Injuries, Symptoms & Treatments

Knee

Kick your knee pain for good.

Knee pain is a common complaint that affects people of all ages. Knee pain may be the result of an injury, such as a ruptured ligament or torn cartilage. Medical conditions — including arthritis, gout and infections — also can cause knee pain.

 

Knee pain can have different causes. Being overweight puts you at greater risk for knee problems. Overusing your knee can trigger knee problems that cause pain. If you have a history of arthritis, it could also cause knee pain.

 

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Use the convenient search tool to find information on orthpedic conditions and treatments offered by our practice.. his assures that the information you are researching has been confirmed by Dr. Bellapianta as well as The American Academy of Orthpaedic Surgeons.

Diseases/Conditions of the knee

Common Knee Injuries
Meniscus Tears
ACL Injuries
Ligament Injuries
Fractures of the Knee
Osgood Schlatter Disease
Patellar Tendon Tear
Arthritis of the Knee
Shin Splints
Patellofemoral Pain Syndrome
Common Knee Injuries

Common Knee Injuries

 

 Your knee is a complex joint with many components, making it vulnerable to a variety of injuries. Some of the most common knee injuries include fractures, dislocations, sprains, and ligament tears. 

Many knee injuries can be successfully treated with simple measures, such as bracing and rehabilitation exercises. Other injuries may require surgery to correct.

 

 

Anatomy

 

The knee is the largest joint in the body, and one of the most easily injured. It is made up of four main things: bones, cartilage, ligaments, and tendons.

 

  • Bones. Three bones meet to form your knee joint: your thighbone (femur), shinbone (tibia), and kneecap (patella).
  • Articular cartilage. The ends of the femur and tibia, and the back of the patella are covered with articular cartilage. This slippery substance helps your knee bones glide smoothly across each other as you bend or straighten your leg.
  • Meniscus. Two wedge-shaped pieces of meniscal cartilage act as "shock absorbers" between your femur and tibia. Different from articular cartilage, the meniscus is tough and rubbery to help cushion and stabilize the joint. When people talk about torn cartilage in the knee, they are usually referring to torn meniscus.
  • Ligaments. Bones are connected to other bones by ligaments. The four main ligaments in your knee act like strong ropes to hold the bones together and keep your knee stable.
     
  • Collateral ligaments. These are found on the sides of your knee. The medial collateral ligament is on the inside of your knee, and the lateral collateral ligament is on the outside. They control the sideways motion of your knee and brace it against unusual movement.
  • Cruciate ligaments. These are found inside your knee joint. They cross each other to form an "X" with the anterior cruciate ligament in front and the posterior cruciate ligament in back. The cruciate ligaments control the back and forth motion of your knee.
     
  • Tendons. Muscles are connected to bones by tendons. The quadriceps tendon connects the muscles in the front of your thigh to your patella. Stretching from your patella to your shinbone is the patellar tendon.

 

 

Common Knee Injuries

 

Your knee is made up of many important structures, any of which can be injured. The most common knee injuries include fractures around the knee, dislocation, and sprains and tears of soft tissues, like ligaments. In many cases, injuries involve more than one structure in the knee.

 

Pain and swelling are the most common signs of knee injury. In addition, your knee may catch or lock up. Many knee injuries cause instability — the feeling that your knee is giving way.

 

Fractures

The most common bone broken around the knee is the patella. The ends of the femur and tibia where they meet to form the knee joint can also be fractured. Many fractures around the knee are caused by high energy trauma, such as falls from significant heights and motor vehicle collisions.

 

Dislocation

A dislocation occurs when the bones of the knee are out of place, either completely or partially. For example, the femur and tibia can be forced out of alignment, and the patella can also slip out of place. Dislocations can be caused by an abnormality in the structure of a person's knee. In people who have normal knee structure, dislocations are most often caused by high energy trauma, such as falls, motor vehicle crashes, and sports-related contact.

