Knee

Knee pain is common. It can start with a twist or can come on gradually. You can wake up with it and it can then progress over days. Initial treatment is to rest it and avoid activity that aggravates it. If you are having severe pain in the knee especially after a fall and/or if the pain builds over hours and is associated with swelling, tenderness or redness, you need to see a doctor.

If you don’t fall into this category you can try some treatments on your own. You can decrease the weight bearing until the pain subsides. You stop impact activity. If it hurts to walk you go on crutches. If it still hurts while on crutches you make sure you place no weight on the painful leg 100% of the time. If you do all that and it still hurts you need to see a doctor as soon as possible.

If you are able to get to the point where your knee doesn’t hurt putting less weight on it, then you can start reconditioning the knee. You start with straight leg raise staying within the pain free range. If you can bend the knee you can use a stationary bike. If you are not sure what to do you need to see a doctor who will be able to direct you. If the rest and simple exercises doesn’t relieve your pain, again it is time to see a doctor.

Your doctor’s visit will usually involve being asked a series of questions and an examination possible along with an x-ray. Depending on the problem you will be prescribed rest, exercise and/or medication. The exercise will either involve home exercises or supervised physical therapy. You will be given follow-up visits to see how you are doing and to make adjustments in your treatment plan.

If your pain persists or gets worse it frequently means you are putting too much weight on your leg. Limping is not a problem that you can will away. It means your knee can’t handle the weight you are putting on it. So you need to take the weight off you knee with crutches. It may take several days of no weight bearing for the pain to subside. If the pain doesn’t go away or is severe, you will need to call the doctor.

Additional treatments may be needed. This may include additional x-rays, joint aspiration or injection. Sometimes the knee pain is caused by a problem that requires surgery. This may be due to a break in the bone, a tear in one of the ligaments or damage to the cartilage of the knee that the body can’t heal. Sometimes this surgery can be done arthroscopically through small incisions as an outpatient. Sometimes bigger surgery is necessary. The recovery varies depending on what the problem is. It can be as short as a week or take several months.

Normal Anatomy of the Knee Joint

The knee is made up of four bones. The femur or thighbone is the bone connecting the hip to the knee. The tibia or shinbone connects the knee to the ankle. The patella (kneecap) is the small bone in front of the knee and rides on the knee joint as the knee bends. The fibula is a shorter and thinner bone running parallel to the tibia on its outside. The joint acts like a hinge but with some rotation.

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Avascular Necrosis

Avascular necrosis also called osteonecrosis, refers to a painful condition which results from lack of blood supply to bone tissue gradually leading to bone death, collapse of the bone, collapse of articular cartilage covering the bone and finally to disabling arthritis.

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Knee Fracture

A fracture is a condition in which there is break in the continuity of the bone. In younger individuals these fractures are caused from high energy injuries, as from a motor vehicle accident. In older people the most common cause is weak and fragile bone.

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Meniscus Tear

Meniscus tear is the commonest knee injury in athletes, especially those involved in contact sports. A suddenly bend or twist in your knee cause the meniscus to tear. This is a traumatic meniscus tear. Elderly people are more prone to degenerative meniscal tears as the cartilage wears out and weakens with age.

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Patellofemoral Instability

The knee can be divided into three compartments: patellofemoral, medial and lateral compartment. The patellofemoral compartment is the compartment in the front of the knee between the knee cap and thigh bone.

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Osteonecrosis

Osteonecrosis is a condition in which death of a section of bone occurs because of lack of blood supply to it. It is one of the most common causes of knee pain in older women. Women over the age of 60 years of age are commonly affected, three times more often than men.

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Knock Knee Deformity

Angular deformities of the knee are common during childhood and usually are variations in the normal growth pattern.

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Arthroscopy of the Knee Joint

Knee Arthroscopy is a common surgical procedure performed using an arthroscope, a viewing instrument, to look into the knee joint to diagnose or treat a knee problem. It is a relatively safe procedure and a majority of the patient’s discharge from the hospital on the same day of surgery.

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Total Knee Replacement (TKR)

Total knee replacement, also called total knee arthroplasty, is a surgical procedure in which the worn out or damaged surfaces of the knee joint are removed and replaced with artificial parts. .

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Anterior Cruciate Ligament (ACL) Reconstruction

The anterior cruciate ligament is one of the major stabilizing ligaments in the knee. It is a strong rope like structure located in the center of the knee running from the femur to the tibia. When this ligament tears unfortunately it doesn’t heal and often leads to the feeling of instability in the knee.

ACL reconstruction is a commonly performed surgical procedure and with recent advances in arthroscopic surgery can now be performed with minimal incision and low complication rates.

ACL Reconstruction Hamstring Tendon

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ACL Reconstruction Patellar Tendon

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Unicondylar Knee Replacement

Unicompartmental knee replacement is a minimally invasive surgery in which only the damaged compartment of the knee is replaced with an implant. It is also called a partial knee replacement.

