CONDITIONS & CARE

Knee

Knee problems are one of the most common reasons people visit orthopaedic physicians. The knee is a vulnerable joint that absorbs a lot of pressure from everyday activities as well as high impact sports. And when children and adults are especially active, they become more susceptible to overuse injuries and acute injuries to the knee.

Anatomy
The knee joint works like a hinge joining the thigh bone (femur) to the shin bone (tibia). The ends of the bones are covered with cartilage which can become damaged or worn away over time. The patella, or kneecap, is the other main bone of the knee. The knee joint is held together by ligaments, connecting bone to bone, and tendons that connect muscles to bones. Most common sports injuries occur to one of the ligaments: anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), and the medial and lateral collateral ligaments. These ligaments that join the knee bones work together to prevent the knee from sliding too far in any one direction.

Treatment
Diagnosis of your knee injury or condition will begin with a discussion of your health history and a physical examination. X-ray and MRI diagnostic testing may also be needed to confirm a diagnosis or eliminate possibilities before a course of treatment can be decided between you and the doctor. Care for the knee can include non-surgical options such as activity modification, anti-inflammatory medications, physical therapy and steroid injections. If the case is acute or non-surgical treatments have not provided the desired results, many surgical options are available. Arthroscopy is widely used for many knee surgeries, with the possible exception of total knee replacement.

Common Knee Injuries

Knee Anterior Cruciate Ligament Injury (ACL Injury/Tear)
Anterior Cruciate Ligament injury or ‘ACL injuries’ are common in contact sports and especially those that are combined with a sudden change of direction such as soccer or football. ACL tears rarely occur in isolation and are in most cases are associated with damage to other structures within the knee

Meniscal Tear
Meniscal tears may occur suddenly during sports where players may bend and twist the knee at the same time causing a tear. Meniscus tears and injuries are very common during the sports activities.

Knee Arthroplasty (Total Knee Replacement)
Total knee arthroplasty (TKA), or total knee replacement (TKR), is an orthopaedic procedure during which the three articular surfaces of the knee (femoral, tibial, and patellar) are replaced with prosthetic components.

Cartilage Injuries
Articular cartilage can be damaged through accidents, such as a tear to the anterior cruciate ligament (ACL), or degenerate slowly over time, eventually leading to osteoarthritis. Poor alignment of the joint, excessive weight, excessive activity, overuse, or injury can all cause cartilage to wear away.

Loose Bodies/Spurs in the Knee
Small outgrowths of bone called bone spurs can grow inside the knee, and break off, becoming “loose bodies”, which float in the knee and cause pain and more damage. This can happen after one serious injury to the knee or after repeated minor injuries.

Lateral Collateral Ligament Injury (LCL Injury)
LCL injuries normally occur when the knee is forced into an excessive ‘bow-legged’ position. This may happen when the inside of the knee is struck or when the foot is fixed and the knee is forced out sideways.

Medial Collateral Ligament Injury (MCL Injury)
The medial collateral ligament (MCL) is the most commonly damaged ligament in the knee. The MCL can be sprained or torn as a result of a blow to the outer side of the knee, by twisting the knee, or by quickly changing directions while walking or running.

Posterior Cruciate Ligament Injury (PCL Injury)
The PCL most often is sprained when the front of the knee hits the dashboard during an automobile accident. During sports activities, the PCL also can tear when an athlete falls forward and lands hard on a bent knee, which is common in football and soccer.

Sprains & Strains
Knee pain is often caused by ligament sprains, muscle strains, or irritated/damaged cartilage. These can be a result of a traumatic injury or stress over time. Trauma, falls, or sports injuries can produce forces that tear, over stretch or compress the joint or the soft tissue.