Knee disorders and treatments
The knee joint is the body’s most complicated weight-bearing joint, located between the bottom of the thigh bone (femur) and the top of the shin bone (tibia). It is a complex hinge-type joint providing a combination of bending, gliding and twisting movement. The joint surface is covered by articular cartilage which enables smooth movements of the joint. There is a semi-lunate shaped meniscus (sports cartilage) on each side of the knee e.g. between the joint surfaces, providing further cushioning. The knee is stabilized by several ligaments of which the most important ones are the two ligaments) at the sides and the two cruciate ligaments within the joint. Normal movement for the knee is usually between 0-150 degrees.
Knee Arthritis (Osteoarthritis)
When the knee joint wears out the cartilage gradually disappears from the joint surfaces causing inflammation in the knee. Bone spurs develop at the edges of the joint and movement becomes restricted and painful.
Torn Meniscus (sports cartilage)
A torn meniscus is one of the most common knee injuries involving damage to the semi-lunate shaped cushions the knee joint. Typically, this occurs when forcefully twisting or hyper-flexing of the knee joint. Athletes involved in football, rugby and skiing are particularly susceptible to meniscus tears. Symptoms of a torn meniscus may include pain, locking, inability to straighten the knee and a popping or clicking sensation.
Anterior Cruciate Ligement (ACL) tear
Anterior cruciate ligament (ACL) tears are common among both professional and recreational athletes. The ACL is most commonly damaged with a rapid change of direction, stopping suddenly, landing awkwardly from a jump, or from direct impact to your knee joint. It is well established that in over half of the cases other structures of the knee such as the meniscus, articular cartilage or other knee ligaments are also demaged.
ARTHROSCOPIC MENISCECTOMY (KEYHOLE OPERATION)
Apart from the periphery the meniscus does not have blood supply and cannot heal. The torn part therefore has to be removed to alleviate symptoms and to prevent further damage to the joint surface. This operation is most likely to be successful if the leg is normally aligned and there is no significant arthritis present.
ARTHROSCOPIC MENISCUS REPAIR (KEYHOLE OPERATION)
If the meniscus is torn at the periphery where there is blood supply it may be possible to repair it instead of removing it. Acute repair in conjunction with an ACL reconstruction have particularly good rates of healing because of the abundance of blood flow as a result of the procedure.
TOTAL KNEE REPLACEMENT (TKR)
Total Knee Replacement (TKR) procedure replaces all of the knee joint with a prosthesis to eliminate pain and restore joint movement.
PARTIAL KNEE REPLACMENT (UKR)
In cases where the tear and wear process affects only part of the knee it is possible to replace only that part. This means an overall smaller intervention, less pain, quicker recovery and a more natural feel of the knee.
INJECTIONS AROUND THE KNEE
If you have a flair-up of your arthritis a steroid injection can improve the pain and reduce swelling. It is not a cure though and the effect will wear off with time. If the tear and wear process progresses you may need joint replacement surgery later.
Chronic inflammation around the knee such as sprains that do not settle down after several months and overuse syndromes like jumper`s knee may be amenable to ultrasound guided injections.