The knee is the largest joint in the human body. Because it is located central to the lower extremities, it is susceptible to trauma.

Many people are vulnerable to an injury to the knee joint because of traffic accidents, falling and sports/exercise. Particularly during the winter season, the number of patients who injure themselves falling increases because of sports (e.g., skiing and boarding), icy roads and muscle stiffness.

Patients frequently sustain a sports injury because of the overflexion of the knee joint while skiing. In addition, a large number of patients sustain an injury to the knee joint because of muscle stiffness caused by decreased body temperature or falling due to icy roads. In the knee joint, the ligament tear (the medial and lateral collateral ligament and the anterior and posterior cruciate ligament) or the meniscal one (cartilage) frequently occur because of trauma.

In these injuries, however, the pain spontaneously disappears two-three weeks later. Therefore, this can easily be considered a sprain of the knee joint. In addition, because it is not easy to make a diagnosis, even if patients visit the outpatient clinic after an injury, there is also a possibility that patients cannot be treated early. 

A lack of the appropriate treatment following the onset of ligament tear may lead to the repeated occurrence of an injury to the knee joint. This in turn contributes to the occurrence of degenerative arthritis.

Once degenerative arthritis occurs, even the best treatment cannot achieve recovery to the normal status. It is therefore inevitable that patients are afflicted with lifetime sequelae. If patients have a popping sound from the knee joint or cannot perform a gait due to joint swelling and severe pain at the time of injury, they should be suspected of having a severe injury to the medial collateral ligament or the anterior cruciate ligament and then should be treated as early as possible. In addition, if there are any patients who produce a snapping sound together with the knee joint pain following the onset of an injury, they should be suspected of having a meniscal tear.

Even in the absence of trauma, knee joint pain might also occur. That is, it also occurs because of a discoid lateral meniscus tear, Osgood-Schlatter’s disease, chondromalacia of the patella, rheumatoid arthritis or inflammatory arthritis. In cases of a discoid lateral meniscus tear, a snapping sound is heard very loudly during movement of the knee joint. There are also some patients who suffer from the impaired movement of the knee joint. Osgood-Schlatter’s disease is characterized by pain and the protuberance of a bony structure over the anterior region of the knee joint at puberty where the growth and development occur most actively. Most of these cases are spontaneously improved.

Chondromalacia of the patella frequently occurs in relatively younger patients, which is accompanied by the presence of a snapping sound and pain in the patella. Rheumatoid arthritis frequently occurs in young women, which is characterized by the concurrent presence of pain and swelling in multiple joints other than the knee. Inflammatory arthritis is characterized by a high fever and a severe arthralgia.

To prevent the occurrence of an injury to the knee joint during the winter season, be sure to do warm-up exercises before activities such as skiing or boarding.

People are also at increased risk of sustaining an injury to the knee joint when there is increased fatigue in the muscles of the lower extremities due to long-term exercise. In particular, patients should be cautious when performing exercises at dawn during the winter, both because it is dark and also because they are less awake. In these cases, patients can prevent injury to the knee by thoroughly warming up, including through free gymnastics or stretching indoors before going outside and thereby attempting to provide flexibility for the muscles and sufficiently circulate the synovial fluid in the knee joint.

Recommendations for patients with arthritis during the winter season

1 Pay special attention to injuries resulting from a fall during the winter season.

2 Take part in regular exercise. Indoor exercises like using a treadmill, using a stationary bicycle or swimming are recommended.

3 Maintain body temperature when going outside. Arthritis can be worsened in cold weather. You therefore need to pay special attention to maintaining body temperature.

4 Use a cane if you have an unsteady gait.

5 Listen to the weather forecast. If it rains or snows, you need to prevent the occurrence of such accidents from falling by avoiding going outside if possible.

6 Place supports on stairs, doorsills, the bathroom and washroom. These are needed to prevent the occurrence of an injury.

7 Prevent weight gain as much as you can. Body weight can easily be gained because of insufficient exercise during the winter season, which might cause the aggravation of arthritis. Body weight should be controlled through diet and exercises.

 By Dr. Moon Young-wan

The author is a professor of Sungkyunkwan University School of Medicine’s Department of Orthopedic Surgery and doctor at Samsung Seoul Hospital. ― Ed.