Arthritis of the Knee
As with all joints, movement of the knee is permitted by smooth cartilage that allows for minimal friction when moving the joint. As a result of injury, wear and tear, and other conditions, arthritis can develop when that cartilage breaks down. Cartilage doesn’t heal when damaged, so the body attempts to heal by making more bone, resulting in irregular joints and/or bone spurs. Arthritis is often accompanied by dull pain with motion or activity, which may progress over time, as well as stiffness and swelling. In order to relieve pain and restore function, we start with conservative approaches like physical therapy or steroid injections. If these treatments fail to provide relief, surgery may be necessary.
A bursa is a fluid-filled sac that reduces friction between tendons and bones. The bursa in the knee are important structures, as they ensure that the joints in the knee can move smoothly. Bursitis is caused by inflammation of the bursa; bursitis of the knee could be a result of a fall directly onto the knee or bursa, continuous pressure that involves prolonged kneeling, or repetitive injury to the bursa and tendon from jumping. Symptoms of bursitis include pain and tenderness over the location of the bursa, pain during activities, and swelling, often accompanied by loss of motion of the knee. Conservative treatment options for knee bursitis can include medication to reduce discomfort, nonsteroidal medication, drainage of fluid, and injections. Surgery can also be done to remove the affected bursa.
A knee sprain refers to torn or overstretched ligaments, or the tissues that hold bones together. If you have a sprained knee, the structures within the knee joint that connect the thigh bone to the shin bone have been injured. Knee sprains are named for the specific ligament that has been injured, and include the ACL (anterior cruciate ligament), PCL (posterior cruciate ligament), LCL (lateral collateral ligament), and MCL (medial collateral ligament). Signs of a knee sprain include stiffness, decreased movement, pain and tenderness, a painful pop you can hear and/or feel, and swelling or bruising. Most knee sprains can be treated with non-surgical procedures, including physical therapy or bracing as the injury heals. Surgery is only recommended if the knee sprain is the result of a full ligament tear. In that case, arthroscopic surgery will be performed to repair the damaged ligament.
Inflammation of the muscle tendon is called tendonitis, and usually results when the tendon is being pinched by surrounding structures. With knee tendonitis, The tendon affected connects your kneecap to your shinbone. Knee tendonitis stems from repetitive stress on the knee, most often from overuse in sports or exercise. Repetitive stress on the knee creates tiny tears in the tendon that, over time, inflame and weaken the tendon. Symptoms of knee tendonitis include pain, tenderness, swelling, burning, and pain when kneeling or squatting. Your doctor may begin with conservative treatment to control inflammation and allow tendon healing, which can include immobilization, anti-inflammatory medications, injections, or physical therapy for the knee. When these treatment options fail to provide relief, surgery may be done to release tension in the affected tendon and remove any inflamed tissue.
Ligament Tears: Ligaments are tough bands of tissue that connect bones and provide stability and strength to the joint. There are four ligaments in the knee that are prone to injury that connect the thigh bone to the shin bone:
ACL: The anterior cruciate ligament (ACL) is one of the primary stabilizers of the knee, and is the most commonly injured knee ligament. The ACL controls rotation and forward movement of the shin bone. An ACL can tear due to a sudden twisting motion, like in skiing or football.
PCL: The posterior cruciate ligament (PCL) controls backward movement of the shin bone. PCL injuries are usually a result of sudden, direct impact, such as in a car accident.
LCL: The lateral collateral ligament (LCL) gives stability to the outer knee. Tears are caused by a blow to the outer knee.
MCL: The medial collateral ligament (MCL) gives stability to the inner knee. Tears are caused by a blow to the inner knee.
As a ligament tear occurs, you may hear a popping sound, followed by the leg buckling when trying to stand on it, then swelling. Treatment for a ligament tear can include medication, physical therapy, and a protective knee brace for use during exercise and other activity. If these conservative treatments fail to provide relief, ligament repair surgery may be necessary to replace a torn ligament with a healthy tendon and restore stability in the knee.
The knee is composed of four bones. Each knee has two pieces of cartilage that act as a cushion between your shinbone and your thigh bone, which are the menisci. There is a medial meniscus on the inner aspect of the knee and a lateral meniscus on the outside of the knee. A meniscus tear typically occurs from a traumatic injury to the knee, like getting hit on the outside or inside of the knee. However, sometimes something as simple as an awkward turn can cause a meniscus tear. Signs of a meniscus tear include knee pain and swelling, pain with walking and weight bearing, a popping or clicking sound in the knee, and loss of motion. Conservative treatment for a meniscus tear can include rest, ice, and medication to help relieve pain. Physical therapy can help strengthen the muscles around the knee and in the legs to help stabilize and support the knee joint. If pain continues with conservative treatment, surgery may be recommended to repair the torn meniscus.
Patellar Tracking Disorder
Patellar tracking disorder occurs when the kneecap, or patella, moves out of place when the leg bends or straightens. The knee cap is designed to help protect the knee joint, and to help connect the muscles in the upper and low leg. In most cases, the kneecap will shift too far to the outside of the leg. This condition usually arises from an accumulation of issues, like repeated stress on the knee, weak thigh muscles, and overuse or overtraining. Because the knee has many working parts and carries a heavy load, it’s prone to problems. Symptoms of patellar tracking disorder can include a popping or clicking when bending or straightening the leg, pain in the front of the knee during activity, like squatting or walking downstairs, or feeling like the knee cannot support your weight. Most cases of patellar tracking disorder can be healed with rest, support, and physical therapy to strengthen the knee and the muscles around it. Depending on the cause of the condition, surgery can be done to treat patellar tracking disorder if non-surgical treatment fails to fix the problem.