Knee injuries are extremely common in motor vehicle accident cases. In automobile collisions, drivers and passengers will brace for impact by pressing their feet against the floorboard. As the body is propelled forward, this can cause compression trauma and/or a twisting injury to the knee. In frontal impacts, the victims are often thrown forward, causing the knee to impact the dashboard or seat back. In motorcycle, bicycle, and pedestrian collisions, knee trauma produced when striking the pavement can cause severe fracture and soft-tissue damage.
The knee is the most inherently unstable joint of the body. The knee is the union between the femur (the long bone of the thigh) and the tibia and fibula (the two bones of the lower leg). These bones are held together by four primary ligaments:
- the anterior cruciate ligament (ACL),
- the posterior cruciate ligament (PCL),
- the lateral collateral ligament (LCL), and
- the medial collateral ligament (MCL).
The patella, or kneecap, sits at the front of the knee. This is a cartilage cap that feels and performs like bone and shields the front of the knee joint. The meniscus is a two-part pad that cushions the union between the upper leg bone and the two lower leg bones. The meniscus can be worn thin or torn through years of use or by direct impact and trauma to the knee. Tears to the meniscus can cause significant sharp pains and difficulty when walking, jumping, or climbing/descending stairs.
When describing the instability of the knee, some doctors compare the knee to two matchsticks held together by rubber bands. This description simply explains the inherent instability of the joint. The elasticity of the knee ligaments and the flexibility of the joint create a high susceptibility to injury whenever trauma occurs. Unfortunately, most traumatic injuries to the knee will not heal over time. While physical therapy can be utilized to strengthen the muscles and to increase range of motion and decrease pain, underlying damage to the joint capsule typically will require surgical repair.
Most knee surgeries are performed arthroscopically. Thus, the repair is not terribly invasive and surgical results are typically quite positive for the patient. Knee injuries are commonly overlooked or misdiagnosed. While X-rays will show obvious dislocation of the bones of the knee joint, an MRI is typically the best diagnostic tool to reveal the true extent of ligament, nerve, and soft-tissue damage.
The medical claim presentation in a knee-injury case should include a narrative report from an orthopedic surgeon. The full surgical report will also demonstrate all steps undertaken in surgery. If symptoms persist after surgery, physical therapy and occasionally a second surgical procedure will be required. If the victim had no prior problems with knee pain prior to the collision, it is wise to provide past medical records to confirm that the subject collision was the true cause of the claimed knee injury. The knee injury case presentation should also describe the impact of this injury on the patient’s hobbies, day-to-day activities, and lifestyle. Also, proof of permanency, the potential need for and cost of future medical care, and the medical expectation of future symptoms and suffering must be proven to secure proper compensation for a knee injury.