 

Anterior Cruciate Ligament (ACL) Injuries

The anterior cruciate ligament is often injured during sports activities. Athletes who participate in high demand sports like soccer, football, and basketball are more likely to injure their anterior cruciate ligaments. Changing direction rapidly or landing from a jump incorrectly can tear the ACL. About half of all injuries to the anterior cruciate ligament occur along with damage to other structures in the knee, such as articular cartilage, meniscus, or other ligaments.

 

Posterior Cruciate Ligament (PCL) Injuries

The posterior cruciate ligament is often injured from a blow to the front of the knee while the knee is bent. This often occurs in motor vehicle crashes and sports-related contact. Posterior cruciate ligament tears tend to be partial tears with the potential to heal on their own.

 

Collateral Ligament Injuries

Injuries to the collateral ligaments are usually caused by a force that pushes the knee sideways. These are often contact injuries. Injuries to the MCL are usually caused by a direct blow to the outside of the knee, and are often sports-related. Blows to the inside of the knee that push the knee outwards may injure the lateral collateral ligament. Lateral collateral ligament tears occur less frequently than other knee injuries.

 

Meniscal Tears

Sudden meniscal tears often happen during sports. Tears in the meniscus can occur when twisting, cutting, pivoting, or being tackled. Meniscal tears may also occur as a result of arthritis or aging. Just an awkward twist when getting up from a chair may be enough to cause a tear, if the menisci have weakened with age.

 

Tendon Tears

The quadriceps and patellar tendons can be stretched and torn. Although anyone can injure these tendons, tears are more common among middle-aged people who play running or jumping sports. Falls, direct force to the front of the knee, and landing awkwardly from a jump are common causes of knee tendon injuries.

Content by the American Academy of Orthopaedic Surgeons 

Meniscus Tears
ACL Injuries
Ligament Injuries
Fractures of the Knee
Osgood Schlatter Disease
Patellar Tendon Tear
Arthritis of the Knee
Shin Splints
Patellofemoral Pain Syndrome

Meniscus Tear

This is a common injury of the knee. Your knee joint is cushioned by two c-shaped wedges of cartilage called the "menisci." Each individual cushion is called a "meniscus." This injury is a tear of one of these cushions.

Patellofemoral Pain Syndrome

This is a pain you feel in the front of your knee. It involves the patella. That's the bone we commonly call the "kneecap."

ACL Tear

This injury is a tearing of the ACL ligament in the knee joint. The ACL ligament is one of the bands of tissue that connects the femur to the tibia. An ACL tear can be painful. It can cause the knee to become unstable.

Shin Splints

This is pain you feel in the front of one or both of your lower legs. It can be a problem for runners, dancers, gymnasts and other active people.

Common Treatments of General Orthopedics 

Knee Arthroscopy
Total Knee Replacement
Patellofemoral Replacement
Minimally Invasive Total Knee Replacement
Osteotomy of the Knee
Knee Arthroscopy

Knee Arthroscopy

 

Knee arthroscopy is a surgical procedure that allows doctors to view the knee joint without making a large incision (cut) through the skin and other soft tissues. Arthroscopy is used to diagnose and treat a wide range of knee problems.

 

 During knee arthroscopy, your surgeon inserts a small camera, called an arthroscope, into your knee joint. The camera displays pictures on a video monitor, and your surgeon uses these images to guide miniature surgical instruments.

 

Because the arthroscope and surgical instruments are thin, your surgeon can use very small incisions, rather than the larger incision needed for open surgery. This results in less pain for patients, less joint stiffness, and often shortens the time it takes to recover and return to favorite activities.

 

 

Anatomy

 

Your knee is the largest joint in your body and one of the most complex. The bones that make up the knee include the lower end of the femur (thighbone), the upper end of the tibia (shinbone), and the patella (kneecap).

