A dashboard knee injury often happens when a person is involved in a head-on collision and is not seat-belted or is seat-belted. Still, the momentum of the crash causes the knees to propel forward underneath the seatbelt and strike the automobile’s dashboard.
The most common injury in a dashboard knee injury is a posterior cruciate ligament injury, which is disruption or damage to the posterior cruciate ligament that generally, along with the anterior cruciate ligament, helps stabilize the knee in its proper alignment. When the ligament is torn from direct trauma, the knee will be painful and unstable when walking on it. Swelling of the knee is joint after this type of injury.
The posterior cruciate ligament is an intra-articular ligament that attaches the femur to the tibia within the knee joint. It forms an X arrangement within the anterior cruciate ligament, so both are required to keep the knee in place. Posterior cruciate ligament injuries are much less common than anterior cruciate injuries and usually only occur when there is direct trauma to the bent knee, such as is seen in a dashboard knee injury.
Signs and Symptoms of a Dashboard Knee
When the dashboard knee injury leads to a posterior cruciate ligament tear, the symptoms can be the following:
- Knee pain. This pain at rest can worsen when walking on the knee.
- The knee may have a feeling of giving way when putting pressure on it. With posterior cruciate knee injuries, you can still ambulate on the leg, but symptoms gradually worsen as time goes on and you continue to walk on the knee.
- The swelling is usually caused by bleeding into the knee and occurs immediately following the posterior cruciate ligament tear.
Causes of a Posterior Cruciate Ligament Tear
The posterior cruciate ligament is usually torn when the proximal tibia (the shin bone) is struck just below the knee joint, rupturing the ligament. This commonly happens in a motor vehicle accident when the knee hits the dashboard at high velocities. Other causes of posterior cruciate ligament tears include contact sports, soccer, and football. In such cases, the athlete falls on the bent knee while the foot is tilted downward (dorsiflexed).
Because males are more likely to be involved in motor vehicle accidents and are more likely to play contact sports, this type of injury is more common in this gender. Other parts of the knee are often damaged, such as the anterior cruciate ligament and the knee cartilage. Long-term knee pain and instability can occur if other parts of the knee are affected. Years later, you are at a higher risk of getting an arthritic knee with a lifelong problem of knee pain and disability.
Diagnosis of a Dashboard Knee
A dashboard knee is best diagnosed by taking a detailed history of the incident and a thorough physical examination of the knee. Doctors will feel for looseness of the joint or excess fluid in the joint due to bleeding from the damaged ligaments. X-rays of the knee will show evidence of fracture of the kneecap or the proximal tibia and fibula. Still, they will not be able to see any damage to the posterior cruciate ligament. A bony avulsion injury can sometimes be seen within the joint. This happens when the ligament is torn at the level of the bone, tearing away a piece of the bone in the process. This is also known as an “avulsion fracture” and is an intra-articular fracture treated much the same as if the ligament itself were torn.
MRI scanning of the knee uses a strong magnetic field, a computer, and radio waves to see what is happening with the bones and soft tissues within the knee. An MRI can quickly pick up on an intraarticular knee injury, particularly those involving the ligaments and cartilage. Excess swelling in the knee can be identified through an MRI examination as well.
Arthroscopy may be necessary if the diagnosis remains unclear after MRI and regular X-rays. This involves using a camera attached to a tube inserted into the joint after making small incisions in the skin overlying the joint. The camera can see the ligaments directly and tell the extent of the tear in the posterior cruciate ligament. Any other joint damage can also be seen using an arthroscope, including cartilaginous injuries.
Treatment of a Dashboard Knee Injury
No surgery is required to repair a posterior cruciate ligament tear. Doctors will initially recommend the RICE Protocol, which stands for:
- Rest. Staying off the leg for a few days to a couple of weeks can allow the ligament to heal.
- When ice is applied to the knee, the pain is better, and the swelling is minimal.
- This can be accomplished by putting an ACE bandage around the knee to decrease swelling.
- This means keeping the knee up, preferably above the level of the heart, to minimize swelling.
You can also take over-the-counter pain medications that act as anti-inflammatory agents. These include medicines that contain aspirin, ibuprofen, or naproxen. You may also undergo physical therapy, where knee strengthening exercises build up the knee’s stability. You may need crutches or a knee brace for some time, so you don’t use the knee much while the posterior cruciate ligament heals.
Surgery may be necessary. It may be as simple as having a joint aspiration, which removes excess blood and fluid around the knee joint. Sometimes, the procedure must be repeated because the fluid has built up again.
If you have other injuries to the knee, a fracture, or a ligament that just won’t heal, knee surgery is sometimes indicated. Most knee surgery is done using a laparoscope, which involves inserting a camera on the end of a fiber-optic tube to visualize the damaged structures and making other tiny incisions around the joint to manipulate and suture injured areas and to replace areas of cartilage that have become dislodged.
Sacramento Knee Injury Lawyers
I’m Ed Smith, a Sacramento Knee Injury Lawyer that can help in any acute knee injury accident. Call me anytime for free, friendly advice at 916-921-6400 or 800-404-5400. See Reviews on Yelp, Avvo, and Google. I’m a member of the Million Dollar Advocates Forum.