Knee Pain and Injuries

Your knee is made up of two main bones, the thigh bone, or femur, and lower leg bone, or tibia. These bones are held together by four main ligaments: the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), lateral collateral ligament (LCL) and medial collateral ligament (MCL). The meniscus is the rubbery cartilage that sits between these bones. When you step down, the meniscus acts as a shock absorber between the thigh bone, or femur, and the leg bone, or tibia. The bones come together to form a joint. It is at this joint that the bones move over one another to allow you to move about and move your body. At this joint the bones are lined with a hard substance called cartilage.

knee

Anatomy of the Knee

The knee is the body's largest joint. It's the place where three bones meet: the tibia, the femur and the patella. The knee is a "hinge" joint. It allows the leg to bend in one direction only. Let's take a closer look at the main parts of the knee's anatomy.

The patella is a disk shaped bone in the front of your knee. Your patella is attached to your tibia bone by a tendon called the patellar tendon. The kneecap also attaches to the quadriceps muscles which are the large muscles in the front of your thigh. The patellar tendon, quadriceps, and other soft tissue surround the patella in what we call a soft tissue envelope. Normally this soft tissue envelope is well balanced and strong allowing your knee to function without pain.

Normally your patella rides smoothly in a groove at the end of your thigh bone, or femur, when you bend and straighten your knee. The vastus medialis obliquus, or VMO, is important in maintaining this normal patellar movement and allowing balance of the soft tissue envelope around the patella. The movement of the patella in this groove at the end of the femur is called patellar tracking.

The largest joint in the body, the knee is also one of the easiest to injure. Knee problems can be caused by trauma, particularly from sports; physiologic issues like misalignment; degeneration from conditions like osteoarthritis; or just plain overuse. To learn about some of the most common knee injuries and conditions, view the videos, below.

knee

Anatomy of the Knee

The knee is the body's largest joint. It's the place where three bones meet: the tibia, the femur and the patella. The knee is a "hinge" joint. It allows the leg to bend in one direction only. Let's take a closer look at the main parts of the knee's anatomy.
ACL injury

Anterior Cruciate Ligament (ACL) Injuries in Women

The anterior cruciate ligament, commonly called the ACL, is a thick, elastic band of tissue that runs from the bottom of the femur to the top of the tibia. It helps stabilize the knee joint. The ACL can become stretched or torn when the knee is twisted or hyperextended. For reasons that are not fully understood, ACL injuries are much more common in women than in men.
torn ACL

Anterior Cruciate Ligament Tear (ACL Tear)

This injury is a tearing of the ACL ligament in the knee joint. The ACL ligament is one of the bands of tissue that connects the femur to the tibia. An ACL tear can be painful. It can cause the knee to become unstable.
meniscus tears

Meniscus Tear

This is a common injury of the knee. Your knee joint is cushioned by two c-shaped wedges of cartilage called the "menisci." Each individual cushion is called a "meniscus." This injury is a tear of one of these cushions.
Tendon pulls away from bone

Osgood-Schlatter Disease

This is a type of injury that causes knee pain in children. It's an inflammation of a growth plate in the tibia. Growth plates are places where new bone tissue forms. They are found in the long bones of growing children. But growth plates are weaker than the surrounding bone. That makes them easier to injure.
knee arthritis

Osteoarthritis of the Knee

Osteoarthritis, also called degenerative arthritis, is a gradual breakdown of cartilage in the joints. Cartilage is a tough, flexible connective tissue that protects the ends of bones in the joints. Osteoarthritis is common in the knees because the knees bear the weight of the body. Osteoarthritis of the knee can severely impact a person's lifestyle.
patella fracture

Patella Fracture (Broken Knee Cap)

This is a break of the patella. That's the small bone in the front of your knee often called the "kneecap." The kneecap protects the joint and helps link your thigh muscles to your lower leg. A fracture can cause pain and other problems.
patella tendon rupture

Patella Tendon Rupture

This is a tear of a large tendon in the front of your knee. We call it the "patellar tendon." It connects the bottom of the kneecap to the top of the shinbone. It helps you straighten your leg. You can have a tear that doesn't go all the way through the tendon, or you can tear the tendon completely. A complete tear is a disabling injury.
Patella tendon inflamation

Patellar Tendonitis (Jumper's Knee)

This is a pain you feel just below your patella (the bone we commonly call the "kneecap"). It's an injury to your patellar tendon, which connects the bottom of the kneecap to the shinbone.
patellar tracking disorder

Patellar Tracking Disorder

This is a problem with the alignment of the patella (the bone at the front of the knee, commonly called the "kneecap"). With this disorder, the patella shifts out of its normal track as you bend or extend your knee.
Irritation on back of patella

Patellofemoral Pain Syndrome (Runner's Knee)

This is a pain you feel in the front of your knee. It involves the patella. That's the bone we commonly call the "kneecap." The patella slides up and down in a groove on your femur as you bend and extend your knee. If you have this syndrome, you may have injured the soft tissues that support and cushion your kneecap. Or, you may have some damage to the cartilage on the underside of the kneecap.
kneecap bursitis

Prepatellar Bursitis (Kneecap Bursitis)

This condition is an inflammation of the prepatellar bursa, a fluid-filled sac that covers the front of the kneecap. Prepatellar bursitis results in pain and swelling at the front of the knee.
quad tendon rupture

Quadriceps Tendon Tear

This condition is a tear of the tendon that connects the patella to the quadriceps muscles of the thigh. The quadriceps muscle is used to straighten the leg from the bent position. A complete rupture of the quadriceps tendon is a disabling injury.
supracondylar femur fracture

Supracondylar Femoral Fracture

This condition is a break in the femur at the knee joint. The fracture can range from a small crack to a full break that allows part of the bone to separate. This injury can involve the cartilage on the base of the femur in the knee joint, and may increase the risk of developing knee arthritis later in life.
tibial fractures

Tibial Fractures

This condition is a break in the shin bone, called the tibia. A tibial fracture can occur anywhere along the bone, and can range from small cracks to a full break that allows the bone to separate.
Torn PCL

Torn Posterior Cruciate Ligament (PCL)

Strong bands of tissue called "ligaments" help stabilize the bones that form the knee joint. One of these ligaments is called the "PCL." It helps connect the femur to the tibia. If you stretch or tear a PCl, your knee may become unstable.

