The rubbery meniscus cartilage in the knee can get damaged by twisting, pivoting or through a hard impact. The hard articular cartilage can be damaged by trauma, general wear and tear or poor blood supply to the joint. Patients with cartilage damage experience pain, swelling, clicking, giving way and locking of the knee.
Treatment: This is usually non-surgical including physiotherapy/exercise treatment, anti-inflammatories and a range of injections. Keyhole surgery may be performed to remove or repair damaged cartilage. If articular cartilage damage is severe, micro-fracture surgery can be performed. This involves boring small holes into the surface of the bone to allow stem cells from the bone marrow to seep out and repair the area with fibrocartilage. It is also possible to transplant cartilage from another part of the knee or to harvest cartilage cells from the knee, grow them in a laboratory and use them to cover the damaged area.
Shin Bone, Kneecap and Thigh Bone Fractures
Fractures are usually caused by a sudden physical trauma.
- Non-displaced stable fracture:occurs when the bones are cracked but remain in their natural position.
Treatment: Patients are usually treated with a plaster cast or brace.
- Unstable fracture: occurs when the bones are at risk of shifting out of their natural position.
Treatment: Surgery may be needed.
- Displaced fracture: occurs when the bones are misaligned.
Treatment: Surgical pins, plates and wires may be required to reposition the bone fragments and stabilise the knee joint.
Meniscus is the cartilage that cushions the knee. Meniscal tears are extremely common. They are often sports injuries resulting from sudden twisting of the knee. Older patients sometimes suffer meniscal tears as a result of degeneration over time. Patients experience pain, swelling, locking and a sensation of the knee giving way.
Treatment: Non-surgical treatments include painkillers, anti-inflammatories and physiotherapy. More severe tears or those that do not respond to non-operative treatment may require keyhole surgery. Increasingly tears are being repaired which enables patients to return to their pre-injury level of activity and reduces the risk of arthritis in later life. Meniscal transplants are increasingly being performed.
Sprains, tears and ruptures are common ligament injuries. There are several important ligaments that help stabilise the knee:–
Anterior Cruciate Ligament (ACL):
This ligament is a thick ligament in the middle of the knee. Damage to this ligament is a common sporting injury and often requires surgery. It can tear when you twist, jump or land awkwardly or suddenly change direction. Patients experience pain, swelling and sensations of popping, snapping or giving way.
Treatment: Non-surgical treatments include painkillers, anti-inflammatories and physical therapy. Surgical treatments include anterior cruciate ligament reconstruction. This is keyhole surgery using either your own tissues or donor tissues to reconstruct the torn ligament.
Medial Collateral Ligament (MCL):
This is located on the inner side of the knee and prevents the lower leg bending outwards. It can be injured by twisting or sudden impacts. Sprains of this ligament are common.
Treatment: Non-surgical treatments include painkillers, anti-inflammatories and physiotherapy for the milder ligament injuries. The more severe injuries may require a knee brace to protect the ligament whilst it is healing. Very occasionally this ligament will need surgical repair if it is combined with multiple other ligament injuries.
Posterior Cruciate Ligament (PCL):
This is the largest ligament in the knee. Damage to this ligament can cause pain, swelling and knee instability. PCL tears are less common than ACL tears.
Treatment: Non-surgical treatments include physical therapy. Surgical treatments include keyhole reconstruction of the ligament.
Tendonitis is inflammation and/or tearing of a tendon. It can happen from overuse or as a result of injury. Patients typically experience severe pain, swelling and weakness. Treatment: Non-surgical treatments include rest, physical therapy, shock wave therapy and a range of injections. Occasionally surgery may be required to treat the damaged tendon.