 

Other important structures that make up the knee joint include:

 

  • Articular cartilage. The ends of the femur and tibia, and the back of the patella are covered with articular cartilage. This slippery substance helps your knee bones glide smoothly across each other as you bend or straighten your leg.
  • Synovium. The knee joint is surrounded by a thin lining called synovium. This lining releases a fluid that lubricates the cartilage and reduces friction during movement.
  • Meniscus. Two wedge-shaped pieces of meniscal cartilage act as "shock absorbers" between your femur and tibia. Different from articular cartilage, the meniscus is tough and rubbery to help cushion and stabilize the joint.
  • Ligaments. Bones are connected to other bones by ligaments. The four main ligaments in your knee act like strong ropes to hold the bones together and keep your knee stable.
  • The two collateral ligaments are found on either side of your knee.
  • The two cruciate ligaments are found inside your knee joint. They cross each other to form an "X" with the anterior cruciate ligament in front and the posterior cruciate ligament in back.

 

 

When Knee Arthroscopy is Recommended

 

Your doctor may recommend knee arthroscopy if you have a painful condition that does not respond to nonsurgical treatment. Nonsurgical treatment includes rest, physical therapy, and medications or injections that can reduce inflammation.

 

Knee arthroscopy may relieve painful symptoms of many problems that damage the cartilage surfaces and other soft tissues surrounding the joint.

 

Common arthroscopic procedures for the knee include:

 

  • Removal or repair of a torn meniscus
  • Reconstruction of a torn anterior cruciate ligament
  • Removal of inflamed synovial tissue
  • Trimming of damaged articular cartilage
  • Removal of loose fragments of bone or cartilage
  • Treatment of patella (kneecap) problems
  • Treatment of knee sepsis (infection)

 

 

Preparing for Surgery

 

Evaluations and Tests

Your orthopaedic surgeon may recommend that you see your primary doctor to assess your general health before your surgery. He or she will identify any problems that may interfere with the procedure. If you have certain health risks, a more extensive evaluation may be necessary before your surgery.

To help plan your procedure, your orthopaedic surgeon may order preoperative tests. These may include blood tests or an electrocardiogram (EKG).

 

Admissions Instructions

If you are generally healthy, your knee arthroscopy will most likely be performed as an outpatient. This means you will not need to stay overnight at the hospital.

 

Be sure to inform your orthopaedic surgeon of any medications or supplements that you take. You may need to stop taking some of these before surgery.

 

The hospital or surgery center will contact you ahead of time to provide specific details of your procedure. Make sure to follow the instructions on when to arrive and especially on when to stop eating or drinking prior to your procedure.

 

Anesthesia

Before your surgery, a member of the anesthesia team will talk with you. Knee arthroscopy can be performed under local, regional, or general anesthesia:

 

  • Local anesthesia numbs just your knee
  • Regional anesthesia numbs you below the waist
  • General anesthesia puts you to sleep
  • Your orthopaedic surgeon and your anesthesiologist will talk to you about which method is best

 

 

Surgical Procedure

 

Positioning

Once you are moved into the operating room, you will be given anesthesia. To help prevent surgical site infection, the skin on your knee will be cleaned. Your leg will be covered with surgical draping that exposes the prepared incision site.

 

At this point, a positioning device is sometimes placed on the leg to help stabilize the knee while the arthroscopic procedure takes place.

 

Procedure

To begin the procedure, the surgeon will make a few small incisions, called "portals," in your knee. A sterile solution will be used to fill the knee joint and rinse away any cloudy fluid. This helps your orthopaedic surgeon see the structures inside your knee clearly and in great detail.

 

Your surgeon will insert the arthroscope and surgical instruments through small incisions called "portals."

Your surgeon's first task is to properly diagnose your problem. He or she will insert the arthroscope and use the image projected on the screen to guide it. If surgical treatment is needed, your surgeon will insert tiny instruments through other small incisions.

 

Specialized instruments are used for tasks like shaving, cutting, grasping, and meniscal repair. In many cases, special devices are used to anchor stitches into bone.

 

Closure

Most knee arthroscopy procedures last less than an hour. The length of the surgery will depend upon the findings and the treatment necessary.

 

Your surgeon may close each incision with a stitch or steri-strips (small bandaids), and then cover your knee with a soft bandage.

