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The force of a car accident can send the knee crashing into the dashboard, twist it into an unnatural position, or drive it into the door or another object inside the vehicle. Because the knee is a complex joint built from bone, cartilage, and several stabilizing ligaments, this can result in anything from a mild sprain to a full ligament tear requiring reconstructive surgery.
Common Types of Knee Injuries from Car Accidents
Knee injuries after a crash can vary in severity, and the same accident can cause multiple of the following injuries.
Knee Sprains and Strains
Sprains and strains are considered the least severe knee injuries, though they can still be painful and debilitating. A sprain occurs when a ligament is stretched or torn, while a strain involves damage to a muscle or tendon. Most sprains and strains can be managed with rest, ice, compression, and elevation, though a severe (grade-three) sprain can leave the joint nonfunctional and may require more intensive medical care.
MCL Injuries
The medial collateral ligament (MCL) stabilizes the inner knee. When the knee is forcefully and unexpectedly twisted, the MCL can tear. Some MCL injuries heal on their own over roughly six weeks, while others require surgery and rehabilitative therapy.
ACL Injuries
The anterior cruciate ligament (ACL) sits in the center of the knee and works with the posterior cruciate ligament to keep the femur and tibia stable. In a car accident, an ACL tear typically happens when the knee changes direction suddenly, such as when an object forces it one way or another, or when the leg makes direct contact with part of the vehicle. Most ACL injuries involve a complete or near-complete tear, and the ligament often has to be surgically rebuilt. An ACL tear is frequently accompanied by other injuries, including fibula fractures, and is marked by loss of range of motion, tenderness, swelling, and difficulty walking. Depending on severity, treatment may involve a brace and physical therapy, or full surgical reconstruction, with many patients able to resume normal activity roughly six months after surgery.
PCL Injuries
The posterior cruciate ligament (PCL) is the strongest ligament in the knee and the least likely to be injured. When it is hurt, it's usually the result of a direct blow, such as the knee striking the dashboard or door. Because of the force required, PCL injuries are often associated with especially severe collisions, such as being rear-ended by a heavy vehicle.
Meniscus Tears
The meniscus is the cartilage that cushions the joint between the thighbone and shinbone. A meniscus tear can occur when the knee is twisted awkwardly under force, something that can easily happen during a collision. Tears vary by location and pattern and are known by names such as parrot-beak, bucket handle, flap, longitudinal, and complex tears. Common symptoms include intense pain, a feeling that the knee will give way, swelling, stiffness, trouble fully extending the leg, and often a popping sensation when the injury occurs. Treatment ranges from a knee brace, ice, and anti-inflammatory medication to arthroscopic surgery for more severe tears; a patient's age can also affect which treatment path is recommended.
When a Knee Injury Leads to Total Knee Replacement
The full extent of your knee injury may not be obvious right away, which is part of why seeking prompt medical attention matters even when symptoms seem to develop gradually. Ligament tears, fractures, and dislocations sustained in a crash can lead to long-term joint deterioration that eventually requires total knee replacement (TKR) surgery, sometimes years after the original accident. During a total knee replacement, a surgeon replaces the damaged parts of the knee with synthetic materials to relieve pain, though the joint may never fully return to normal, and patients may be unable to return to running, high-impact sports, or other strenuous activity. Recovery typically involves several days in the hospital followed by a period using crutches or a walker.
The need for a total knee replacement may not be known until well after a claim would otherwise be resolved, it's critical that the cost of this surgery be factored into settlement negotiations from the start, not treated as an afterthought.
Who Pays for a Knee Injury After an Iowa Car Accident?
Iowa follows a modified comparative fault rule, often referred to as the 51% rule. Under this system, fault doesn't have to belong entirely to one driver. Instead, each driver involved in the crash can be assigned a percentage of fault based on what they did, or failed to do, leading up to the collision.
Here's what that means for you:
If you're found to be 50% or less at fault, you can still recover compensation, but your damages will be reduced by your percentage of fault. So if your total damages are $100,000 and you're found 20% at fault, you'd recover $80,000.
If you're found to be 51% or more at fault, Iowa law bars you from recovering anything at all.
This is exactly why insurance adjusters push so hard to assign you even a small percentage of blame. Every point of fault they can shift onto you is money they don't have to pay out. It's rarely a fair fight, which is why so many injured Iowans choose not to negotiate with an adjuster on their own.
How is Fault Decided?
Fault in Iowa car accident claims is grounded in Iowa's Rules of the Road, found in Iowa Code Chapter 321. These laws spell out exactly what every driver owes to everyone else on the road. Some of the duties that come up often include:
- The duty to maintain a safe following distance and stay in control of your vehicle. Drivers are required to leave enough room to stop safely, which is why tailgating is such a common factor in rear-end crashes.
- The duty to yield the right-of-way. Iowa law lays out exactly who has to yield in different situations, from uncontrolled intersections to merging onto a highway.
- The duty to obey traffic signals and signs. Running a red light or blowing through a stop sign is one of the clearest indications of fault.
- The duty to execute turns safely. Drivers turning left across oncoming traffic, for example, must yield to vehicles close enough to be a hazard.
These rules sound straightforward, but real accidents rarely play out that cleanly. That's why it helps to look at how fault is determined.
Treatment for a serious knee injury can also become expensive well before a case ever settles, which is why many victims wonder how to keep up with medical bills while their claim is still pending.
Protecting Your Right to Compensation
Because knee injuries can range from a strain that heals in weeks to a ligament tear that leads to surgery years down the road, it's important not to underestimate an injury just because it feels manageable at first. A knee injury that seems minor immediately after a crash can turn out to require significant treatment down the line, and a settlement reached too early may not account for that.
It's important to remember that when an insurance adjuster tells you how fault is going to be assigned, they're not doing you any favors. Their job is to protect their company's bottom line, not to make sure you're fairly compensated.
With a car accident in Iowa, the State of Iowa follows a modified comparative fault system. The Des Moines personal injury attorney team at Walker, Billingsley & Bair work hard to level the field between injured Iowans and insurance companies. That's why we provide this FREE book; The Legal Insider's Guide to Iowa Car Accidents: 7 Secrets to Not Wreck Your Case. To learn more about what our legal team will do to help you protect your Iowa injury claim, contact Walker, Billingsley & Bair to schedule a no-cost consultation. Call 641-792-3595 to order your free accident book today.
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