Knee Problems

October 21, 2022by nimrah zulfiqar

Cartilage and meniscus injuries

The meniscus is C-shape cartilage sandwiched between the connecting point of a shinbone and thigh bone guarding against friction as a knee joint moves. Cartilage tear is a frequently encountered injury among athletes. A forceful knee rotation or twist, suddenly stopping or taking a turn while running, excessive kneeling, squatting, and lifting heavy weights could be a reason for this trauma. Also, degeneration of knee bones with growing age and obesity can cause meniscus tears. For minor tears, symptoms devise after 24 hours of injury. Sensations like popping and locking are intuited whereas pain and instability are sensed with swelling and stiffness in the joint.

A physical examination uncovers the signs as a doctor check mobility of the knee joint through assisted movement, observes the walking pattern, and demands to squat which exposes related symptoms. Further confirmation is made over internal examination through x-ray, MRI, CT scan, or arthroscopy. Mild injuries are treated conservatively by taking rest from activities accountable for cartilage injury. Icing and certain medicines help to reduce pain and swelling while healing occurs naturally. Expert-guided physical therapy is encouraged for muscle strengthening and to recapture stability. Arthroscopic repairs are recommended under severe conditions to promote healing. Knee replacement surgery is conceived for arthritis pain that couldn’t be cured.


Dislocation of the kneecap (patella)

Displacement of the kneecap from its rooted position brings about this disorder. A sudden twist or turn, direct blow to the knee while standing, inappropriate step, or fall causes patella dislocation. Moreover, weak ligaments and tendons that ensure the stability of a kneecap, keeping it in position are also blamable to bring about such a condition. Swelling, bruising, pain, inability to put weight over the affected knee, difficulty walking or standing, visible deformity, and joint locking are protuberant indications. A pop sound is heard at the instant kneecap dislocates.

Patellar dislocation distorts the knee form which could be easily diagnosed by looking at and comparing the patient’s affected knee with a healthy one. While a physical examination your surgeon will ask concerned questions to reach the conclusion. The surgeon will relocate the displaced patella and then prescribe imaging tests to evaluate the internal matter. It is essential to look for any fracture or injury to nearby soft tissues. In some cases, the patella repositions itself, leaving bruises, swelling, and pain which indicate other issues, so imaging tests become essential to uncover actual matter.

The foremost step is to relocate the patella via the reduction method, other procedures are instigated afterwards. Crucial damages call for surgical upkeeps also if a patient has a history of repeated patellar dislocation surgery becomes a preference. Medications to kill pain are prescribed, and patients are advised to use crutches or brace to support the joint until it heals. A patient may also be directed towards a physical therapist for rehabilitation as physical therapy helps strengthen the joint.


Ligament sprains or tears

It transpires when ligaments holding knee bones in place are torn or overstretched. Four key ligaments even out front, back and side-to-side movement of the knee joint imparting stability. These are:

  1. An anterior cruciate ligament (ACL)

It runs in the front and gives a pop sound or sensation when injured breaching joint stability.

  1. A posterior cruciate ligament (PCL)

Located at the back of the knee, it is painful to kneel when damaged.

  1. Lateral collateral ligament (LCL)

Goes along the knee sides stabilizing sideward movements. Damage to it buckles the knee towards the direction opposite to the defective ligament.

  1. Medial collateral ligament (MCL)

This ligament is situated inside the knee and also gives a buckling sensation when hurt.

Possible symptoms tolerated by patients are swelling, bruising, tenderness, pain, and stiffness around the affected area. The Joint felt weak and muscle spasms may happen. A sudden twist, fall or turn that forcefully moves the knee out of its existing location grounds knee sprains. This often happens while sports involve jumping, running, or twisting moreover, vehicle accidents are also a reason for this ailment.

An orthopedist will check the joint stability by pressing and moving the joint. Through physical inspection, he searches for bruises, deformities and swelling. Assisted and non-assisted knee movement divulges range of motion. The internal state is gauged through imaging tests which specify damage that occurred to soft tissues. A treatment plan is laid over the sternness of injury whereas mild ones are cured by RICE and physical therapy along with medications for pain management. The injured knee is immobilized through a brace until healing begins. Severe injuries mandate surgery by which ligaments are either reattached to bone or rejuvenated using a tendon graft.

