Overview of acute knee injuries

This topic aims to provide advice about initial and nonsurgical management for the 3 most common and significant acute soft-tissue injuries of the knee. This includes damage to the:

These injuries are covered individually below. Sometimes they occur as isolated injuries, but at times they occur in combination.

Other acute soft-tissue injuries of the knee are less common and include damage to the:

  • posterior cruciate ligament—less disabling and usually managed nonsurgically (with rehabilitation)
  • lateral collateral ligament—less likely to tear because it is thicker and stronger than the MCL, and varus stress is a less common mechanism of injury to the knee
  • lateral meniscus—associated with a significantly poorer prognosis than medial meniscal injuries
  • patellar dislocation.

Nonsurgical principles of initial management for acute knee injuries are outlined in:

Longer-term management for knee injuries may follow different pathways depending on the injury and patient preference. Strategies include:

  • nonsurgical treatment with an option for surgery if there are ongoing problems (eg knee instability)
  • specific ‘prehabilitation’ (strengthening and range-of-movement therapy preoperatively) followed by surgery
  • early surgery followed by rehabilitation.

Surgery to the knee does not reduce the risk of developing osteoarthritis, so choosing nonsurgical management is a reasonable course of action. If surgical management is indicated, refer the patient for a surgical opinion.

Note: Surgery to the knee does not reduce the risk of developing osteoarthritis, so choosing nonsurgical management is a reasonable course of action.