Knee Issues After Car Accident: Symptoms and Treatment

Knee issues resulting from a car accident?

Hello Doctor: Four months ago, I had a car accident that resulted in a contusion of my left knee, which was very swollen.
Within a month, I visited the doctor three times, and they diagnosed me with bursitis.
I received anti-inflammatory injections, took anti-inflammatory medication, and applied ice, which helped a bit.
Afterward, the doctor said I was fine and advised me to switch to heat therapy.
However, it has now been four months, and while I have no issues straightening or bending my knee, there is still a bruise on the surface.
I feel tight when squatting, and going down stairs feels off.
When I wear long pants, if my knee bends and touches the fabric, it causes pain, which is why I now have to wear very loose pants.
I also hesitate to squat, run, jump, or kneel.
It seems that the bone in my left knee is slightly more prominent than in my right knee, and I'm unsure if this is due to swelling.
I previously had an X-ray that showed no issues with the bones, but I am very concerned...
Since four months have passed, I recently visited a clinic where the doctor mentioned that my patella is still inflamed and prescribed me anti-inflammatory medication.
He advised me to apply heat.
I would like to ask if my knee is normal? Could this be turning into chronic inflammation? Is there a possibility of an internal injury to the knee or ligament damage? Should I be applying ice or heat? Thank you, Doctor.
I really appreciate it!

s, 20~29 year old female. Ask Date: 2018/11/09

Dr. Shi Guozheng reply Orthopedics

Swelling of the knee joint after a car accident is typically due to incomplete tissue repair and usually occurs without a fracture.
With rehabilitation and heat therapy, recovery is generally expected.
If there are concerns about potential internal joint issues, it is advisable to consult a physician to determine if further imaging, such as an MRI, is necessary.
This type of examination can reveal any damage to the cartilage, meniscus, or anterior and posterior cruciate ligaments.

Reply Date: 2018/11/09

More Info

After a car accident, knee issues can arise due to various injuries, including soft tissue damage, ligament injuries, and even joint inflammation. Your symptoms, including persistent swelling, bruising, tightness when squatting, and pain when bending or touching the knee, suggest that there may be underlying issues that need to be addressed.

From your description, it seems that you have been diagnosed with bursitis (inflammation of the bursa), which is common after trauma. The fact that you have been experiencing symptoms for four months indicates that there may be more than just a simple case of bursitis at play. The ongoing pain, tightness, and the visible difference in the knee's appearance (with the left knee appearing more prominent than the right) could suggest several possibilities, including:
1. Chronic Inflammation: If the inflammation persists, it can lead to chronic pain and discomfort. This can occur if the initial injury was not fully resolved or if there is ongoing irritation in the knee joint.

2. Soft Tissue Injury: Injuries to the ligaments, tendons, or muscles around the knee may not always be visible on X-rays. An MRI might be necessary to assess the soft tissues and determine if there are any tears or significant damage.

3. Patellar Issues: Given that your doctor mentioned patellar inflammation, it is possible that the kneecap (patella) is not tracking properly due to swelling or soft tissue damage. This could lead to pain during activities such as squatting or going down stairs.

4. Bursitis: While you have been treated for bursitis, if the underlying cause of the inflammation has not been addressed, the symptoms may persist.
5. Osteoarthritis: Although less likely given your age and the recent nature of the injury, it is worth considering that joint changes could develop over time, especially if there has been significant trauma.

Regarding your treatment, it is essential to follow your doctor's advice. Heat therapy can help with muscle relaxation and pain relief, while ice therapy is beneficial for reducing inflammation and swelling. In the acute phase of an injury, ice is typically recommended, but in chronic cases, heat may be more appropriate.
Here are some recommendations for managing your symptoms:
- Rest and Activity Modification: Avoid activities that exacerbate your pain, such as squatting, running, or jumping. Listen to your body and allow it time to heal.

- Physical Therapy: A physical therapist can provide a tailored rehabilitation program to strengthen the muscles around your knee, improve flexibility, and restore function. They can also help assess your knee mechanics and address any issues with patellar tracking.

- Medication: Continue to follow your doctor's recommendations regarding anti-inflammatory medications. If your symptoms persist, discuss the possibility of corticosteroid injections or other treatments with your healthcare provider.

- Imaging Studies: If your symptoms do not improve, consider asking for further imaging studies, such as an MRI, to evaluate the soft tissues around your knee.

- Follow-Up: Regular follow-ups with your healthcare provider are crucial to monitor your progress and adjust your treatment plan as necessary.

In conclusion, while it is encouraging that you can extend and bend your knee without significant issues, the ongoing pain and swelling warrant further investigation. It is essential to address these symptoms proactively to prevent them from becoming chronic. Always consult with your healthcare provider before making any changes to your treatment plan.

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