Knees

Knee Pain

What causes knee pain?

Many things! It may be caused by something as simple as a fall or be due to arthritis or soft tissue injuries in and around the joint.

How will I know what the cause is?

Your surgeon will inform you based on the history and examination performed. You might need to have some scans or Xrays to help make the diagnosis.

Do I need to have surgery?

This again will depend on your examination findings.

What non surgical options are there?

If indicated, your surgeon may send you for physiotherapy and then assess you after this. Sometimes, for mild pain, a steroid with or without local anaesthetic can be injected into the joint to help with acute problems. It may also heli in making a diagnosis.

Sports Related Injuiries

How will I know if I have a sport related injury?

Most people will have pain after a period of sport. However, it should resolve within a few days. If you have persistent pain or swelling in your knee after a sporting activity, it may be worth seeing a knee specialist.

What can go wrong?

The knee joint is a type of modified hinge joint. It is made up of three bones; the femur at the top, the tibia at the bottom and the patella or knee cap in front. All of these bones are connected via muscles, tendons and ligaments which help them glide over one another and allow us to walk. Tendons can ligaments can be stretched and even torn in some cases.

How are such injuries diagnosed?

Such injuries are diagnosed using a combination of clinical history, examination and possibly a scan or Xray of the joint.

How are they treated?

This may vary on structure that is injured and the severity of the damage. Strained ligaments around the knee tend to settle with targeted physiotherapy. Ruptured cruciate ligaments, meniscal injuries or cartilage damage may require surgery.

Knee Arthritis and Knee Cartilage Problems

What is cartilage?

Cartilage is an important type of connective tissue. It covers the surfaces of almost all joints in the body and acts as a smooth surface and a source of lubricant to allow the moving joint to glide seamlessly and painlessly over each other.

What can go wrong with cartilage?

Loss of cartilage due to degeneration is known as arthritis. Sometimes this can cause small flaps of cartilage to detach and even float around the joint. When cartilage is lost, the bones may end up rubbing directly on one another. This process can cause pain and swelling of the joint.

Do I need to get any Xrays or scans?

This will depend on your examination by the surgeon. A Xray will show the bones and give an idea of the degree of arthritis in the joint. If indicated, you may be asked to have a MRI scan of the knee which will give much more detail about not only the bones and cartilage, but the other soft tissue structures in and around the knee.

What can be done about it?

A knee arthroscopy is a safe and good method of treating such problems. Loose flaps and pieces of cartilage can easily be removed. It will also allow the surgeon to have a direct view of the surface of the joint.

Do I have to have an operation?

Not at all. Some patients will benefit from non operative treatments such as physiotherapy, weight loss and regular exercise. In cases of acute pain, injections inside the joint will help relieve pain.

Can the cartilage be replaced?

Currently it is not possible to replace loss cartilage. There are new and emerging techniques trying to solve this problem but they are still in the experimental phase.

What if there is a lot of cartilage loss?

In the case of moderate to severe arthritis, your surgeon will have a discussion with you about how best to proceed. If the joint is very painful, swollen and stopping you going about your daily activities, then you may be a candidate for a knee replacement.

Do supplements such as glucosamine and vitamins help?

There is no high quality scientific evidence to prove that supplements help, however many patients report some improvement in their symptoms

Knee Arthroscopy

About the joint

The knee joint is a type of modified hinge joint. It is made up of three bones; the femur at the top, the tibia at the bottom and the patella or knee cap in front. All of these bones are connected via muscles, tendons and ligaments which help them glide over one another and allow us to walk.

What is a knee arthroscopy?

A knee arthroscopy is a key hole operation. It involves two small (1-2cm) cuts on either side of your knee cap, through which the surgeon passes a thin fibre optic camera and a shaving device. Then, whilst looking at a high resolution computer screen, the surgeon can inspect the structures within the knee.

What is cartilage?

Cartilage is an important type of connective tissue. It covers the surfaces of almost all joints in the body and acts as a smooth surface and a source of lubricant to allow the moving joint to glide seamlessly and painlessly over each other. The process of arthritis can lead to loss of cartilage causing pain and swelling of the joint.

What is a meniscus?

There are 2 menisci within the knee that sit on top of the tibia. These are essentially moon shaped (semi lunar) folds of cartilage that act as shock absorbers between the femur and the tibia. These can often be torn leading to pain, swelling and locking of the joint.

What is a cruciate ligament?

There are 2 cruciate ligaments within the knee; an anterior and a posterior. These are strong bands of tissue that hold the tibia and the femur together and help stabilise the knee during motion. These can be torn leading to knee swelling and instability.

What can the surgeon do during a knee arthroscopy?

Lots of things! Any damage or loss of the articular cartilage can be clearly seen and so an assessment of the degree of arthritis within the joint can be made. Loose bodies (such as pieces of cartilage or bone) can be removed, meniscal tears can be repaired or shaved away and cruciate ligaments can be inspected and assessed.

Is it painful?

You will have a general anaesthetic for this procedure. When you wake up, the knee will feel a bit swollen but almost all patients go home the same day with some simple pain killers. You will also be allowed to put your full weight on the operated limb.

What are the aims of surgery?

The aim of an arthroscopy is both to allow the surgeon to have a direct view of the knee joint and the soft tissue structures, but also to perform surgery that may make your symptoms better.

Benefits?

It is a relatively simple day case procedure which will give valuable information about the structure of the knee.