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KNEE

Your knee joint is made up of the femur (thigh bone), patella (knee cap), and the tibia and fibula (shin bones). Ligaments hold the bones together and muscles and tendons help the knee joint move. When any of these structures is hurt or diseased, you have knee problems. Knee problems can cause pain and difficulty walking.

Today’s active lifestyle can put tremendous strain on the knees. Athletes may suffer knee injuries from a sudden blow or fall, or simply by twisting. Women are particularly prone to knee cap problems, while older adults may have trouble from aging joints. Many knee problems arise from damage to the soft tissues (the cartilage and ligaments) inside the joint. Until recently, these could not always be easily diagnosed.

No matter what causes your knee problem, the knee specialists at Orthopedic Associates of Hartford can help. We utilize the latest technology and treatment options, with immediate access to advanced imaging reserved exclusively for out patients. We have expertise in advanced arthroscopy, ligament reconstruction, as well as partial and total knee replacement using robotic assisted technology.

Common Conditions

Ligament Tear/Sprain:

The knee is the largest joint in your body and one of the most complex. It is also vital to movement. Your knee ligaments connect your thighbone to your lower leg bones. Knee ligament sprains or tears are common sports injuries. Tears and injuries to the knee ligaments include:

ACL injuries: The anterior cruciate ligament (ACL) is one of the most commonly injured ligaments of the knee. The incidence of ACL injury is higher in people who participate in high-risk sports, such as basketball, football, skiing, and soccer. Learn more about Anterior Cruciate Ligament (ACL) Tears

PCL injuries: The posterior cruciate ligament is located in the back of the knee. It is one of several ligaments that connect the femur (thigh bone) to the tibia (shin bone). The posterior cruciate ligament keeps the tibia from moving backwards too far. An injury to the posterior cruciate ligament requires a powerful force – for example, a bent knee hitting a dashboard in a car accident or a football player falling on a knee that is bent. Learn more about PCL injury (posterior cruciate ligament)

MCL injuries: An MCL injury is a sprain or tear to the medial collateral ligament. The MCL is a band of tissue on the inside of your knee. It connects your thighbone to the bone of your lower leg. The MCL keeps the knee from bending inward. Learn more about MCL Injuries

Meniscus/Cartilage Tear: The meniscus is a C-shaped cushion of cartilage in the knee joint that keeps your knee steady by balancing weight across the knee. A meniscus tear is a common injury that can be caused by twisting or turning quickly, lifting something heavy, or playing sports. It will often cause pain with pivoting and squatting, and may give a feeling as though something is catching in the knee. Treatment of meniscus tear can be nonoperative, or occasionally may require surgical repair or trimming of the damaged meniscus tissue. Without the meniscus cushion, persistent knee pain and arthritis can develop. Learn more about Torn cartilage

Arthritis of the Knee:

Arthritis is a common disease that affects the bones in your knees. The cartilage in the knee can gradually wear away, causing pain and swelling. Although there are many types of arthritis, most knee pain is caused by one of three types: osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis.

Osteoarthritis. This is an age-related “wear and tear” type of arthritis. It usually occurs in people 50 years of age and older, but may occur in younger people, too. The cartilage that cushions the bones of the knee softens and wears away. The bones then rub against one another, causing knee pain and stiffness.

Rheumatoid arthritis. This is a disease in which the synovial membrane that surrounds the joint becomes inflamed and thickened. This chronic inflammation can damage the cartilage and eventually cause cartilage loss, pain, and stiffness. Rheumatoid arthritis is the most common form of a group of disorders termed “inflammatory arthritis.”

Post-traumatic arthritis. This can follow a serious knee injury. Fractures of the bones surrounding the knee or tears of the knee ligaments may damage the articular cartilage over time, causing knee pain and limiting knee function.

Other Knee Conditions:

There are a variety of other knee conditions that can cause knee pain and can be the result of an active lifestyle, repetitive motion, overuse, or aging. Click here to learn about other common knee conditions including:

Osteochondritis Dissecans

Patello Femoral Pain Syndrome

Symptoms

Signs and symptoms that sometimes accompany knee pain include:

Swelling and stiffness
Redness and warmth to the touch
Weakness
Instability – the feeling that your knee is giving way
Popping or crunching noises
Feeling of catching or locking (inability to fully straighten the knee)
Inability to fully straighten the knee
Pain on the inside of the knee
Pain on the outside of the knee
Swelling over the site of an injury
Acute pain resulting from sports injury, accident, or fall

Diagnosis

Medical History and Examination
During your first visit, our OAH knee expert will talk to you about your symptoms and medical history. During the physical examination, your doctor will check all the structures of your injured knee, and compare them to your non-injured knee.

Diagnostic Tests
Depending on the type of injury or condition, your doctor may perform additional tests to determine the source of the issue and develop the optimal treatment plan. These tests to confirm your diagnosis may include:

X-ray: can show whether the injury is associated with a broken bone.

Magnetic resonance imaging (MRI) scan: creates better images of soft tissues like the collateral ligaments. Orthopedic Associates of Hartford has immediate access to an MRI scanner which is reserved for use only by our patients. This helps establish your diagnosis quickly.

Blood tests: may assist in the diagnosis of inflammatory arthritis.

Depending on the type of injury or condition, your doctor may perform additional tests to determine the source of the issue and develop the optimal treatment plan.

Treatment Options

There are a number of non-surgical and surgical options to restore mobility and reduce pain.

Non-Surgical Options: There are several conservative treatments for knee pain that may include physical therapy, medications, bracing, and steroid injections. In non-surgical treatment, progressive physical therapy and rehabilitation can restore the knee to a condition close to its pre-injury state and educate the patient on how to prevent instability.

Surgical Options:Arthroscopy: Arthroscopy is a surgical procedure that allows a physician to treat a damaged or problem knee without making a large incision on the outer skin, which protects the knee joint. Fiber optic technology has led to the creation of the arthroscope, an instrument that allows our team to look directly into the knee and diagnose most problems. Learn more about Arthroscopy (The Problem Knee)

Cartilage Transplant: Up until recent years the treatment of articular cartilage defects has been remarkably poor. The most that could be done was to shave it down with mechanical instruments in an attempt to smooth it, but very little could be done to replace the defect in the smooth surface. Now, there are new options for achieving success. Learn more about Cartilage Transplant

Total or Partial Knee Replacement: If nonsurgical treatments like medications and using walking supports are no longer helpful, you may want to consider total or partial knee replacement surgery. Joint replacement surgery is a safe and effective procedure to relieve pain, correct leg deformity, and help you resume normal activities. Learn about knee replacement and when surgery is recommended

ACL Reconstruction: Anterior cruciate ligament reconstruction (ACL reconstruction) is a surgical tissue graft replacement of the anterior cruciate ligament, located in the knee, to restore its function after an injury. The torn ligament is removed from the knee before the graft is inserted in an arthroscopic procedure. Learn more about Anterior Cruciate Ligament (ACL) Tears