Symptoms
Small haematomas are often accompanied by only slight swelling and painful pressure. In addition, the affected area is visibly discoloured from the outside, first red, then blue, later yellow. In the case of larger bruises on the knee, a greater, permanent pain can occur.
This is also known as tension pain, which is caused by the spread and swelling of the effusion. The swelling also restricts the freedom of movement. In the case of large bruises in the knee joint, the so-called “dancing patella” occurs. Here, even slight pressure on the kneecap causes the patella to appear to float in the knee due to the accumulated fluid. However, this phenomenon only occurs at joint effusions of about 50ml.
Treatment
In most cases, haematomas are not dangerous and will disappear by themselves within a few days. The blood that has passed from the vessel into the tissue first coagulates and is then removed by the body breaking it down through enzymes. The various degradation products that are produced in this process also explain the development of the colours of the “blue spot” from red, through blue and green, to yellow.
Immediately after the injury and the beginning of the swelling at the knee, the knee must be cooled. The cool temperature causes the blood vessels to contract, reducing or stopping the bleeding. As a result, the haematoma does not spread as far into the tissue and the swelling is also reduced.
A doctor should decide how to proceed with the treatment. The bruise itself usually does not require treatment once the cause of the bruise has been eliminated. In other cases, the orthopaedic surgeon can also apply a so-called “haematoma tape” to the knee, which accelerates the healing process and makes it easier by relieving pain at the same time.
In rare cases, the joint effusion cannot heal by itself and a puncture of the knee becomes necessary. In this case, a needle is used to suck the blood out of a cavity in the knee joint. A bruise in the knee can also be treated by the so-called “taping”.
They are also called “kinesiotape” or “meditape”. Not all kinesiotapes are suitable for use on knee joint effusions. Special tapes for the treatment of bruises are also called “haematoma tapes”.
You can buy these tapes in pharmacies and medical supply stores and apply and stick them yourself. This requires some practice at first, so it is advisable to consult an orthopaedic surgeon first. The tapes must be stuck very tightly to the skin and should cover the haematoma completely.
For this you need particularly wide tapes that are elastic in all directions, so not all kinesiotapes are suitable. The haematoma tape should relieve the pain and speed up the healing process. If this does not happen and the haematoma is still present after weeks, you should talk to your doctor about a further procedure.
In such cases, it may be necessary to remove the bruise through surgery or puncture. Basically, bruises should be cooled; the cold causes the blood vessels to constrict, less blood flows into the affected tissue, which improves the swelling and the effusion is reduced more quickly. Cooling (in addition to painkillers and anti-inflammatory drugs such as ibuprofen) is also a proven remedy for pain.
Ideally, a cool pack stored in the refrigerator should be wrapped in a towel and placed on the affected area so that the skin does not freeze. If the bruise in the joint does not resolve itself, the knee should be punctured and as much blood as possible removed. In the long term, the blood in the joint cavities can damage the cartilage and cause inflammation.
In these cases, the doctor can puncture the knee and the patient should immediately notice an improvement in the bruise and pain. With a thin needle the doctor punctures the knee joint and tries to suck off as much of the blood as possible. However, there are also risks involved in the puncture.
If the puncture is performed incorrectly, structures in the knee joint can be injured by the needle. It can also happen that new bleeding occurs as a result of the puncture. If the puncture is performed unhygienically, the knee can become inflamed and cause further pain and joint effusions.
Care should also be taken to ensure that the original injury that caused the bruise is repaired. Otherwise, the success of the puncture will be short-lived, as the joint cavity can quickly fill with blood again. In addition to the proven conventional medical treatment methods and the application of a cool pack, various household remedies can also help to treat a bruise in the knee.
A cloth soaked in acetic clay (from the pharmacy) and wrapped around the knee can be helpful, as can a bath with arnica essence. However, neither should be used on open wounds (for example after an operation). A proven remedy is also quark wraps: For this, about 250g of cold quark from the refrigerator are evenly distributed on a towel and wrapped around the knee. However, once the bruise is present, in most cases waiting is the only thing that helps. If the bruise changes colour to yellowish after a few days, it is a good sign that the haematoma is healing itself.