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Revision Knee Replacement

Revision knee replacement surgery involves replacing part or all of your previous knee prosthesis with a new prosthesis. Although total knee replacement surgery is successful, sometimes the procedure can fail due to various reasons and require a second revision surgery.

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Custom Knee Replacement

Total knee replacement is often the last option when conservative options fail to relieve the pain and retard the progression of joint damage in patients with severe arthritis. Knee replacement surgery involves replacing the damaged cartilage and bone from the surface of the knee joint with a synthetic implant.

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Adolescent Anterior Knee Pain

Anterior knee pain is a characterized by a chronic pain over the front and center of the knee joint. It is common in athletes, active adolescents (especially girls) and overweight individuals. Anterior knee pain refers to a variety of conditions which include runner’s knee or patellar tendinitis and chondromalacia of the patella. There is an inter-individual variation in the duration and presentation of pain.

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Anterior Cruciate Ligament Injuries

The anterior cruciate ligament, or ACL, is one of the major ligaments of the knee that is located in the middle of the knee and runs from the femur (thigh bone) to the tibia (shin bone). It prevents the tibia from sliding out in front of the femur. Together with posterior cruciate ligament (PCL) it provides rotational stability to the knee.

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Arthritis of Knee

Arthritis is a general term covering numerous conditions where the joint surface or cartilage wears out. The joint surface is covered by a smooth articular surface that allows pain free movement in the joint. This surface can wear out for a number of reasons; often the definite cause is not known.
When the articular cartilage wears out the bone ends rub on one another and cause pain. This condition is referred to as Osteoarthritis or “wear and tear” arthritis as it occurs with aging and use. It is the most common type of arthritis.

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Cemented and Cementless Knee Replacement

Total knee replacement is the surgical treatment for knee arthritis, where the damaged knee is removed and replaced with an artificial knee implant. Traditionally performed as an inpatient procedure, total knee replacement surgery is now being conducted on an outpatient basis, allowing patients to go home the same day of the surgery.

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Deep Vein Thrombosis

The condition in which a blood clot forms in the deep veins of the body is referred to as Deep Vein Thrombosis (DVT). Clots form when blood thickens and clumps together. DVT occurs most often in the deep veins of the leg and thighs.

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Goosefoot Bursitis of the Knee

A bursa is a small fluid-filled sac found between soft tissues and bones. It lubricates and acts as a cushion to decrease friction between bones when they move. Bursitis refers to the inflammation and swelling of the bursa. Goosefoot bursitis or pes anserine bursitis is the inflammation of the bursa present between the tendons of the hamstring muscle and the tibia (shinbone) on the inner side of the knee.

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Knee Implants

Knee implants are artificial devices that form the essential parts of the knee during a knee replacement surgery. The knee implants vary by size, shape, and material. Implants are made of biocompatible materials that are accepted by the body without producing any rejection response. Implants can be made of metal alloys, ceramics, or plastics, and can be joined to the bone. The metals used include stainless steel, titanium, and cobalt chrome; whereas, the plastic used is polyethylene.

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Kneecap (Prepatellar) Bursitis

A bursa is a small fluid-filled sac found between soft tissues and bones. It lubricates and acts as a cushion to decrease friction between bones when they move. Bursitis refers to the inflammation and swelling of the bursa. Inflammation of the bursa in front of the kneecap (patella) is known as kneecap bursitis or prepatellar bursitis.

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Osgood-Schlatter Disease

Osgood-Schlatter disease refers to a condition of an overuse injury that occurs in the knee region of growing children and adolescents. This is caused by inflammation of the tendon located below the knee cap (patellar tendon). Children and adolescents who participate in sports such as soccer, gymnastics, basketball and distance running are at higher risk of this disease.

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Posterior Cruciate Ligament (PCL) Tear

Posterior cruciate ligament (PCL), one of four major ligaments of the knee is situated at the back of the knee. It connects the thighbone (femur) to the shinbone (tibia). The PCL limits the backward motion of the shinbone.

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Runner’s Knee (Patellofemoral Pain)

Runner’s knee, also called patellofemoral pain syndrome refers to pain under and around your kneecap. Runner’s knee includes a number of medical conditions such as anterior knee pain syndrome, patellofemoral malalignment, and chondromalacia patella that cause pain around the front of the knee. As the name suggests, runner’s knee is a common complaint among runners, jumpers, and other athletes such as skiers, cyclists, and soccer players.

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Unstable Kneecap

Damage to any of these supportive structures causes the instability of the knee joint. This can be caused by sudden twisting of the knee, tears of the meniscus, ligament or capsule, osteoarthritis of the knee (wear and tear of the cushioning cartilage tissue between bones) and sports injuries.

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Viscosupplementation Treatment for Arthritis

Viscosupplementation refers to the injection of a hyaluronan preparation into the joint. Hyaluronan is a natural substance present in the joint fluid that assists in lubrication. It allows smooth movement of the cartilage covered articulating surfaces of the joint.

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Click on the topics below to find out more from the orthopedic connection website of American Academy of Orthopedic Surgeons.

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