Knee - Soft Tissue Injuries

From the mechanism, history of injury and past history, physical examination and X-ray where indicated: establish a diagnosis 
Rupture of extensor mechanism  or suspicion of complete ligamentous rupture  
Refer orthopaedics 
Locked knee  
- X-ray to exclude ossific loose body
- Refer orthopaedics. 
- If there has been a significant injury and from the history the patient has a haemarthrosis (i.e. knee swelled very rapidly) 70% of these have an ACL tear – refer orthopaedics
- Otherwise double tubigrip/ Robert Jones bandage/ Extension knee brace
- Review Clinic in one week. 
Definite minor sprain without instability
- Support bandage    
- Analgesia as necessary
- Encourage early weight-bearing but crutches if necessary. Advise on quads exercises
- Review clinic 14 days 
Diagnosis uncertain  
- Ask senior advice
- Support bandage as for sprain,  
- Analgesia and crutches as necessary
- Review Clinic at 1 week for further assessment.