If you have knee pain, schedule an appointment with Dr. Michael Gustavel with Gustavel Orthopedics in Boise, Idaho for adequate diagnosis and treatment. Let's dive into the essentials of knee and knee pain.
What Is the Anatomy of a Knee?
The patella is commonly known as the knee cap. It's a triangular-shaped bone that connects the femur, the quadriceps tendon, and the thigh muscles.
The femur is the human thigh bone. It connects to the pelvic bone at the hip joint and the tibia and patella at the knee joint. The femur is also the hardest bone in the human body.
The Anterior Cruciate Ligament (ACL) is one of the four cruciate ligaments at the knee joint. This ligament connects the femur and the tibia and runs on the anterior of the knee joint.
The Lateral Collateral Ligament (LCL) is the ligament that runs on the outside part of the knee connecting the femur and the fibula.
The Medial Collateral Ligament (MCL) runs on the inner edge of the knee and connects the femur and the tibia. This ligament improves the overall strength and function of the knee.
The Posterior Cruciate Ligament (PCL) is one of the cruciate ligaments that connects the femur and the tibia. The ACL and PCL run opposite each other and form an "X" as they cross each other.
The lateral meniscus is c-shaped cartilage that runs between the shin and the thigh. It runs on the outer side of the knee and cushions movement between the femur and the tibia.
The medial meniscus is also c-shaped cartilage that runs on the interior side of the knee. It cushions the knee joint and helps with the distribution of lubricating fluid.
The fibula is one of the bones below the knee joint. It runs on the outer side of the lower leg and provides lateral stability for the lower leg.
The tibia is the main bone in the lower leg. It's larger and stronger than the fibula and carries most of the weight.
The quadriceps tendon connects the quadriceps muscles (muscles in the front thigh) to the patella. This tendon helps your legs stretch for walking, jumping, and bending.
What Are Common Conditions of the Knee? Which Is The Most Common?
ACL tears are some of the most common sports injuries. When the injury occurs, individuals often hear a "pop," and the knee moves in incorrect anterior motion.
Articular Cartilage Injuries
Articular cartilage injuries affect the cartilage that lines the ends of the knee bones and reduces friction. The damage can occur due to normal wear and tear or high impact. As a result, patients experience pain, swelling, stiffness, and decreased knee motion.
Arthritis is a medical condition that causes joint inflammation. For example, in the knee, arthritis causes the wear and tear of the cartilage at the knee joint, causing stiffness, decreased movement, and pain.
Chondromalacia patella is a common chronic knee pain that occurs due to the poor alignment of the patella to the thigh bone. As friction occurs between the patella and the femur, the cartilage between the two bones degenerates, causing more friction.
This condition occurs when the bursae at the knee joint (fluid-filled sacs) become inflamed. The condition causes swelling and pain in the knee joint. Knee bursitis develops for several reasons, including prolonged kneeling and obesity.
Kneecap dislocation occurs when the patella moves from its position causing the knee to swing from side to side. This condition is common among people with weak bones and athletes.
Lateral Collateral Ligament Tear
LCL tears occur due to high impact, sudden side-to-side twisting, and overextension. The injury can vary from a minor sprain to a complete tear.
Medial Collateral Ligament Tear
Medial Collateral Ligament tears are injuries to the MCL tissue that connects the femur to the tibia on the inner side of the knee. This injury is typical in high-impact sports. The tear can be mild, causing pain and stiffness, or severe, causing complete knee displacement.
Meniscus tears are injuries to the disc-shaped cartilage that act as shock absorbers and lie laterally at the knee joint. There are two menisci- the medial and the lateral. Of the two, the medial meniscus, which lies on the inside of the knee, is prone to more injury.
Osteoarthritis and Osteochondral Injuries
An osteochondral injury is a damage to the articular cartilage that lines the ends of your bones. The progressive deterioration of the articular surfaces causes osteoarthritis.
Patellofemoral pain occurs when the kneecap grinds abnormally on the femoral trochlea resulting in stiffness and pain.
PCL injuries affect the posterior cruciate ligament, which connects the femur and the tibia in the rear. Injuries often occur due to impact to the tibia right below the knee.