 

Complications

The complication rate after arthroscopic surgery is very low. If complications occur, they are usually minor and are treated easily. Possible postoperative problems with knee arthroscopy include:

 

  • Infection
  • Blood clots
  • Knee stiffness
  • Accumulation of blood in the knee

 

 

Recovery

 

After surgery, you will be moved to the recovery room and should be able to go home within 1 or 2 hours. Be sure to have someone with you to drive you home and check on you that first evening.

While recovery from knee arthroscopy is faster than recovery from traditional open knee surgery, it is important to follow your doctor's instructions carefully after you return home.

 

Pain Management

After surgery, you will feel some pain. This is a natural part of the healing process. Your doctor and nurses will work to reduce your pain, which can help you recover from surgery faster.

 

Medications are often prescribed for short-term pain relief after surgery. Many types of medicines are available to help manage pain, including opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and local anesthetics. Your doctor may use a combination of these medications to improve pain relief, as well as minimize the need for opioids.

 

Be aware that although opioids help relieve pain after surgery, they are a narcotic and can be addictive. Opioid dependency and overdose has become a critical public health issue in the U.S. It is important to use opioids only as directed by your doctor. As soon as your pain begins to improve, stop taking opioids. Talk to your doctor if your pain has not begun to improve within a few days of your surgery.

 

Medications

In addition to medicines for pain relief, your doctor may also recommend medication such as aspirin to lessen the risk of blood clots.

 

Swelling

Keep your leg elevated as much as possible for the first few days after surgery. Apply ice as recommended by your doctor to relieve swelling and pain.

 

Dressing Care

You will leave the hospital with a dressing covering your knee. Keep your incisions clean and dry. Your surgeon will tell you when you can shower or bathe, and when you should change the dressing.

Your surgeon will see you in the office a few days after surgery to check your progress, review the surgical findings, and begin your postoperative treatment program.

 

Bearing Weight

Most patients need crutches or other assistance after arthroscopic surgery. Your surgeon will tell you when it is safe to put weight on your foot and leg. If you have any questions about bearing weight, call your surgeon.

 

Rehabilitation Exercise

You should exercise your knee regularly for several weeks after surgery. This will restore motion and strengthen the muscles of your leg and knee.

 

Therapeutic exercise will play an important role in how well you recover. A formal physical therapy program may improve your final result.

 

Driving

Your doctor will discuss with you when you may drive. Typically, patients are able to drive from 1 to 3 weeks after the procedure.

 

 

Outcome

 

Many people return to full, unrestricted activities after arthroscopy. Your recovery will depend on the type of damage that was present in your knee.

 

Unless you have had a ligament reconstruction, you should be able to return to most physical activities after 6 to 8 weeks, or sometimes much sooner. Higher impact activities may need to be avoided for a longer time.

 

If your job involves heavy work, it may be longer before you can return to your job. Discuss when you can safely return to work with your doctor.

 

For some people, lifestyle changes are necessary to protect the joint. An example might be changing from high impact exercise (such as running) to lower impact activities (such as swimming or cycling). These are decisions you will make with the guidance of your surgeon.

 

Sometimes, the damage to your knee can be severe enough that it cannot be completely reversed with surgery.

Content by the American Academy of Orthopaedic Surgeons 

Total Knee Replacement
Patellofemoral Replacement
Minimally Invasive Total Knee Replacement
Osteotomy of the Knee

Knee Arthroscopy

If you have a joint problem, your surgeon may want to try arthroscopy. This lets your surgeon see inside your joint with a small, thin camera called an "arthroscope."

ACL Reconstruct.

This procedure repairs your knee after a tear of the anterior cruciate ligament (commonly called the "ACL"). This ligament is in the center of the knee. It helps anchor the femur to the tibia.

Total Knee Replacement

This procedure restores function to a severely damaged knee. Most commonly, it is used to repair a knee that has been damaged by arthritis.

Partial Meniscectomy

The meniscus is a cushion of cartilage. There are two in each knee. If one of these shock absorbers is worn out or hurt, you may need a partial meniscectomy to remove the damaged areas.

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