Knee

INFORMATION

The knee is an important weight bearing joint that is to acute injuries as well as wear and tear. Pain in the knee could be due:

Osteoarthritis of knee OA : is degeneration or wear and tear between joint surfaces of the knee. It usually occurs in knees that have experienced trauma, infection or injury or age related changes. Osteoarthritis develops as the cartilage that protects the bone ends thins down and the bones will begin to rub against each other when the joint is moved.  With the worn-out cartilage, the joint space between the bones narrows. The surrounding bones react by becoming thicker and grow outward and form bone spurs. All these changes can lead to pain, swelling and discomfort in the knee on movement or rest.

Ligament Sprains or Tear: The knee has four major ligaments. The ligaments inside the knee joint are called ACL and PCL while the ligaments on either side of the knee are called MCL and LCL. These ligaments provide stability to the knee. Knee Ligament Injury can lead to pain and instability with the “giving way” feel. These can be associated with muscle weakness and lack of balance in the long run.

Meniscus Tears:  A knee has two menisci. Any activity that causes forcefully twisting or rotating the knee, especially when there is full weight on it, can lead to a torn meniscus. A torn meniscus causes pain, swelling and stiffness of the knee. Torn meniscus might also lead to a block to knee movement and cause trouble while extending the knee fully.

Iliotibial Band Syndrome: Often seen in runners. Iliotibial band is a tight band of muscle and connective tissue on the outer thigh which causes stress on the knee resulting in pain on outer side of knee and typically with running and going downstairs.

Patellofemoral pain syndrome (PFPS)

Pain arises from the patella (kneecap) & excludes other soft tissue. PFPS constitutes 16 to 25 % of all injuries in runners. It can cause pain under the knee cap and swelling around the knee joint. Pain may increase after activities such as jumping, running down slopes, steps, prolonged walking or squatting.

Fractures: Occur in and around the knee joint due to direct or indirect trauma and may involve the patella, femur or tibia.

Dislocation or Shifting of Patella (Knee Cap): When the kneecap is partially or completely displaced out of its normal alignment. The most common direction for a patella to dislocate is outwardly (laterally). When this happens, the muscles and ligaments on the inside of the knee become overstretched and damaged.

Baker’s Cyst: pain at the back of the knee with a round swelling.

Chondromalacia Patella CMP: Happens when the patella glides through the groove with a lateral shift during the knee movement. This causes irritation of the cartilage between the patella and the femur and often results in pain.Pain is mainly with stair climbing, prolonged sitting and knee bending with weight bearing exercises. Pre-disposing factors may include flat fleet, overuse, tight muscles on the outer side of the knee, injury or weak muscles on the inside of the knee (vastus medialis).

Osgood Schlatter’s Disease: is seen in adolescents who develop pain and a bump just below the knee due to constant overuse and traction on the insertion of the patellar tendon.