications used after a knee injury. This type of medicine is commonly used for short-term reductions in the pain caused by tears to the collateral (ACL or PCL) or cruciate (MCL or LCL) ligaments in the knee.

This class of drugs is also frequently recommended and taken after a meniscal tear, however the benefits in this situation are still being researched. Similarly, the effects of NSAID use after tendon tears also remain unclear, as this class of medication may interfere with tendon healing after a partial tear.

To add to this, NSAIDs can have negative side effects in individuals with gastrointestinal, kidney, or bleeding disorders. As such, it is important to speak to your healthcare provider before beginning any new medication regimen.

Acetaminophen

Another OTC medication that may be an option after damaging your knee is acetaminophen. This drug, sold under the brand name Tylenol, is commonly taken to relieve the pain caused by meniscus injuries. Like NSAIDs, however, high-level studies showing its benefit in this condition are still lacking.

Acetaminophen typically does not cause adverse side effects in individuals with kidney, blood, or gastrointestinal issues. Because of this, it may be a more appealing option than NSAIDs for some people.

It is worth noting, however, that high doses of this medication can cause liver damage, making it contraindicated in people with liver conditions or who consume alcohol.

Prescriptions

Some patients are unable to take OTC pain medication due to other health concerns or because their pain is too intense. In these circumstances, certain prescription medications may be utilized for short-term symptom control.

Selective NSAIDs

Selective nonsteroidal anti-inflammatory drugs, like Celebrex or Meloxicam, can provide short-term pain relief by reducing the inflammation that tends to develop after a knee injury. Unlike OTC NSAIDs, however, they do not block the production of a stomach-protecting compound called prostaglandin. Because of this, selective NSAIDs generally do not cause gastrointestinal side effects and are easier for people with other stomach conditions to take.

This class of medications may elevate your risk of developing a heart attack or stroke, however, so individuals with cardiovascular disease should use caution prior to taking it.

Opioid Analgesics

In rare instances, opioid analgesic pain medication may be prescribed to help control your pain. This class of drugs, which includes hydrocodone and morphine, is generally reserved for severe pain that is unable to be controlled with other OTC or prescription medications.

Opioids are extremely habit-forming and are generally only utilized for short periods of intense pain. In addition, this medication can cause side effects like:

• Nausea
• Drowsiness
• Constipation
• Confusion

Because of this, healthcare providers generally use a significant amount of caution before prescribing opioids.

Surgeries and Specialist-Driven Procedures

While at-home remedies and medications can help alleviate some of the initial pain and swelling, these treatments do not address the underlying damage done within your joint. Because of this, further interventions are usually necessary to help you overcome a knee injury.

The sections below detail the most frequently performed surgeries and specialist-driven procedures.

Physical Therapy

Following certain types of injuries, physical therapy (PT) may be prescribed by your healthcare provider to help you regain the range of motion, strength, and stability in your knee.

PT is often recommended after a meniscal tear and has been shown to produce outcomes in function and pain that are similar to those from a partial meniscectomy surgery. This is especially true for individuals with pre-existing osteoarthritis in their knee.

Therapy is also frequently prescribed following a traumatic ligament tear. Some individuals attend PT before a ligament reconstruction surgery in an effort to reduce their swelling and improve their range of motion. Others choose to avoid surgery completely and to treat their injury with therapy. It is important to note that when dealing with the ACL, this option has been linked to decreased overall knee function, increased long-term instability, and a greater risk of osteoarthritis development when compared to surgery.

Finally, physical therapy is also an option for individuals after a dislocation of their knee cap. While PT can help restore your movement and build strength in your leg, the likelihood that another subluxation will occur is higher than if the injury is addressed surgically.

Ligament Reconstruction

Following a complete tear of one of the stabilizing ligaments in the knee, reconstruction surgery is frequently performed to re-create these important structures in your joint. Typically, a graft from another area of the body—like your hamstring or patellar tendon—is utilized, though in some cases one from a cadaver may be needed.

While any of the four primary ligaments can be torn, the ACL is most commonly affected. Reconstruction surgery provides the highest chance of returning to prior levels of activity while reducing the risk of long-term instability. It is worth noting, however, that in spite of this procedure, there is still an elevated risk of re-tearing the graft or developing osteoarthritis in the joint.

Partial Meniscectomy

Partial meniscectomy surgery is frequently performed on people who experience a torn meniscus. This procedure involves arthroscopically removing the portion of the meniscus that is torn or damaged. While this is an extremely common intervention, recent evidence has raised some questions about its long-term outcomes. 

Studies have found that the improvements in pain and function after a partial meniscectomy are comparable to those from physical therapy alone. This seems to be especially true for people with pre-existing osteoarthritis in their joints.

