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Non-operative Management of Acute Knee Injuries

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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.

Summary

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.

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Correspondence to Nathaniel S. Jones.

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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.

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Jadidi, S., Lee, A.D., Pierko, E.J. et al. Non-operative Management of Acute Knee Injuries. Curr Rev Musculoskelet Med 17, 1–13 (2024). https://doi.org/10.1007/s12178-023-09875-7

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