Knee Pain
Knee pain is a common condition affecting individuals of various age groups. It not only affects movement but also impacts your quality of life. An injury or disease of the knee joint or any structure surrounding the knee can result in knee pain. A precise diagnosis of the underlying cause is important to develop an appropriate treatment plan.
Knee Sports Injuries
Trauma is any injury caused during physical activity, motor vehicle accidents, electric shock, or other activities. Sports trauma or sports injuries refer to injuries caused while playing indoor or outdoor sports and exercising.
ACL Tears
The anterior cruciate ligament (ACL) is one of the major ligaments of the knee. It is located in the middle of the knee and runs from the femur (thighbone) to the tibia (shinbone). The ACL prevents the tibia from sliding out in front of the femur. Together with the posterior cruciate ligament (PCL), it provides rotational stability to the knee.
Runner's Knee
Patellofemoral pain syndrome also called runner’s knee refers to pain under and around your kneecap. Patellofemoral pain is associated with a number of medical conditions such as anterior knee pain syndrome, patellofemoral malalignment, and chondromalacia patella.
Jumper's Knee
Jumper’s knee, also known as patellar tendinitis, is inflammation of the patellar tendon that connects your kneecap (patella) to your shinbone. This tendon helps in the extension of the lower leg.
Multiligament Knee Injuries
Injury to more than one knee ligament is called a multiligament knee injury and may occur during sports or other physical activities.
Kneecap Bursitis
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.
Knee Sprain
Knee sprain is a common injury that occurs from overstretching of the ligaments that support the knee joint. A knee sprain occurs when the knee ligaments are twisted or turned beyond its normal range, causing the ligaments to tear.
Knee Fracture
A fracture is a condition in which there is a break in the continuity of the bone. In younger individuals, these fractures are caused by high energy injuries, as from a motor vehicle accident. In older people, the most common cause is a weak and fragile bone.
Iliotibial Band Syndrome
Iliotibial band syndrome is an overuse injury resulting from the inflammation of the iliotibial band. It occurs when the iliotibial band and the lower outside portion of the thighbone at the knee joint rub against each other.
Fractures of the Tibia
The lower leg is made up of two long bones called the tibia and fibula that extend between the knee and ankle. The tibia or shinbone is the larger of the two bones. It bears most of the body’s weight and helps form the ankle joint and knee joint.
Fractures of the Patella
The patella or kneecap is a small bone present in the front of your knee where the thigh bone meets the shinbone. It provides protection to your knee and attachment to muscles in the front of the thigh. An injury to the knee can result in a break or fracture of the patella.
Knee Angular Deformities
Angular deformities of the knee are variations in the normal growth pattern during early childhood and are common during childhood.
Meniscal Injuries
Meniscal tears are one of the most common injuries to the knee joint. It can occur at any age but are more common in athletes involved in contact sports. The meniscus has no direct blood supply and for that reason, when there is an injury to the meniscus, healing is difficult.
PCL Injuries
Posterior cruciate ligament (PCL), one of the 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.
Meniscal Tears
A meniscal tear is a common knee injury in athletes, especially those involved in contact sports. A sudden bend or twist in your knee causes the meniscus to tear. Elderly people are more prone to degenerative meniscal tears as the cartilage wears out and weakens with age.
Multiligament Instability
The knee is a complex joint of the body that is vital for movement. The four major ligaments of the knee are anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL) and lateral collateral ligament (LCL). They play an important role in maintaining the stability of the knee.
Patellofemoral Instability
Patellofemoral instability means that the patella (kneecap) moves out of its normal pattern of alignment. This malalignment can damage the underlying soft structures such as muscles and ligaments that hold the knee in place.
Patellar Dislocation/Patellofemoral Dislocation
Patellar dislocation occurs when the patella moves out of the patellofemoral groove, (trochlea) onto the bony head of the femur. If the kneecap partially comes out of the groove, it is called subluxation; if the kneecap completely comes out, it is called dislocation (luxation).
Articular Cartilage Injury
Articular or hyaline cartilage is the tissue lining the surface of the two bones in the knee joint. Cartilage helps the bones move smoothly against each other and can withstand the weight of the body during activities such as running and jumping.
Chondral or Articular Cartilage Defects
The articular or hyaline cartilage is the tissue lining the surface of the two bones in the knee joint. Cartilage helps the bones move smoothly against each other and can withstand the weight of your body during activities such as running and jumping. Articular cartilage does not have a direct blood supply to it, so has less capacity to repair itself.