Meniscus injuries

Laceration to the cartilage covering the ends of the thighbone and shinbone is denoted as a meniscus injury. Sudden rotation or twisting of the knee brings about such tears moreover deep squatting, lifting a heavy object from the floor, and kneeling could also prove disastrous. Noticeable signs include a popping sensation when a tear occurs, stiffness and swelling around the joint, pain that makes it hard to move the joint, knee joint is felt as being locked, and natural stability vanishes.

A physical inspection by an orthopedist reveals the prominent symptoms as he moves the knee or leg in various directions to check joint motion. He may ask a patient to squat or walk. To rule out other reasons and examine the internal condition x-ray or MRI is recommended whereas a detailed analysis is made through arthroscopy.

The location, type and size of the tear decide which treatment plan to follow. Mild injuries are treatable through rest and restraining the knee from motion. Swelling could be reduced by elevating the knee joint and putting on a compression bandage. Icing the affected knee and oral intake of medicines such as painkillers help relieve pain. An orthopedist will recommend physical therapy to strengthen muscles and ligaments for joint stability. When the conventional methods are no more effective and pain persists surgery is an ultimate option. Through arthroscopy damaged cartilage is trimmed or under more severe conditions replacement surgery is executed to substitute spoiled cartilage with a prosthetic one.

Loose or foreign bodies

Fractures or an injury to the knee joint could have abrasive internal effects. Severe bone fractures shatter bone into pieces these small fragments of bones or cartilage moving around interfere with joint motion. In cases where cartilage is healthy, these tiny particles can damage cartilage sourcing joint diseases like osteoporosis. Removing such loose bodies is essential as they cause swelling and pain. The patient loses range of joint motion and it feels like something is blocking the movement.

Imaging tests are conducted to diagnose the internal condition for which X-ray is an immediate source which exposes the presence of loose bodies. However, for in-depth evaluation, MRI is best to have as it indicates the number of loose bodies, their size, and location, which helps conceive surgery for their removal.

The treatment plan comprises anti-inflammatory drugs with painkillers to relieve pain. Physical therapy is advised to keep intact joint flexibility but surgery is the only solution to remove loose bodies. Arthroscopy is the minimally invasive technique used to eliminate loose bodies through a small incision. It’s a good diagnostic tool and surgical method to cure such issues.

Osgood-Schlatter disease

Also referred to as a jumper’s knee or growing pains it’s a pain induction when the patellar tendon in a knee pulls on the shinbone. Mostly occur in growing children and teenagers who are involved in sports that exert recurrent pressure on the patellar tendon. Usually, children between the ages of 11 to 14 years with rapid growth are subject to this disorder. Swelling and tenderness appear with pain below the kneecap which may develop slowly or trigger suddenly making it tough to run, walk, or jump. A bony bump just below the kneecap will be visible on the knee.

The doctor will give a physical examination to search for symptoms and will ask relative questions like routine activities, involvement in sports, and most significantly age of the patient. All such inquiries are useful for an exact diagnosis. To rule out other issues that might be a concern imaging test is conceived to assess internally. Break from the activities that put stress over tendons is advised by doctors along with medications to relieve pain. In some cases, an orthopedist may ask to wear a brace to limit knee joint motion unless it gets better. A patient will be directed to a physical therapist who tries to strengthen muscles and make them flexible enough through certain exercises. As a last resort surgery is recommended whereby a bony piece under the kneecap is surgically removed.


People of any age can complain of knee pain. It’s a common concern which may develop either gradually due to a disease or suddenly because of an injury. Mechanical issues can also occur that are caused by the presence of loose bodies, a syndrome, or a knee joint dislocation. Arthritis is the major reason for knee pain in most cases, specifically among old people. Knee pain brings about swelling, joint stiffness, redness over the affected knee, and warmth. The Joint feels weak, and unstable, and makes a crunching or popping sound while moving. The patient slowly loses joint range of motion which will deter routine activities.

An orthopedist in the first place scrutinizes physically to search for visible signs. Through assertive and non-assertive movement he checks the motion of a joint. Further investigations include imaging tests for internal evaluation and laboratory tests to see the development of infection. A treatment plan is laid out by looking at the cause of pain. Physical therapy and RICE therapy (rest, ice, compression, and elevation) are advised to practice as a home remedy to manage symptoms. Prescription of medicine is provided by the doctor to cure pain and inflammation which may include oral medicines or topical ointments. Therapeutic injections may also be added to the treatment if the pain is unbearable. Surgical procedures including arthroscopy, knee joint replacement, and osteotomy are kept as the last solution to cure the untreatable state.


