Services

Knee

Meniscus Tear

About The Meniscus

The knee has two menisci: the medial and lateral meniscus. These structures are fibrocartilaginous rings that sit between the femur and tibia bone. They function during weight bearing to cushion the joint and protect the articular cartilage surfaces. Otherwise, the meniscus can become damaged and torn.

Symptoms of a Tear

Symptoms of a torn meniscus are typically knee pain, joint swelling, limping, knee clicking or locking, an inability to run or perform at a previous baseline level of activity. Treatment for a torn meniscus in some cases is pain management. This can include the use of oral anti-inflammatory medications, steroid injections, knee bracing and exercises. In other cases surgical treatment is recommended.

Cartilage Defect

About Cartilage Transplantation

A healthy knee has an uninterrupted layer of articular cartilage on all bone surfaces. As a result of traumatic injury or degeneration the articular cartilage layer can become damaged. This is a common cause of knee pain and is the precursor of osteoarthritis. In cases where the articular cartilage damage is limited to a focal area a cartilage transplant can be performed.

Deformity Correction

About Osteotomy

Lower extremeity alignment is normally neutral with the mechanical axix of the limb falling throught the center of the knee. This neutral alignement allows for evenly distributed physical stress on both the medial and lateral weight bearing compartments of the knee. In cases of lower extremity malalignment the mechanical axis is shifted to either the medial or lateral weight bearing compartment.

This condition causes mechanical overload of the compartment and causes progressive deterioration of the joint cartilage in that area-osteoarthritis. If this condition is left uncorrected the end result will be complete loss of the articular cartilage surface with advanced degenerative arthritis and the need for a knee replacement. Symptoms of lower extremity malalignemt are 'bow legge' (varus) or 'knock knee' (valgus) deformity with associated knee pain.

Patella Malalignment

About The Patella

The patella is positioned at the center of the knee within a concave groove of the distal femur called the trochlea. With flexion and extension of the knee, the patella is designed to glide within the trochlea groove and remain centered. Patella malalignment is a condition where the patella does not centrally align within the trochlea. This is often present as a result of congenital malalignment but can also develop or be made symptomatic by associated muscle imbalances which can develop over time. Symptoms related to patella malalignment include anterior knee pain, intermittent knee swelling, knee crackling, knee buckling and occasionally patella dislocation.

Anterior Cruciate Ligament Tear

About the Anterior Cruciate Ligament(ACL)

The anterior cruciate ligament is one of 4 major ligaments that maintains knee joint stability. As a result of traumatic injury, the ACL can be torn. An injury that results in disruption of the ACL causes acute knee pain and swelling.

Symptoms

Symptoms of ACL insufficiency include knee pain, weakness, intermittent swelling and episodes of the knee giving out or buckling. In cases of acute ACL injury, symptomatic treatment is recommended initially with pain management, bracing and a physical therapy program to restore motion and diminish inflammation in the knee.  Low ACL demand would include individuals with sedentary work and lifestyles with minimal recreational sports activity. The likelihood of symptomatic instability in this patient group is low and under these circumstances ACL reconstruction is not necessary. In cases of ACL treatment. High ACL demand clients include those that work at physically stressful jobs and/or are engaged in routine athletics and sports activity. The likelihood of symptomatic instability in this group is moderate-high and under these circumstances an ACL reconstruction is recommended.

Other Ligament Injuries

AboutOther Ligament Injuries

Other ligaments that can be injured include the medial collateral MCL, lateral collateral LCL and posterior cruciate PCL . Injury to these ligaments along with the ACL can occur individually or can occur in combination (multiligamentous injury). Depending on the pattern of injury and the nature and extent of knee instability, nonsurgical management in a brace or surgical repair/reconstruction of the ligments may be indicated.

Fracture

About Fractures

Fractures in the area of the knee may involve the distal femur, femoral condyles, tibia plateau and proximal tibia. These fractures can be complex and can have long term consequences if not treated appropriately. These fractures if incorrectly treated can result in deformity and malalignmen

Knee Arthritis

About Knee Arthritis

The knees are major weight bearing joints and are therefore subject to extreme physical stresses which can over time result in the deterioration of the cartilage within the joint. This is the most common type of arthritis to affect the knee. Other types of arthritis include post traumatic arthritis which is arthritis secondary to a fracture or traumatic injury to the knee and inflammatory arthritis which is related to connective tissue diseases such as rheumatoid arthritis. The symptoms associated with knee arthritis are knee, thigh and leg pain, limping, weakness and joint stiffness. Typically there will be a progressive inability to perform routine activities such as putting on shoes and socks. Treatment for cases of minor or moderate arthritis are oral anti-inflammatory medications, injections, exercise and physical therapy.

The Treatment

In cases of mild to moderate arthritis where non-invasive treatment has not been effective and injectable medication to cushion and lunricate the joint can be used. This medication is a form of hyaluronic acid which is the normal lubricant and cushion in the knee and tends to lose its biomechanical properties as part of the degenerative process. By restoring the level of hyaluronic acid in the knee.

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