Quadriceps Tendon Rupture
The quadriceps can rupture after a fall, direct blow to the leg and when you land on your leg awkwardly from a jump. Quadriceps tendon rupture most commonly occurs in middle-aged people who participate in sports that involve jumping and running.
Patellar Tendon Rupture
The patellar tendon works together with the quadriceps muscle and the quadriceps tendon to allow your knee to straighten out. Patella tendon rupture is the rupture of the tendon that connects the patella (kneecap) to the top portion of the tibia (shinbone).
Loose Bodies in the Knee
Loose bodies are fragments of detached cartilage or bone inside the knee joint. These fragments may be free floating (unstable) or may be trapped (stable) within the joint. Depending on the severity, you may have one or more loose bodies in your knee joint.
Chondromalacia Patella
Chondromalacia patella is a common condition characterized by softening, weakening and damage of the cartilage. The condition is most often seen in young athletes and older adults who have arthritis of the knee. It especially occurs in women.
Pediatric ACL Tears
The anterior cruciate ligament (ACL) is a ligament that provides stability, reduces stress and prevents the knee from rotating or slipping out of position while jumping, running and landing. This ligament can tear during sports activities and exercise, as a result of a non-contact twisting injury, and is becoming a common injury in children.
Knee Injury
Pain, swelling, and stiffness are the common symptoms of any damage or injury to the knee. If care is not taken during the initial phases of injury, it may lead to joint damage, which may end up destroying your knee.
MCL Sprains
The medial collateral ligament (MCL), a band of tissue present on the inside of your knee joint, connects your thighbone and shinbone (bone of your lower leg). The MCL maintains the integrity of the knee joint and prevents it from bending inward.
Knee Ligament Injuries
Knee problems may arise if any of these structures get injured by overuse or suddenly during sports activities. Pain, swelling, and stiffness are the common symptoms of any damage or injury to the knee.
Knee Arthroscopy
Knee arthroscopy is a common surgical procedure performed using an arthroscope, a viewing instrument, to diagnose or treat a knee problem. It is a relatively safe procedure and you will usually be discharged from the hospital on the same day of surgery.
Knee Osteotomy
Knee osteotomy is a surgical procedure in which the upper shinbone (tibia) or lower thighbone (femur) is cut and realigned. It is usually performed in arthritic conditions affecting only one side of your knee. The aim is to take the pressure off the damaged area and shift it to the other side of your knee with healthy cartilage.
Meniscal Surgery
Meniscal surgery is a surgical procedure employed for the treatment of torn or damaged meniscal tissues in the knee. It is mostly performed as a minimally invasive keyhole procedure.
ACL Reconstruction
ACL (anterior cruciate ligament) reconstruction is a commonly performed surgical procedure. With recent advances in arthroscopic surgery, it can now be performed with minimal incision and low complication rates.
PCL Reconstruction
PCL reconstruction surgery is a procedure to correct torn posterior cruciate ligament (PCL) in the knee using a tissue graft taken from another part of the body, or from a donor.
LCL Reconstruction
LCL reconstruction is a surgical procedure to repair torn or damaged lateral collateral ligament in the knee using a tissue graft taken from another part of the body, or from a donor.
MCL Reconstruction
MCL reconstruction is a minimally invasive surgical procedure in which a tendon graft is utilized to reconstruct the injured MCL.
Multiligament Reconstruction of the Knee
Multiligament knee reconstruction is a surgical procedure to repair or replace two or more damaged ligaments of the knee joint. The surgery can be performed using minimally invasive techniques.
Medial Patellofemoral Ligament Reconstruction
Medial patellofemoral ligament reconstruction is a surgical procedure indicated for severe patellar instability.
Knee Fracture Surgery
A knee fracture is a broken bone or a crack in or around the joint of the knee. This can involve the tibia (shin bone), the kneecap (patella), or femur (thighbone) where they connect with the knee.
Arthroscopic Debridement
Arthroscopic debridement or a clean-up is a surgical procedure performed using an arthroscope. In this procedure, the cartilage or the bone that is damaged is removed using surgical instruments and the edges of the articular cartilage that are rough will be smoothened.
Quadriceps Tendon Repair
Quadriceps tendon is a thick tissue located at the top of the kneecap. The quadriceps tendon works together with the quadriceps muscles to allow us to straighten our leg. The quadriceps muscles are the muscles located in front of the thigh.
Patellar Tendon Repair
Patellar tendon repair is the surgery performed to reattach the torn tendon to the kneecap and to restore normal function in the affected leg.
