Old Knee Injuries: Impacts and Concerns

Old knee injury

Hello, doctor! I would like to ask a question.
When I was in the ninth grade (about six years ago), I had an incident where I collided with a classmate, and my knee was pressed down suddenly.
At that moment, I felt a tendon in my knee suddenly shift, and after I straightened my leg, it seemed to return to its original position.
I also felt a noticeable pop inside my knee.
Since it didn't seem serious at the time, I didn't seek medical attention.

Later, one day while sitting cross-legged on my bed, when I suddenly tried to stand up, I used both legs to push my body up, and the tendon shifted again.
However, this time, straightening my leg did not improve the situation.
When I visited a traditional Chinese medicine practitioner, they referred to this as "guai" (in Taiwanese), and since there was no pain, I didn't have time to see a doctor.

I would like to know what impact this could have on my knee.
If I remember correctly, at that time, I didn't feel the tendon return to its original position.
Could you please tell me which part of the knee might be injured?

Lin Tongxue, 20~29 year old female. Ask Date: 2007/05/24

Dr. Zhou Lizhi reply Orthopedics

According to the user, it may be a patellar dislocation, often caused by tight lateral ligaments or previous injuries, leading to dislocation of the knee during certain positions or activities.
Generally, the patella will spontaneously reduce after the knee is fully extended; however, habitual dislocation can result in wear and tear of the patellofemoral joint, potentially leading to arthritis over time.
Therefore, it is recommended that the user consult an orthopedic specialist for diagnosis and treatment, and surgical intervention may be necessary if indicated.

Reply Date: 2007/05/24

More Info

Understanding old knee injuries is crucial, especially when they manifest symptoms long after the initial incident. Your experience of feeling a "muscle" or tendon snap and then return to its position suggests that there may have been some form of soft tissue injury, possibly involving the ligaments or tendons around the knee joint.
When you described the sensation of a muscle or tendon "running away" and then returning, it could indicate a temporary displacement or strain of the patellar tendon or possibly the quadriceps tendon. These tendons are essential for knee stability and function, and any injury to them can lead to long-term issues if not properly addressed.
The knee joint is a complex structure composed of bones, cartilage, ligaments, and tendons. The ligaments, such as the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL), provide stability, while the menisci (cartilage) act as shock absorbers. If there was a significant injury to any of these components, it could lead to chronic instability, pain, or even the development of osteoarthritis over time.

Your decision not to seek medical attention immediately after the injury may have allowed for compensatory mechanisms to develop, where other muscles and tendons took over the function of the injured area. This can sometimes mask the symptoms but may lead to further complications, such as muscle imbalances or overuse injuries in other areas of the body.
The fact that you experienced a recurrence of symptoms when sitting cross-legged and then standing suggests that the knee may not be functioning optimally. The knee joint relies on a delicate balance of strength and flexibility in the surrounding muscles. If the muscles are weak or tight, it can lead to improper movement patterns, which may exacerbate any underlying issues.

In terms of potential impacts, if the injury involved significant soft tissue damage, it could lead to chronic pain, decreased range of motion, and instability in the knee joint. Over time, these issues can contribute to degenerative changes in the joint, such as osteoarthritis, particularly if the joint is subjected to repetitive stress without adequate support from the surrounding musculature.

It is essential to address these concerns proactively. I recommend consulting with an orthopedic specialist or a physical therapist who can perform a thorough evaluation of your knee. They may suggest imaging studies, such as an MRI, to assess the condition of the ligaments and cartilage. A tailored rehabilitation program can help strengthen the muscles around the knee, improve flexibility, and restore proper function.

In summary, while it may seem that the initial injury was minor, the long-term effects can be significant if not addressed. Early intervention can prevent further complications and help maintain knee health. Ignoring symptoms or assuming they will resolve on their own can lead to chronic issues that may require more extensive treatment down the line. Therefore, seeking professional advice is crucial for your knee's long-term well-being.

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