KNEE CONDITIONS

Common knee conditions treated at Ortho Specialist Centre

Arthritis refers to inflammation of the joints and can affect the knee, causing pain, swelling, stiffness, and reduced range of motion. Osteoarthritis is the most common type of arthritis in the knee, but other forms, such as post-traumatic arthritis or secondary arthritis due to previous injuries or conditions, can also occur. Treatment focuses on managing symptoms and may include medications, physical therapy, lifestyle adjustments, and in some cases, joint injections or surgery.

Osteoarthritis in the knee is a degenerative condition where the cartilage that covers the end of the bones making up the knee joint deteriorates over time. This leads to bone surfaces rubbing against each other, causing pain, swelling, and reduced mobility. Symptoms include pain during activities, stiffness, and decreased range of motion. Treatment options include medications, physical therapy, lifestyle modifications, and in severe cases, knee replacement surgery.

A meniscus tear occurs when the meniscus cartilage in the knee joint becomes damaged, often due to twisting motions or degeneration. Symptoms include pain, swelling, stiffness, and a clicking or locking sensation in the knee. Treatment ranges from conservative approaches like rest and physical therapy to surgical repair or partial trimming of the torn edge.

ACL injuries are common in sports and involve tearing of the ACL, a ligament crucial for stabilising the knee joint. Symptoms include a popping sensation at the time of injury, pain, swelling, and instability in the knee. Treatment options include physical therapy to strengthen surrounding muscles and surgical reconstruction to repair the torn ligament.

PCL injuries occur when the PCL, another key ligament in the knee, is damaged, typically due to a direct blow to the front of the knee or from hyperextension. Symptoms include pain, swelling, and instability, particularly when walking or bearing weight on the knee. Treatment usually involves a combination of rest, physical therapy, and, in some cases, surgical intervention.

MCL injuries involve stretching or tearing of the ligament on the inner or outer side of the knee, often caused by a blow to the outer knee or a twisting motion. Symptoms include pain, swelling, and instability, particularly when bending the knee sideways. Treatment varies depending on the severity but may include rest, bracing, physical therapy, and possibly surgery.

Patella tendinitis is an overuse injury affecting the tendon connecting the patella (kneecap) to the shinbone. It commonly occurs in athletes who engage in repetitive jumping activities. Symptoms include pain and tenderness around the patella tendon, especially just below the kneecap. Treatment includes rest, ice therapy, physical therapy to strengthen the quadriceps muscles, and anti-inflammatory medications.

Patellofemoral pain syndrome causes pain around and behind the patella, often aggravated by activities that involve bending the knee, such as running, squatting, or climbing stairs. It can result from overuse, muscle imbalances, or poor dynamic lower limb alignment. Treatment involves rest, physical therapy to correct biomechanics and strengthen muscles, orthotics, and sometimes injections for pain relief.

Patella dislocations occur when the patella (kneecap) slips out of its normal groove in the femur, usually towards the outer side of the knee. This can happen due to a sudden change in direction or trauma. There may be predisposing factors such as structural abnormalities in the knee joint or generalised ligament laxity. Symptoms include severe pain, swelling, and difficulty straightening the knee. Treatment involves relocating the dislocation, immobilisation with a brace or splint, physical therapy to strengthen the surrounding muscles. In some cases, surgery is necessary to stabilise the patella.

These are both specific and severe types of meniscal tears that generally require surgery. A bucket handle meniscal tear is a tear where a portion of the meniscus flips into the joint, causing pain, swelling, and locking of the knee. This type of tear may require surgical intervention to repair or remove the torn portion and restore knee function. Symptoms include sudden onset of pain, difficulty fully extending the knee, and a sensation of catching or locking. Meniscus root tears affect the area of meniscal attachment to the tibia, causing complete meniscal dysfunction. Repairing these tears early is crucial to prevent further damage to cartilage and rapid development of arthritis.

Knee bursitis is inflammation of the bursa, a small fluid-filled sac under the skin at the front of the knee. It can occur due to overuse, injury, or prolonged pressure on the knee such as kneeling. Symptoms include pain, swelling, and tenderness around the affected bursa. Treatment involves rest, ice therapy, anti-inflammatory medications, and sometimes aspiration of fluid from the bursa for relief.

ITBS occurs when the iliotibial band, a thick band of fascia running along the outside of the thigh, becomes irritated or inflamed. This syndrome is common in long distance runners and cyclists due to repetitive knee flexion and extension. Symptoms include pain on the outside of the knee, which worsens with activity and may radiate up the thigh. Treatment includes rest, ice therapy, stretching exercises, physical therapy to correct biomechanical issues, corticosteroid injections or surgery in severe cases.

A Baker's cyst, also known as a popliteal cyst, is a fluid-filled swelling that develops behind the knee. It is often associated with underlying knee conditions such as arthritis or meniscus tears. Symptoms include swelling, a feeling of tightness behind the knee, and sometimes pain or discomfort when bending the knee. Typically uncomplicated Baker’s cysts do not cause problems themselves thus treatment involves addressing the underlying knee problem, such as managing arthritis or repairing a meniscus tear. In rare circumstances image guided draining the cyst can be considered if it is very large and causes significant discomfort. There is a high rate of recurrence in this situation if the underlying problem is not addressed.