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Knee

The knee is a highly vulnerable joint that endures significant stress from daily movements. These include lifting, kneeling and bending, as well as high-impact activities like jogging or aerobics.

Knee pain is the most widespread issue among adults, often resulting from general wear and tear caused by routine actions. Athletes, particularly those who engage in running, jumping or quick directional changes, are at an increased risk of knee injuries. Whether due to ageing or injury, knee pain can range from a mild inconvenience to a severely debilitating condition.

Knee Structures

Despite being the biggest joint in the human body, the knee is also the most susceptible to injury. It consists of four key components: bones, cartilage, ligaments, and tendons.

  • Bones: 3 bones, including the thighbone (femur), shinbone (tibia), and kneecap (patella) come together to make the knee joint. Positioned at the front of the joint, the patella provides added protection.
  • Articular cartilage: A smooth, slippery layer of articular cartilage covers the ends of the femur and tibia, as well as the back of the patella. This thus allows the bones to move smoothly against each other when the knee bends and straightens.
  • Meniscus: 2 wedge-like meniscal cartilage pieces serve as shock absorbers between the femur and tibia. Unlike the articular cartilage, this meniscus is hard and rubbery, helping to stabilise and cushion the joint. A “torn cartilage” in the knee usually refers to a meniscus tear.
  • Ligaments: Ligaments are strong bands of tissue that connect bones and help maintain joint stability. The knee is composed of these main ligaments:
    • Collateral ligaments: These ligaments regulate side-to-side movement and are located on the sides of the knee. The medial collateral ligament is on the inner side, whereas the lateral collateral ligament is on the outer side.
    • Cruciate ligaments: Found within the knee joint, these ligaments cross one another to create an “X” shape. The anterior cruciate ligament (ACL) is positioned at the front, while the posterior cruciate ligament (PCL) is at the back. Together, they control the knee’s forward and backward movement.
  • Tendons: Tendons link muscles to bones to enable movement. The quadriceps tendon joins the muscles at the front of the thigh and the kneecap, whereas the patellar tendon extends from the patella towards the tibia.

Common Knee Problems

The most frequent knee injuries involve damage to soft tissues such as ligaments and the meniscus, as well as fractures and dislocations. Often, multiple structures within the knee are affected simultaneously.

Pain and swelling are the primary indications of a knee injury. Additionally, knee catching or locking may occur during movement. Certain injuries, like an ACL tear, can as well lead to instability, making the knee feel as if it might give way.

Some of the most common knee issues include:

  • Meniscal cartilage tears
  • Knee osteoarthritis (OA)
  • Patellofemoral joint pain
  • Baker’s cyst
  • ITB friction syndrome
  • Patella tendinopathy (jumper’s knee)
  • Infrapatellar fat pad inflammation
  • Pes anserine bursitis

Diagnosing Knee Problems

To diagnose knee issues, healthcare providers typically conduct a thorough medical history review and a physical examination. More diagnostic tests may include:

  • X-ray – Uses electromagnetic energy beams to create pictures of inner structures, including bones and joints.
  • Magnetic resonance imaging (MRI) – Utilises powerful magnets, radio waves, and a computer to generate detailed images of body structures and organs. This allows for the detection of damage or disease near the muscle or ligament.
  • Computed tomography (CT) scan – Combines X-ray technology with computer processing to produce cross-sectional images of the body. A CT scan normally gives a more detailed view of bones, fat, muscles, and other structures than a standard X-ray.
  • Arthroscopy – This minimally invasive procedure involves inserting a small, lighted camera (arthroscope) into the joint through a tiny incision. By using this method, medical professionals can assess the interior structure of the knee in addition to identifying bone disease, arthritis or inflammation.
  • Radionuclide bone scan – This nuclear imaging method involves injecting a small volume of radioactive material into the bloodstream. This test helps assess blood flow and cellular activity in the bone, aiding in the detection of infections, tumours, or other abnormalities.

When to Seek Medical Attention

Immediate medical care is recommended if you:

  • Notice a popping sound, and your knee gives out during injury.
  • Experience severe discomfort.
  • Have difficulty moving the knee.
  • Develop a limp.
  • Notice significant swelling at the injury site.

Treatment Options

When a knee injury occurs, following the RICE procedure can help accelerate recovery:

  • Rest – Do not put weight on the injured knee to prevent further strain.
  • Ice – Apply ice packs for about 20 minutes at a time, multiple times daily. Avoid direct contact with the skin in order to prevent frostbite.
  • Compression – Wrap the knee lightly with a bandage or ace wrap to reduce swelling.
  • Elevation – Keep the injured knee elevated above heart level during rest to minimise swelling.

Other treatment options include:

Nonsurgical treatment:

Most knee problems can be managed with these conservative treatments:

  • Immobilisation – A brace may be used to limit knee movement, while fractures may require a cast or brace to keep bones in place during healing. The use of crutches may as well be advisable to reduce weight-bearing pressure.
  • Physical therapy – Targeted exercises aid in restoring knee function and strengthening the surrounding muscles to ensure better support.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) – Medications like ibuprofen and naproxen can help ease pain and inflammation.

Surgical treatment:

Some knee injuries, such as fractures or severe ligament tears, may necessitate surgery to fully reinstate function. Examples of these surgical procedures include:

  • Arthroscopic surgery. Minimally invasive procedures using small instruments and incisions are commonly used for ACL repairs and other ligament injuries.
  • Open surgery. More complex fractures may require traditional open surgery, hence allowing the surgeon direct access to the damaged structures for proper repair.

Summary

The knee is the largest joint in the body and, at the same time, prone to many forms of injuries ranging from mild discomfort to severe conditions affecting mobility and quality of life. Early diagnosis and proper treatment are key to a successful recovery. Whether your knee pain is due to an injury, overuse, or an underlying condition, seeking professional care can help you regain strength, stability, and function.

Schedule an appointment today to receive an expert evaluation and personalised treatment options tailored to your needs.