Knee Problems: An Overview
Annually, millions of trips to the doctor are made for knee problems; they are the most common reason for seeing an orthopedic surgeon.
Common injuries to the knee can involve soft tissues such as ligaments which help to stabilize the joint and control motion by connecting bones(femur to tibia) and the meniscus which is a wedge of cartilage between the femur and tibia that acts as a cushion/shock absorber and secondary stabilizer of the joint.
Four Major Ligaments
There are four major ligaments found in the knee. The anterior cruciate ligament(ACL) and medial collateral ligament(MCL) are the two most frequently injured during sports participation. ACL injuries are often the result of non contact events such as rapid change of direction on a planted foot (football, soccer), catching the edge of a ski while turning, landing “wrong” from a jump (basketball, volleyball) or slowing down suddenly (decelerating ) when running. MCL injuries often result from a direct blow applied to the outside of the knee.
There are two menisci (plural for meniscus); one medial (inside) and one lateral (outside). Tearing of the meniscus often occurs as the result of a twisting episode that can frequently occur in many sports activities. Changes occur in the menisci due to the aging process. They can then become susceptible to degenerative tearing as the result of “trivial” activities such as getting up from a squatted position or rising off the floor after sitting “Indian”style or cross legged.
The Patella (kneecap) Pain
The patella (kneecap) can also be a source of pain often associated with ordinary activities of daily living such as going up or down stairs, getting in and out of a car, kneeling or squatting and rising from a chair or seat. A direct blow to the front of the knee can lead to anterior (kneecap) knee pain, but just as likely, it can seem to appear “out of the blue”. The patella is located within the tendon of the quadriceps muscle and glides in and out of the groove at the end of the femur as the knee is flexed and extended. Forces equaling about 5 times one’s body weight are transmitted across the patellofemoral joint during activities such as stair climbing and squatting. If the patella has been injured or if the mechanics of gliding in and out of the groove at the end of the femur are abnormal, anterior knee pain can be encountered.
Osteoarthritis of the Knee
The knee is also subject to wear and tear associated with the aging process. Cartilage that covers the ends of the femur, tibia and back of the patella can degenerate with time. Unfortunately, this type of cartilage (articular) does not have significant healing ability and as we age, this cartilage becomes thinner and irregular. The bone underneath this cartilage may become exposed and pain, swelling and loss of motion may occur. This is osteoarthritis.
Treatment for Knee Problems
Treatment is available for all the knee problems mentioned above. For minor problems and injuries, “RICE” is a good first step. That means rest, ice, compression and elevation. Over the counter medications like acetaminophen or ibuprofen can also be used to help for pain relief and swelling. It is best, however, to seek medical attention/treatment with an orthopedic surgeon as soon as possible, to have your knee condition properly assessed and treated, especially if a “pop” was heard at the time of injury and/or a feeling of instability or giving way is experienced. Severe pain and swelling and inability to move the knee through a complete range of motion are also indications to seek expeditious orthopedic attention.