The knee is made up of four main substances: bone, cartilage, tendons, and ligaments. These pieces hold your knee in place, absorb and mitigate impact stressors, and allow for flexibility. Most of the common knee ailments we see are a result of injury to one of those four pieces, usually from high-energy impact or turning suddenly. These are a few of the most common knee ailments we see here at Sideline Orthopedics.
When a patella (kneecap) is dislocated, the bone shifts out of place. If your knee appears deformed, is bent and cannot straighten, is “sloppy” (meaning you can move the kneecap too far to the right or left), or if you’re experiencing pain, tenderness, and swelling, the patella has probably been dislocated.
Not every dislocation requires surgery, although repeated dislocations usually call for reconstruction of the medial patellofemoral ligament. After one dislocation, you increase your chances of more in the future; wearing a patella stabilizing brace will help support the kneecap and help prevent it from slipping.
There are four ligaments that make up your knee: LCL, ACL, PCL, and MCL. You’ve most likely heard of the Anterior Cruciate Ligament (ACL), as it’s a common injury for athletes.
Each of these ligaments can be stretched and sprained, as well as torn. All ligament injuries are a result of too-fast or overextended movements, such as changing directions rapidly or landing from a jump incorrectly.
Sudden and severe pain, a loud “pop” or snap, swelling, and severely reduced mobility and use of the knee are all symptoms of a torn ligament. LCL, PCL, and MCL tears and sprains can be healed with rest, ice, compressing and stabilizing the knee with a sleeve or brace, and elevating the knee. You will also need to rehabilitate the knee with stretching and strengthening exercises only once your doctor determines it is safe for you to begin.
ACLs, however, cannot be repaired. A torn ACL will require surgical reconstruction, in which donor tendons are used to replace the torn ligament.
The meniscus is a rubbery, C-shaped disc that cushions your knee, and each knee has two: one on the outer edge and one on the inner edge. Twisting, cutting, pivoting, or being tackled can all cause a meniscal tear. Meniscal tears often coincide with ACL injuries as well; approximately 50% of ACL tears include a torn meniscus.
When the meniscus tears, most people will feel a popping sensation. Many people can still walk after tearing their meniscus, and often athletes will continue to play with a tear. After a few days, however, the knee will swell and stiffen. Limited motion, catching or clicking, pain along the joint line, and an inability to straighten your leg are all symptoms of a tear.
The type of tear determines the treatment. Oftentimes, your doctor might advise a conservative treatment of rest, ice, and Nonsteroidal anti-inflammatory drugs to reduce pain and swelling. If there is no improvement, or if you wish to return to activity as soon as possible, surgery may be necessary.
The patella is the most common knee bone to suffer a break or fracture. Most breaks occur from high-energy impact trauma, like a vehicle collision or a fall. Pain and swelling at the front of the knee are the two main symptoms of a broken patella. Bruising, and the knee being unable to straighten or bear weight also point to a fracture.
If the broken bones have not been displaced by the force of the injury, you most likely will not need surgery. A splint or knee-immobilizing brace will keep your knee straight while it heals. Once healed, you can begin to rehabilitate your knee with strength building and flexibility exercises.
If the patella was displaced, you will probably need surgery. The bone will be secured with tiny screws to keep the parts in place. Once healed, you can begin to rehabilitate your knee.
Osteoarthritis can affect any of the joints in your body, and your knees are no exception. Also known as “wear-and-tear” arthritis, osteoarthritis occurs when the cartilage in your joints wears away. Cartilage serves as a shock absorber, and without it, the bones will rub against one another and cause pain, swelling, stiffness, and sometimes the formation of bone spurs.
Medication, physical therapy, and walking supports are the first steps to helping treat osteoarthritis of the knee. If those conservative methods don’t work, full or partial knee replacement surgery is the next option.
Dr. Velyvis is a Board Certified Orthopedic Surgeon specializing in robotic knee replacement procedures. He is the only orthopedic surgeon in Southwest Virginia certified in robotic-assisted knee replacement, and he has performed over 2000 robotic-assisted surgeries throughout his career. We’re thrilled to be able to offer our patients this state-of-the-art technology, and Dr. Velyvis’ expertise.
If you experience a knee injury, our walk-in clinic is open during select hours Monday through Friday. You can also make an appointment at one of our three offices. We are happy to help you return to full mobility and get back in the game!