At Weiss Memorial Hospital
What Causes Knee Pain?The knee is the largest joint in the body. It has many moving parts, such as bones, cartilage, muscles, ligaments and tendons. Anyone of these parts can suffer from disease or injury causing pain in the knee. Though the most common disease to cause knee pain is arthritis, a number of injuries can lead to knee pain and with the increasing number of aging adults, overuse injuries are becoming more common.
Diseases that cause knee pain
Osteoarthritis is the number one disease that causes knee pain. Osteoarthritis wears away the cartilage in the knee and eventually affects the adjacent bones. Osteoarthritis most typically affects adults over age 50. Younger people can be prone to osteoarthritis if it runs in the family, or if they had a previous injury that triggers the onset of osteoarthritis. Osteoarthritis treatments include:
Rheumatoid arthritis is another cause of pain in the knee, but it affects a much smaller portion of the population. This autoimmune disease causes the body to attack the membranes that line the joints. This results in inflammation and damage to the bone, tendons and ligaments of the knee. Rheumatoid arthritis treatments include:
Your knee plays an essential role in everyday life and supports the weight of your body, allowing you to walk, run, stoop, bend and jump. Pain in the knee can result from a direct blow, falling, twisting or over-extension. There are many parts of the knee, and each can contribute to knee pain.
Chondromalacia occurs when the cartilage of the kneecap softens. This can be caused by injury, overuse, or muscle weakness, or if parts of the knee are out of alignment. The meniscus is a C-shaped piece of cartilage that acts like a pad between the femur (thigh bone) and tibia (shin bone). It is easily injured if the knee is twisted while bearing weight.
Generally, when you injure a meniscus, you feel some pain, particularly when the knee is straightened. The knee pain may be mild to severe and includes swelling. Although symptoms of meniscus injury may disappear on their own, if they persist or reoccur, treatment is recommended.
Ligament injuries are known as sprains. Two commonly injured ligaments in the knee are the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL). The ACL is most often stretched or torn by a sudden twisting motion. The PCL is usually injured by a direct impact, such as in an automobile accident or football tackle. If a ligament is the cause of your knee pain, you may hear a popping sound, and the leg may buckle when you try to stand on it.
The three main types of tendon injuries and disorders are:
People with tendinitis describe the knee pain as tenderness at the point where the patellar tendon meets the bone. A complete rupture of a tendon is not only painful, but also makes it difficult for a person to bend, extend, or lift the leg.
Is surgery right for my knee pain?
If you have a serious knee injury, surgery may be the preferred option to repair the damage and prevent your pain. You and your doctor will discuss your knee pain and evaluate your options. Often, total knee replacement is the answer for persistent pain, and when the limited range of motion in their knee joint severely affects your quality of life.
Weiss Orthopedic Surgeons are specialists in knee pain and are experts in knee repair. Knee surgery patients who stay in the hospital after surgery recover on an award-winning, dedicated orthopedic unit, Joint University, where the focus is on maximizing recovery through education, early mobility, and patient experience.
Types of surgery for knee pain include:
Some conditions treated by Weiss orthopedic specialists include:
A common tool in treating orthopedic injuries is Arthroscopy. Arthroscopy is a minimally-invasive diagnostic and treatment procedure used for conditions of a joint. Originally, Arthroscopy was a diagnostic tool only, used primarily for planning a standard open surgery. However, because of the development of new instruments and advanced surgical techniques, many conditions can also be treated with arthroscopic surgery alone.
Arthroscopy uses a small fiber optic scope inserted through a small incision in the skin to see inside a joint. It has two purposes: diagnostic and surgical. First, it is a diagnostic tool, allowing surgeons to view joint problems without major surgery. During arthroscopy, the surgeon makes small incisions in the joint and inserts a camera the size of a pencil. This allows the surgeon to evaluate any knee damage. Depending on the problem found, surgeons may use arthroscopy to perform surgery by inserting small instruments through additional incisions to repair damage, such as a torn meniscus or a torn ligament.
Because arthroscopy uses tiny incisions, it results in less trauma, swelling, and scar tissue than conventional surgery. This means less time in the hospital and faster recovery than traditional open surgery. Problems can be diagnosed earlier and treated without serious health risks or more invasive procedures. Furthermore, because injuries are often addressed at an earlier stage, operations are more likely to be successful. Most arthroscopic surgery is performed in an outpatient setting under general anesthesia.
The following are often discovered and/or corrected during an arthroscopic procedure:
Arthroscopic surgeries involve the following:
When a knee is so severely damaged by disease or injury, an artificial knee replacement may be the only option. The most common condition that results in the need for knee replacement surgery is osteoarthritis, a degenerative, joint disease that affects mostly middle-aged and older adults. Osteoarthritis is characterized by the breakdown of joint cartilage and adjacent bone in the knees.
Although each procedure varies, surgery to replace a knee usually lasts about two hours. After the damaged bone and cartilage of the knee is removed, your orthopedic surgeon will place your new, artificial knee in its place.
The prosthesis (artificial knee) is comprised of the following three components:
A fracture is a partial or complete break in the bone. When a fracture occurs, it is classified as either open or closed:
The anterior cruciate ligament (ACL) is located toward the front of the knee and is the ligament of the knee that controls rotation and forward movement of the tibia (shin bone). It is one of the most common ligaments to be injured. The ACL is often stretched and/or torn during a sudden twisting motion (when the feet stay planted one way, but the knees turn the other way). Skiing, basketball, and football are sports that have a higher risk of ACL injuries.
Often, a cruciate ligament injury does not cause pain. Instead, the person may hear a popping sound as the injury occurs, followed by the leg buckling when trying to stand on it, and swelling.
The ends of the three bones in the knee are covered with cartilage that acts as a shock absorber. Between the bones of the knees are two crescent-shaped discs of connective tissue, called menisci, which also act as shock absorbers to cushion the lower part of the leg from the weight of the rest of the body.
Meniscus tears can occur during a rotating movement while bearing weight, such as when twisting the upper leg while the foot stays in one place during sports and other activities. Tears can be minor, with the meniscus staying connected to the knee, or major, with the meniscus, barely attached to the knee by a cartilage thread.
Sometimes called “stiff knee syndrome”, arthrofibrosis can occur following surgery when excessive scar tissue forms in a knee joint and surrounding soft tissue, causing a stiffening of the knee. Arthrofibrosis can break down cartilage in the joint and cause extreme pain. Pain can be treated using physical therapy and cortisone shots. At Weiss, specialists also perform complex treatments using low-dose radiation and surgery to treat arthrofibrosis.
A bursa is a closed, fluid-filled sac that exists to reduce friction between tissues of the body. Bursae are located near major joints such as shoulders, elbows, hips and knees. Bursitis occurs when bursae become inflamed. Two major types of bursitis exist in the hip: trochanteric bursitis and the iliopsoas bursitis.
Trochanteric bursitis causes pain on the outer portion of the hip while iliopsoas bursitis typically causes pain in the front of the hip near the groin.
Treatment options include cortisone injections, PRP injections, physical therapy or stretching. If bursitis does not resolve with these measures, arthroscopic surgery may be used to remove the painful bursa.