Tendinitis is the inflammation of soft tissues connecting muscles to the bones i.e. tendons. It occurs because of repetitive stress over tendons which may tear them inducing pain and restraining joint motion. As for the knee joint, it is the patellar tendon that is affected. It let the leg extend and execute actions like kicking, jumping, and running. Athletes involved in sports that require excessive use of the knee are more likely to get patellar tendinitis. Pain develops gradually and starts to interfere with routine activities upsetting the quality of life.

The doctor will put pressure with hands over and around the kneecap to determine the extent of the pain. He will move the knee to assess a range of motion and for internal examination prescribe certain imaging tests such as x-ray, MRI, and CT-scan to clarify the reason. An orthopedist begins treatment with medications and physical therapies including stretching and strengthening exercises. He may ask to compress the patellar tendon with a strap that takes off the stress from the tendon. When these non-surgical methods don’t work to manage symptoms surgical procedure is implemented through a small incision for debridement. Other helpful procedures include:

  1. Corticosteroid injection is guided through ultrasound and injected around the patellar tendon.
  2. Plasma rich in platelets is injected into the tendon to promote the healing process
  3. A small oscillating surgical needle is guided to the affected tendon which takes off the damaged part and leaves behind a healthy one.


A sudden fall, a hard hit, or a vehicle accident could break the kneecap (patella). A fracture to the kneecap is excruciating that could constrain a patient from conceiving routine activities like walking, bending or stretching the knee, climbing, and jumping. Deformed knee, pain, bruising, tenderness, swelling, cuts and lack of ability to move the joint are visible symptoms. The affected area will feel numb and putting weight over the knee joint becomes tough.

Visible signs reveal the issue during a physical examination by an orthopedist. He will move the joint to check the range of motion or severity of damage and lightly press over the knee joint to see how tender it is. For internal examination, imaging tests are recommended to take an insight into the extent of damage that occurs to the bone and soft tissues nearby.

Contingent to the degree of injury treatment strategy is planned. For minor fractures, RICE therapy is suggested with much emphasis on taking rest. The knee joint is immobilized using a brace, splint, or cast so the bone can heal in the proper position leaving no room for deformity or misalignment. Under severe conditions where the bone is shattered critically surgery is significant to remove loose pieces and repair a broken bone. Surgical hardware like screws, pins, and staples are used to join the bone until it heals. Often a bone grafting technique is implied to promote the healing process. As the period of immobilization is ended physiotherapy phase begins through which muscle strengthening exercises are provided and joint range of motion is recouped.


Tendon tears

Tendons join muscles to the bones to keep the joint stable and ensure smooth movement. The knee joint embraces four kinds of tendons i.e. quadriceps, patellar tendon, hamstring, and iliotibial band. A disease, an injury due to a sudden hit or blow to the knee, or a past knee replacement surgery that put stress over tendons can be a reason for tendon tears. Such tears can be either partial or complete tears. Partial tears don’t deprive joint movement totally but a complete tear entirely dispossesses of straightening the leg. Crucial injuries can also damage the bone to which the tendon is attached.

Prominent symptoms comprise popping sensation, inflammation, swelling, bruising, tenderness, difficulty in moving a joint, instability, and weakness. An orthopedist looks for visible signs and moves the joint to judge a range of motion. However, internal assessment is much more significant to reveal the actual reason so imaging tests are performed to evaluate the extent of core damages. X-ray, ultrasound, or MRI are the most plausible imaging tests to consider.

Partial tears are treatable through non-surgical methods like immobilization and taking complete rest. Tendon will heal naturally but the process of healing can be triggered through shockwave therapy. Medicines to relieve pain and inflammation are added to prescriptions. On the other hand, surgery is required when tendon tears completely either detached from the bone or parted into two. Through surgery torn tendon is attached back using pins, staples, or screws after making general repairs to the bone if damaged. For a tendon that is tough to stick back, the grafting method is preferred by which a graft tendon from another healthy joint of the patient is taken and adhered to the affected part to encourage healing.

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