Knee

Oakland Regional Hospital Orthopaedic Surgeons that can improve your lifestyle:

Jerome V. Ciullo, M.D.
Mark J. Milia, M.D.
Nilesh Patel, M.D.
 
Common Knee Conditions and Treatments:
 
Sudden (acute) injuries
Injuries are the most common cause of knee problems. Sudden (acute) injuries may be caused by a direct blow to the knee or from abnormal twisting, bending the knee, or falling on the knee. Pain, bruising, or swelling may be severe and develop within minutes of the injury. Nerves or blood vessels may be pinched or damaged during the injury. The knee or lower leg may feel numb, weak, or cold; tingle; or look pale or blue. Acute injuries include:
  • Sprains, strains, or other injuries to the ligaments and tendons that connect and support the kneecap.
  • A tear in the rubbery cushions of the knee joint (meniscus).
  • Ligament tears. The medial collateral ligament (MCL) is the most commonly injured ligament of the knee.
  • Breaks (fracture) of the kneecap, lower portion of the femur, or upper part of the tibia or fibula. Knee fractures are most commonly caused by abnormal force, such as a falling on the knee, a severe twisting motion, severe force that bends the knee, or when the knee forcefully hits an object.
  • Kneecap dislocation. This type of dislocation occurs more frequently in 13- to 18-year-old girls. Pieces of bone or tissue (loose bodies) from a fracture or dislocation may get caught in the joint and interfere with movement.
  • Knee joint dislocation. This is a rare injury that requires great force. It is a serious injury and requires immediate medical care.
Overuse injuries
Overuse injuries occur with repetitive activities or repeated or prolonged pressure on the knee. Activities such as stair climbing, bicycle riding, jogging, or jumping stress joints and other tissues and can lead to irritation and inflammation. Overuse injuries include:
  • Inflammation of the small sacs of fluid that cushion and lubricate the knee (bursitis).
  • Inflammation of the tendons (tendinitis) or small tears in the tendons (tendinosis).
  • Thickening or folding of the knee ligaments (Plica syndrome).
  • Pain in the front of the knee from overuse, injury, excess weight, or problems in the kneecap (patellofemoral pain syndrome).
  • Irritation and inflammation of the band of fibrous tissue that runs down the outside of the thigh (iliotibial band syndrome).
Additional conditions that may cause knee problems
Problems not directly related to an injury or overuse may occur in or around the knee.
  • Osteoarthritis (degenerative joint disease) may cause knee pain that is worse in the morning and improves during the day. It often develops at the site of a previous injury. Other types of arthritis, such as rheumatoid arthritis, gout, and lupus, also can cause knee pain, swelling, and stiffness.
  • Osgood-Schlatter disease causes pain, swelling, and tenderness in the front of the knee below the kneecap. It is especially common in boys ages 11 to 15.
  • A popliteal (or Baker's) cyst causes swelling in the back of the knee.
  • Infection in the skin (cellulitis), joint (infectious arthritis), bone (osteomyelitis), or bursa (septic bursitis) can cause pain and decreased knee movement.
  • A problem elsewhere in the body, such as a pinched nerve or a problem in the hip, can sometimes cause knee pain.
  • Osteochondritis dissecans causes pain and decreased movement when a piece of bone or cartilage or both inside the knee joint loses blood supply and dies.
Torn Anterior Cruciate Ligament / ACL Knee Injury
A torn ACL is an injury or tear to the anterior cruciate ligament (ACL). The ACL is one of the four main stabilising ligaments of the knee, the others being the Posterior Cruciate Ligament (PCL), Medial Collateral Ligament (MCL) and Lateral Collateral Ligament (LCL). The ACL attaches to the knee end of the Femur (thigh bone), at the back of the joint and passes down through the knee joint to the front of the flat upper surface of the Tibia (shin bone).
 
Knee Articular Cartilage Injury
Articular or hyaline cartilage is an extremely smooth, hard material, made up of the protein collagen, which lies on a bone's articulating surfaces (those surfaces that come into contact with other bones). Its function is to allow for the smooth interaction between two bones in a joint.
 
Osteochondral Fractures in the Knee
An Osteochondral fracture is a tear of the cartilage which covers the end of a bone, within a joint. This is common in the knee joint, especially in association with other injuries such as ACL tears. Osteochondral fractures of the ankle are also common.
 
Lateral Cartilage Tear
Each knee joint has two crescent-shaped cartilage menisci. These lie on the medial (inner) and lateral (outer) edges of the upper surface of the tibia (shin) bone, also known as the tibial plateau. They are essential components, acting as shock absorbers for the knee as well as allowing for the proper interaction and weight distribution between the tibia and the femur (thigh bone). As a result, injuries to either meniscus can lead to critical impairment of the knee itself.
 
Medial Cartilage Meniscus Injury
Each knee joint has two crescent-shaped cartilage menisci. These lie on the medial (inside) and lateral (outside) of the upper surface of the tibia (shin) bone. They are essential components of the knee, acting as shock absorbers as well as allowing for the proper interaction and weight distribution between the tibia and the femur (thigh bone). As a result, injury to either meniscus can lead to critical impairment of the knee itself.
 
Patellar Dislocation
The patella, or kneecap, is the protective bone which lies in front of the knee joint. The patella bone glides up and down a groove (called the patellofemoral groove) at the front of the thigh bone (femur) as the knee bends.
 
Dislocated Knee
A dislocated knee is where the Femur (thigh bone) and the Tibia (shin bone) are moved apart. This is different to a patella (kneecap) dislocation, and is a far more serious injury.
 
Lateral Cartilage Tear
Each knee joint has two crescent-shaped cartilage menisci. These lie on the medial (inner) and lateral (outer) edges of the upper surface of the tibia (shin) bone, also known as the tibial plateau. They are essential components, acting as shock absorbers for the knee as well as allowing for the proper interaction and weight distribution between the tibia and the femur (thigh bone). As a result, injuries to either meniscus can lead to critical impairment of the knee itself.
 
Medial Cartilage Meniscus Injury
Each knee joint has two crescent-shaped cartilage menisci. These lie on the medial (inside) and lateral (outside) of the upper surface of the tibia (shin) bone. They are essential components of the knee, acting as shock absorbers as well as allowing for the proper interaction and weight distribution between the tibia and the femur (thigh bone). As a result, injury to either meniscus can lead to critical impairment of the knee itself.
 
Fracture of the Tibial Plateau of the Knee
The tibial plateau is the upper surface of the tibia or shin bone. It is prone to becoming fractured in high velocity accidents such as those associated with skiing, horse riding and certain water sports.
 
When is Total Joint Replacement necessary? 
An arthritic or damaged joint is removed and replaced with an artificial joint, called a prosthesis.
 

The goal is to relieve the pain in the joint caused by the damage done to the cartilage. The pain may be so severe, a person will avoid using the joint, weakening the muscles around the joint and making it even more difficult to move the joint. A physical examination, and possibly some laboratory tests and X-rays, will show the extent of damage to the joint. Total joint replacement will be considered if other treatment options will not relieve the pain and disability.

For further information about total joint replacement, please visit A.A.O.S