As such, this surgery may be most beneficial for individuals who fail to get relief from physical therapy or whose meniscal tear physically blocks them from regaining their range of motion.

Depending on the characteristics of the meniscal tear—where it’s located and what type—and the age of the patient, a full repair may also be performed.

Tendon Repair

Tears in the tendons surrounding the knee joint typically occur in the patellar tendon (just below the knee cap) or the quadriceps tendon (just above the knee cap). These muscular injuries are extremely debilitating and almost always require a procedure to repair the damage.

Surgical intervention usually involves suturing the tendon back together and anchoring it to the patella. As a rule, this procedure is usually done acutely after the injury, as delays can make the fixation more challenging.

Long-term outcomes are generally quite good, though there is some increased risk of a re-tear. Chronic stiffness or muscular weakness may also develop in some individuals after this surgery.

Articular Surgeries

The articular cartilage is a smooth, slippery covering that lines the ends of the bones in the knee. This important tissue helps to absorb the forces placed through the joint and allows the bones to slide over one another without friction. While defects in the articular cartilage can occur as the result of degeneration over time, they can also be caused by an acute injury. Depending on the size and location of the damaged cartilage, several different types of articular surgeries may be performed, including:

• Microfracture or abrasion procedures: These involve causing small amounts of bleeding in the affected boney area in an effort to elicit the body’s healing response.
• Osteochondral autograft transfer system (OATS): This consists of taking plugs of cartilage from elsewhere and implanting them in the injured area.
• Autologous chondrocyte implantation (ACI): This procedure attempts to regenerate the body’s cartilage by implanting other cartilage cells in the area of the defect.

A multitude of factors—including defect size, patient age, and prior activity level—go into deciding which technique is appropriate. That said, in most cases the overall improvements appear to be similar regardless of the technique selected.

In the case of large articular defects (over 4.5 square centimeters), however, the OATS or ACI procedure does show significant improvements over a microfracture surgery.

MPFL Reconstruction

A dislocation of the knee cap in the outward (lateral) direction causes damage to a structure on the inner border of the patella called the medial patellofemoral ligament (MPFL). While this injury can be treated conservatively with physical therapy, it is frequently treated surgically with an MPFL reconstruction if the dislocations are recurrent.

This procedure involves taking a graft from another area of the body or from a cadaver and using it to recreate the damaged medial patellofemoral ligament. The surgery aims to add stability to the inner portion of the patella and prevent it from dislocating in the outward direction. Generally, this intervention is very successful, with low rates of dislocation and high percentages of people returning to their preferred sport or exercise.

ORIF

Fractures to one of the three bones that make up the knee joint (the femur, tibia, or patella) occasionally occur as the result of a fall or other traumatic accident. Depending on the location and severity of the injury, surgery is sometimes necessary to stabilize the fractured bone.

The most common type of surgery for a boney fracture in the knee is an open reduction internal fixation (ORIF) procedure.

This technique involves realigning the fracture and placing pins, screws, plates, or rods into the bone to stabilize the area. There many different types of fractures in the knee, each with its own surgical outcomes and potential side effects. In general, however, ORIF procedures in this area require physical therapy to help you regain the function in your leg.                        

Complementary and Alternative Medicine (CAM)

In some situations, complementary or alternative treatments may provide some relief after a knee injury. These are typically not primary treatments, however they may be considered in certain circumstances.

Stem Cell Therapy

Recently, stem cell therapy has become more popular as an alternative way to treat articular defects. This intervention involves taking embryonic stem cells, stimulating them to multiply in a lab, and then implanting the cells into the injured area of your knee.

These cells are thought to have regenerative properties and may stimulate new cartilage growth in the damaged portion of the bone. While there are limited studies on this treatment, the initial results have been promising, and stem cell therapy may provide another way for people with articular defects to address their symptoms.

PRP Injections

Platelet-rich plasma (PRP) injections involve drawing blood from your body, utilizing a centrifuge machine to separate out the plasma portion of the blood, and injecting this substance back into the injured area.

The treatment’s potential benefits center on the fact that plasma contains high amounts of growth factors, a substance that helps with tissue healing. Unfortunately, the evidence supporting this treatment is quite limited at this point, with its pain-reducing benefits appearing to be short lived at best.

A Word From Verywell

Traumatic knee injuries can be extremely painful and may significantly impact your ability to go about your day. Because of this, it is crucial to have them assessed by a healthcare provider as soon as possible.

Following a thorough evaluation, your healthcare provider will be able to recommend the interventions that are right for your specific condition. While your recovery may take some time, in most cases the treatments listed above can help you return to the things you love doing!