Intraarticluar Knee Injection
Knee pain and stiffness can be disabling and difficult to treat. It can limit an individual’s lifestyle and negatively impact body image and emotional well-being.
Knee Ligament Reconstruction
Knee ligament reconstruction is a surgical procedure to repair or replace damaged ligaments of the knee joint. The surgery can be performed using minimally invasive techniques.
Mosaicplasty
Weight-bearing joints, such as the knee, may develop defects in the articular cartilage (spongy tissue that lines and cushions joints during movement) due to stress, trauma or degenerative disease. This can lead to pain, swelling or locking at the joint.
Chondroplasty
Chondroplasty is a surgical procedure to repair and reshape damaged cartilage in a joint. The procedure involves smoothing degenerative cartilage and trimming any unstable flaps of cartilage.
Arthroscopic Reconstruction of the Knee for Ligament Injuries
Arthroscopic knee ligament reconstruction is a surgical procedure to correct a torn knee ligament by replacing the ligament with a healthy tendon tissue using an arthroscope.
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.
Knee Anatomy
The knee is a complex joint made up of different structures - bones, tendons, ligaments, and muscles. They all work together to maintain the knee’s normal function and provide stability to the knee during movement.
Having a well-functioning healthy knee is essential for our mobility and ability to participate in various activities. Understanding the anatomy of the knee enhances your ability to discuss and choose the right treatment procedure for knee problems with your doctor.
Bones of the Knee
The knee is a hinge joint made up of two bones, the thighbone (femur) and shinbone (tibia). There are two round knobs at the end of the femur called femoral condyles that articulate with the flat surface of the tibia called the tibial plateau. The tibial plateau on the inside of the leg is called the medial tibial plateau and on the outside of the leg, the lateral tibial plateau.
The two femoral condyles form a groove on the front (anterior) side of the knee called the patellofemoral groove. A small bone called the patella sits in this groove and forms the kneecap. It acts as a shield and protects the knee joint from direct trauma.
A fourth bone called the fibula is the other bone of the lower leg. This forms a small joint with the tibia. This joint has very little movement and is not considered a part of the main joint of the knee.
Articular Cartilage and Menisci of the Knee
Movement of the bones causes friction between the articulating surfaces. To reduce this friction, all articulating surfaces involved in the movement are covered with a white, shiny, slippery layer called articular cartilage. The articulating surface of the femoral condyles, tibial plateaus and the back of the patella are covered with this cartilage. The cartilage provides a smooth surface that facilitates easy movement.
To further reduce friction between the articulating surfaces of the bones, the knee joint is lined by a synovial membrane that produces a thick clear fluid called synovial fluid. This fluid lubricates and nourishes the cartilage and bones inside the joint capsule.
Within the knee joint, between the femur and tibia, are two C-shaped cartilaginous structures called menisci. Menisci function to provide stability to the knee by spreading the weight of the upper body across the whole surface of the tibial plateau. The menisci help in load-bearing i.e. it prevents the weight from concentrating onto a small area, which could damage the articular cartilage. The menisci also act as a cushion between the femur and tibia by absorbing the shock produced by activities such as walking, running and jumping.
Ligaments of the Knee
Ligaments are tough bands of tissue that connect one bone to another bone. The ligaments of the knee stabilize the knee joint. There are two important groups of ligaments that hold the bones of the knee joint together, collateral and cruciate ligaments.
Collateral ligaments are present on either side of the knee. They prevent the knee from moving too far during side to side motion. The collateral ligament on the inside is called the medial collateral ligament (MCL) and the collateral ligament on the outside is called the lateral collateral ligament (LCL).
Cruciate ligaments, present inside the knee joint, control the back-and-forth motion of the knee. The cruciate ligament in the front of the knee is called anterior cruciate ligament (ACL) and the cruciate ligament in the back of the knee is called posterior cruciate ligament (PCL).
Muscles of the Knee
There are two major muscles in the knee - the quadriceps and the hamstrings, which enable movement of the knee joint. The quadriceps muscles are located in front of the thigh. When the quadriceps muscles contract, the knee straightens. The hamstrings are located at the back of the thigh. When the hamstring muscles contract, the knee bends.
Tendons of the Knee
A tendon is a tissue that attaches a muscle to a bone. The quadriceps muscles of the knee meet just above the patella and attach to it through a tendon called the quadriceps tendon. The patella further attaches to the tibia through a tendon called the patella tendon. The quadriceps muscle, quadriceps tendon, and patellar tendon all work together to straighten the knee. Similarly, the hamstring muscles at the back of the leg are attached to the knee joint with the hamstring tendon.
