Knee Swelling After Car Accident: When to Seek Further Treatment?

Knee swelling after a car accident?

Hello, Doctor.
I am Ms.
Lai, who has previously asked a question.
I apologize for informing you that I have been diagnosed with a knee contusion.

On November 3rd, I was involved in a car accident where I impacted the outer side of my right knee.
However, the left side of my right knee is very painful and noticeably swollen, especially when bending or in a kneeling position, where it feels like a tearing pain.
By mid-November, I still felt pain (although it has improved compared to the pain at the time of the accident).
I have started physical therapy at a rehabilitation clinic (including electrical stimulation and far infrared therapy), but in the past few days, the swelling and pain have become more pronounced (even tight pants cause discomfort), and the swelling seems worse than it was at the time of the accident.
However, walking is still manageable.
I would like to ask if I should continue with rehabilitation or seek further examination.

Lai Xiaojie, 20~29 year old female. Ask Date: 2018/12/10

Dr. Chen Yongxue reply Orthopedics

Hello, generally speaking, a knee contusion may swell and be painful for about one to two weeks, depending on the situation.
If your symptoms do not improve as expected, it would be advisable to seek further evaluation.
Thank you.

Reply Date: 2018/12/10

More Info

After a car accident, experiencing knee swelling and pain can be concerning, especially if the symptoms seem to worsen over time. Based on your description, it appears that you sustained a contusion to your right knee, which is characterized by swelling and pain, particularly when bending or kneeling. While some improvement in pain was noted initially, the recent increase in swelling and discomfort suggests that further evaluation may be necessary.

In general, when dealing with knee injuries post-accident, it is crucial to monitor the symptoms closely. Here are some key points to consider regarding your situation:
1. Persistent Symptoms: If the swelling and pain have increased, especially after starting physical therapy, this could indicate that the initial injury may be more severe than initially assessed. It is not uncommon for soft tissue injuries to present with delayed symptoms, and sometimes underlying issues such as ligament injuries or meniscal tears can be overlooked.

2. Physical Therapy: While physical therapy can be beneficial for rehabilitation, it is essential to ensure that the exercises and modalities being used are appropriate for your specific injury. If you are experiencing increased pain during therapy, it may be a sign that the treatment plan needs to be adjusted. Communication with your physical therapist about your symptoms is vital.

3. Further Imaging: Given the worsening symptoms, it might be prudent to seek further imaging studies, such as an MRI. An MRI can provide a detailed view of the soft tissues, including ligaments, tendons, and cartilage, and can help identify any potential tears or other injuries that may not be visible on X-rays.

4. Signs of Complications: Be vigilant for any signs of complications, such as increased warmth, redness, or fever, which could indicate an infection or other issues. Additionally, if you experience locking of the knee, instability, or significant changes in your ability to bear weight, these are red flags that warrant immediate medical attention.

5. Consultation with an Orthopedic Specialist: If your symptoms do not improve or continue to worsen, it may be beneficial to consult with an orthopedic specialist. They can perform a thorough examination, review your imaging studies, and provide a more comprehensive assessment of your knee injury.

6. Rest and Ice: In the meantime, continue to rest your knee and apply ice to reduce swelling. Elevating the knee can also help manage swelling. Avoid activities that exacerbate the pain, and consider using a knee brace for additional support.

In conclusion, while physical therapy is an essential component of recovery, the worsening of your symptoms suggests that further evaluation is warranted. It is crucial to communicate openly with your healthcare providers about your concerns and symptoms to ensure that you receive the appropriate care. Seeking further imaging and possibly consulting an orthopedic specialist can help clarify the extent of your injury and guide your treatment plan effectively. Your goal of returning to normal function and alleviating pain is achievable with the right approach and timely intervention.

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