A torn meniscus results from natural degeneration, high-impact sports, heavy lifting, or day-to-day activities. A meniscus injury results in a popping sound, stiffness, swelling, and pain in the knee.
What Factors Increase Risk of Knee Conditions?
High Impact Sports
High impact sports such as running, hockey, football, soccer, and basketball increase the risk for knee injuries. Direct impact from a collision with other players, pressure due to sudden stops, and overextension can cause bone placement, ligaments, and cartilage issues. What's more, athletes with previous injuries and improper footwear are at a higher risk for knee injuries.
Osteoporosis is a disease that causes the continuous degeneration and weakening of the bones, which increases the risk of fracturing bones.
Poor training habits, such as incorrect knee placement during as squats or lunges or placing excessive pressure on the knee before adequate strength training, increases the risk of knee injuries. Training with the wrong shoes and poor stability also causes knee conditions.
Overuse knee injuries are common among athletes and workers that use the knee to perform intense activities. The continuous stress on the ligaments and cartilage without adequate recovery increases the risk of getting a knee injury.
Repetitive knee movement with age-related conditions such as osteoporosis and arthritis increase the risk of developing knee complications.
Generally, women are at higher risk of knee conditions due to estrogen that affects ligaments and conditions such as osteoporosis that weaken the bones.
Too much body weight places excessive pressure on the cartilage between the bones, causing faster wear and tear.
How Do You Know If Knee Pain Is Serious?
Knee pain occurs at least once in a person's lifetime. Usually, knee sprains from strenuous physical activity result in mild and slow pain. However, if there is sharp pain accompanied by swelling, tenderness, and fever, it's time to visit Gustavel Orthopedics in Boise, Idaho for a consultation.
Other severe symptoms to look out for include:
- A popping sound
- Inability to put weight on the knee
- A knee that appears deformed
- Intense and sharp pain
Acute pain, which persists 1-7 days after injury, may resolve with rest. However, if the pain lasts longer than eight weeks, it may be chronic and requires medical intervention.
What Are Non-Surgical and Surgical Treatments for Knee Pain
RICE: Rest, Ice, Compress, Elevate
This treatment method includes rest for the sore area, ice to control pain and swelling, compression to decrease swelling, and elevation of the injured knee when sitting or lying down.
Nonsteroidal anti-inflammatory drugs (NSAIDs) relieve inflammation from knee injuries. Other drugs are capsaicin patches or creams that regulate pain reception in the body.
These are cortisone injections that are injected directly into the knee joint for pain relief.
Physical therapy is a long-term technique that uses various motions, massages, stimulations, and heat and cold applications to promote healing, strength, and mobility in the knee.
Meniscus surgery is a surgical procedure that removes a partial tear in the meniscus or the entire meniscus when the injury is severe.
Total Knee Replacement
Knee replacement surgery is a surgical procedure performed on a severely damaged knee. The method involves cutting away the damaged ends of the knee bones and replacing the joint with an artificial one to enhance movement.
Knee arthroscopy is a surgical procedure where the orthopedic surgeon inserts a small camera in the knee joint to diagnose knee conditions and treat the knee.
ACL surgery is a treatment for ACL injuries that cannot heal with medication, rest, physical therapy, and other non-surgical treatments. Instead, the surgeon performs a graft, which transfers tissue from one part of your body to the ACL for healing.
Patellofemoral Ligament Reconstruction Surgery
This is corrective surgery for the ligament that connects the patella and the femur.
PRP/ Human Growth Tissue
Platelet Rich Plasma (PRP) is a regenerative therapy that accelerates healing by concentrating the patient's platelets in the injured area.
When Is Surgery Recommended?
If other treatment techniques fail or if the knee injury is severe, knee surgery may be the only way to rectify knee injuries and restore mobility. Consulting an orthopedic surgeon is the best way to determine if you're a candidate for knee surgery. Gustavel Orthopedics specializes in sports medicine and surgical treatment for knee injuries. Schedule a consultation with Boise’s top Orthopedic Surgeon, Dr. Gustavel, for more information.