From the Guidelines
The most effective treatment for a knee injury, prioritizing morbidity, mortality, and quality of life, is to initially apply the RICE protocol, which includes rest, ice, compression, and elevation, as recommended by the 2010 American Heart Association and American Red Cross International Consensus on First Aid Science 1.
Initial Treatment
The RICE protocol is a crucial first step in managing knee injuries, as it helps reduce swelling, pain, and further injury.
- Rest the knee to prevent further damage
- Ice the area for 20 minutes every 2-3 hours to reduce swelling, with intermittent 10-minute cooling also being acceptable if 20 minutes of cooling causes discomfort 1
- Compress with an elastic bandage to limit swelling
- Elevate the knee above heart level when possible
Medication and Therapy
For mild to moderate injuries, over-the-counter pain medications like ibuprofen (400-800mg every 6-8 hours with food) or acetaminophen (500-1000mg every 6 hours) can help manage pain and inflammation.
- Ibuprofen is preferred for its anti-inflammatory properties
- Acetaminophen is a suitable alternative for patients who cannot tolerate ibuprofen
More severe injuries may require physical therapy focusing on:
- Strengthening exercises for the quadriceps and hamstrings
- Improving range of motion
- Restoring proper movement patterns
Surgical Intervention
Serious injuries like ligament tears (ACL, MCL) or meniscus damage might necessitate surgical intervention, as recommended by the 2023 American Academy of Orthopaedic Surgeons clinical practice guideline summary 1.
- Autograft is preferred over allograft for ACL reconstruction, particularly in young and active patients
- Bone-tendon-bone (BTB) or hamstring autografts may be used, depending on the patient's needs and preferences
Long-term Management
The knee joint bears significant body weight and contains complex structures, including ligaments, cartilage, and tendons, making proper treatment essential to prevent long-term instability or arthritis.
- Sustained weight loss can benefit patients with knee osteoarthritis, particularly those who are overweight or obese 1
- Oral nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen can be effective in managing pain and inflammation, but should be used judiciously due to potential side effects 1
From the Research
Treatment for Knee Injury
The treatment for a knee injury can vary depending on the severity and type of injury.
- For individuals who have experienced a knee injury, including anterior cruciate ligament (ACL) tears, research suggests that neuromuscular and proprioceptive training can be effective in preventing future injuries 2.
- This type of training has been shown to reduce the incidence of knee injury and ACL tears, with a summary incidence rate ratio of 0.731 (95% CI: 0.614,0.871) for knee injury and 0.493 (95% CI: 0.285,0.854) for ACL injury 2.
Rehabilitation and Recovery
While there is limited direct evidence on the treatment of knee injuries, research on other types of injuries, such as ankle fractures, may provide some insights.
- The RICE (rest, ice, compression, and elevation) method is a commonly used approach to reduce swelling and promote recovery 3.
- Some studies have also explored the use of additional techniques, such as negative pressure therapy, to enhance lymphatic flow and reduce swelling 3.
- However, it is essential to note that these findings may not be directly applicable to knee injuries, and further research is needed to determine the most effective treatment approaches.