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Review
. 2024 Jan;17(1):1-13.
doi: 10.1007/s12178-023-09875-7. Epub 2023 Dec 14.

Non-operative Management of Acute Knee Injuries

Shaheen Jadidi  1 , Aaron D Lee  2 , Eliza J Pierko  2 , Haemi Choi  2 , Nathaniel S Jones  3
Affiliations
Review

Non-operative Management of Acute Knee Injuries

Shaheen Jadidi et al. Curr Rev Musculoskelet Med. 2024 Jan.

Abstract

Purpose of review: Acute knee injuries are commonly encountered in both the clinical and sideline setting and may be treated operatively or non-operatively. This article describes an evidence-based approach to non-operative acute knee injury. This includes history, physical exam, imaging, and initial management. In addition, the non-operative management of three such injuries-ligament injury, meniscus injury, and patellar dislocation injury-will be discussed via a case-based practical approach.

Recent findings: Aside from grade III ACL tears, most acute knee ligament injuries, especially in the absence of other concurrent injuries, can be treated non-operatively. There is new evidence that acute traumatic meniscus tears in those younger than 40 can be successfully treated non-operatively and can do equally, as well as those that undergo surgery, at 1 year out from injury. Based on the current literature, a short period of knee bracing in extension with progression to weightbearing to tolerance is recommended after initial patellar dislocation. Many of the most common acute knee injuries, including MCL tears, meniscus tears, and patellar dislocations, can be managed non-operatively. A detailed systemic approach to initial evaluation, including pertinent history, physical exam, and appropriate imaging, is essential and complementary to the subsequent non-operative treatment algorithm.

Keywords: Ligamentous knee injury (ACL, MCL, PCL, LCL); Meniscus tear; Patellar instability; Rehabilitation.

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Conflict of interest statement

Shaheen Jadidi declares that he has no conflict of interest.

Aaron Lee declares that he has no conflict of interest.

Eliza Pierko declares that he has no conflict of interest.

Haemi Choi declares that he has no conflict of interest.

Nathaniel S. Jones declares that he has no conflict of interest.

Figures

Fig. 1
Fig. 1
Adapted from Bunt et al. [4]
Fig. 2
Fig. 2
Criteria for non-operative vs operative management of acute ligamentous knee injuries
Fig. 3
Fig. 3
Management of acute meniscal tear
Fig. 4
Fig. 4
Management of acute patellar dislocation
See this image and copyright information in PMC

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