Treatment Options

Knee braces, sometimes known as knee orthoses, are supports worn on the knees, typically to provide joint stability and correct maladjustments. Braces can be made of metals, fabric and plastic. Braces are part of a treatment program that should be administered by a licensed medical professional.

Knee braces are divided into categories depending on the type of support they provide: ligament, functional, adjustable range-of-motion, OA, post-op and soft supports.

To find out more about knee braces, go to Breg Knee Braces.

If you and your doctor have decided surgery is the best treatment for you, your options may include arthroscopic surgery to repair joint damage, partial knee replacement surgery to replace only the damaged portion of your knee, or total knee replacement surgery. To learn about more about these and other surgical procedures, view the videos, below.

ACL reconstruction

ACL Reconstruction (Patellar Tendon Graft Technique)

This procedure repairs your knee after a tear of the anterior cruciate ligament (commonly called the "ACL"). This ligament is in the center of the knee. It helps anchor the femur to the tibia. This surgery can allow you to regain normal knee function.
Fluid pumped into join

Arthroscopic Chondroplasty

This outpatient procedure is used to repair a small area of damaged cartilage in the knee. The damaged tissue is removed, allowing healthy cartilage to grow in its place. It is performed through small incisions on the sides of the knee with the aid of a small video camera called an arthroscope.
Healthy cells injected

Autologous Chondrocyte Transplantation

This surgical procedure replaces damaged cartilage in the knee joint with healthy cartilage cells. These cells are harvested from healthy portions of the knee and are grown in a lab for implantation. This procedure is usually performed in two stages, with two separate surgeries.
Cells implanted beneath patch

Cartilage Repair

This technique is designed to treat and repair cartilage defects by regenerating the patient's own hyaline cartilage, (a weight-bearing cartilage that lines the surface of the knee joint).
Patella sutures

Lateral Release and Medial Imbrication

This procedure is designed to loosen or tighten ligaments on either side of the patella (kneecap) to improve the movement of the patella in patients suffering from patellar tracking disorder. This procedure is usually performed arthroscopically through one or two small incisions near the patella.
meniscus transplant

Meniscal Transplant

This outpatient procedure is performed to replace lost or severely damaged meniscal cartilage in the knee joint. In a healthy knee, this cartilage is present in two c-shaped wedges called menisci. Each one is called a meniscus. These wedges help cushion and stabilize the knee. This procedure is performed under general anesthesia with the aid of a small camera, called an arthroscope, and miniature instruments.
meniscus repair

Meniscus Repair (Arthroscopic Technique)

Each of your knee joints is cushioned by two c-shaped wedges of cartilage. The two cushions in each knee are called the "menisci." Individually, each cushion is called a "meniscus." Certain motions, such as twisting the knee, can cause a meniscus to tear. In many cases, a torn meniscus can be treated with arthroscopic surgery.
Plastic implant

Partial Knee Replacement (using OXFORD® implant)

Unlike total knee replacement surgery, this less invasive procedure replaces only the damaged or arthritic parts of the knee. The OXFORD® unicompartmental knee uses metal and plastic implants designed to potentially last longer and wear down less easily than traditional implants.
Damaged meniscus removed

Partial Meniscectomy

The meniscus is a cushion of cartilage. There are two in each knee. If one of these shock absorbers is worn out or hurt, you may need a partial meniscectomy to remove the damaged areas.
patellofemoral

Patellofemoral Replacement

This surgical procedure removes portions of damaged cartilage on the femur in the knee joint that have been rubbing against the underside of the patella, causing pain and loss of mobility. This cartilage is then replaced with a specially-designed implant.
Surgical screws inserted

Posterior Cruciate Ligament (PCL) Reconstruction

This surgical procedure replaces a damaged posterior cruciate ligament (PCL). The PCL is a band of tissue that connects the femur to the tibia inside the knee.
Revision knee surgery

Revision Knee Surgery

This procedure replaces worn artificial knee parts and damaged bone with new metal and plastic components.
total knee replacement

Total Knee Replacement

This procedure restores function to a severely damaged knee. Most commonly, it is used to repair a knee that has been damaged by arthritis. During the procedure, the surgeon replaces the damaged portions of the knee with artificial parts. These parts consist of a metal femoral component, a metal tibial component and a plastic spacer. A small plastic patellar component may also be used.
Injection

Visco-supplementation for Arthritis of the Knee

This is an injection of medicine into the knee joint. It lubricates your knee so the bones can glide smoothly. It can help lessen the pain of arthritis.

Other non-surgical options to help manage knee problems and joint instability include cold therapy ranging from simple ice packs to motorized cold therapy (an insulated cooler with a pump and pads that deliver cold to specific joints), your doctor may suggest using cold therapy to reduce pain and swelling of an injured joint. All cold therapy, including ice, can be cold enough to damage your skin, so regardless of what kind of cold therapy you use, follow your doctor’s instructions.

Learn more about Cold Therapy

Exercises for Joint Rehabilitation: Your doctor may recommend exercises to help enhance your recovery. This may include exercises for stretching to gradually increase range of motion, strengthening to regain joint function and proprioception to help with balance and core stability.

Learn more about rehabilitation exercises