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Fell hard on knee. Swelling and large blood bruise appeared. How to cure this?

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Orthopaedic Surgeon
Practicing since : 2004
Answered : 189 Questions

I fell hard on my knee a week ago. It was swollen immediately, now a large blood bruise appeared under my ankle (the same leg). I can walk, and hope it will resolve. Please let me know what you think. The knee is still swollen, but hurts, especially the the bone under the knee cap. The front of the knee has an area where I lost feeling.
Posted Tue, 30 Apr 2013 in Bones, Muscles and Joints
Answered by Dr. Sathyadharan Panneer 3 hours later

Thanks for writing in,

Immediate swelling in knee tells us that the injury / force was quite significant. The blood bruise in your ankle might be due to tracking of blood from the injuried knee. Since you are able to walk, there won't be major bony injury around knee. But still, since there is pain under your knee cap with such big swelling and bruises, I would suggest you to get a Xray of your Knee joint and consult an orthopaedician. If there are any soft tissue injuries, they won't be seen in Xray. For which your doctor might order for an MRI if needed after examining you clinically.

You can apply crepe bandage around your knee. Ice pack application can also be done. These measures along with elevation of limb over pillows during rest will decrease the swelling. If pain is more, you can have NSAID's sos. Try to give rest to knee joint, till we arrive at proper diagnosis.

Wish you a good health.
Above answer was peer-reviewed by
Follow-up: Fell hard on knee. Swelling and large blood bruise appeared. How to cure this? 30 hours later

Thank you for your reply. I am following your advice.
The hard fall on the knee (front) was a week ago, it's less swollen now, not hot to touch, but still swollen and bruised. It's mainly swollen around the knee cap, top of the front (knee cap). It is protruding is protruding forward a bit more than the other knee, and sensitive to touch.
It doesn't hurt when I don't move, I can extend it, but cannot bend more than a right angle to my htigh. The knee feels stiff and pain varies in front and to the outer side of the joint when I stand or walk.
Is the seeping of blood to my ankle (now a medium size blue area below the inner side of my ankle) and both ankles swollen, a possible indication of a serious injury inside of the knee? Could tendons be torn (but my knee is not unstable), or partially torn, and could I have (if not totally broken) a bone (knee cap, patella, injured meniscus, or cartillage, despite the fact that I can walk with some difficulty? It hurts more when I start from inactivity, or if I put later too much pressure on the knee.
If I possibly injured only soft tissue (are ligaments considered soft tissue?), could I be fine even with these symptoms?
I will go to see a doctor, but could you please let me know what you think?

Thank you.
Answered by Dr. Sathyadharan Panneer 3 hours later
Walking with full weight bearing rules out major bony injuries. But if swelling of knee occurs, the chances for soft tissue injuries (tear in meniscus or ligaments) is more, even if you are able to bear weight. You seemed to have also developed contusion of pre-patellar bursa. Hairline or minimally displaced fracture of patella cannot be ruled out.

Stiffness in knee with varying pain when you stand or walk and pain more when you start from inactivity are due to quadriceps muscle spasm, which will go off as the injury heals. This spasm is actually the protecting reflex of our body, to restrict activity in the injured part, so that healing hastens. Unless the injury is severe, this spasm itself masks the minimal instability of the joint.

Initially you described it as ankle swelling only in the affected leg. Did the other ankle also developed the swelling? (".... and both ankles swollen" as you have described). Swelling in another ankle without injury to the side or part, cannot be attributed to the knee injury.

Try to give rest to the knee by restricting activities. Use crepe bandage or simple knee cap or short leg knee brace to decrease swelling and immobilise the knee, till you see your doctor.

Above answer was peer-reviewed by
Follow-up: Fell hard on knee. Swelling and large blood bruise appeared. How to cure this? 1 hour later
Thank you again for replying so quickly and in detail.

Just hypothetically: if I were found with the possible injuries described in the first paragraph (meniscus, ligament tear), hairline fracture of patella (one or all of these injuries), would I need surgical intervention, or could these injuries heal with time on their own?

And to clarify, only the ankle on the foot of the knee injury (right) is swollen (I meant both sides), and blood accumulated under the inner ankle (as I wrote in my first question).

Thank you in advance for replying to this question.
Answered by Dr. Sathyadharan Panneer 1 hour later
Not all meniscal or ligamentous injuries require surgical treatment. MRI will only tell us the severity of such soft tissue injuries. Based on MRI findings, range of movement of knee joint and laxity, surgical option have to be taken.

Hairline fracture of patella can be treated by few weeks of immobilisation in POP cast. Meniscal injuries won't heal. Ligamentous injuries have chances of healing on their own after adequate period of immobilisation.

Hope i have answered all your queries.
Wish you a good health.
Above answer was peer-reviewed by
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