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Knee Ligament Injuries

The knee is a hinge joint made up of two bones, the thighbone (femur) and shinbone (tibia). Ligaments are tough bands of tissue that connect one bone to another bone. The ligaments of the knee stabilize the knee joint. There are two important groups of ligaments that hold the bones of the knee joint together, collateral and cruciate ligaments - medial collateral ligament (MCL) and lateral collateral ligament (LCL), and anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL).

Knee Arthritis

The joint surface is covered by a smooth articular surface that allows pain-free movement in the joint. Arthritis is a general term covering numerous conditions where the joint surface or cartilage wears out. This surface can wear out for several reasons; often the definite cause is not known. Arthritis often affects the knee joint. When the articular cartilage wears out, the bone ends rub on one another and cause pain. The most common type of arthritis is osteoarthritis. It occurs with aging and use.

Knee Fracture

A fracture is a condition in which there is a break in the continuity of the bone. In younger individuals, these fractures are caused by high energy injuries, as from a motor vehicle accident. In older people, the most common cause is a weak and fragile bone.

Treatment options include non-surgical and surgical. Non-surgical treatment involves skeletal traction and use of casts and braces. Skeletal traction involves placement of pin into the bone in order to realign broken bones. Surgery involves internal fixation and external fixation.

Patellar Instability

Any damage to the supporting ligaments may cause the patella to slip out of the groove either partially (subluxation) or completely (dislocation). This misalignment can damage the underlying soft structures such as muscles and ligaments that hold the kneecap in place. Once damaged, these soft structures are unable to keep the patella (kneecap) in position. Repeated subluxation or dislocation makes the knee unstable. This condition is called knee instability. Patellar (kneecap) instability results from one or more complete or partial dislocations (subluxations).

Jumper’s Knee

Jumper’s knee, also known as patellar tendinitis, is inflammation of the patellar tendon that connects your kneecap (patella) to your shinbone. This tendon helps in the extension of the lower leg.

Jumper’s knee usually results from repetitive trauma or overuse, particularly from sports activities that involve jumping such as basketball or volleyball. Therefore, this condition is known as jumper’s knee. Rarely, this condition may also occur because of an acute injury to the tendon that has not healed properly.

Medial Patellofemoral Ligament (MPFL) Tears

The medial patellofemoral ligament (MPFL) is a ligament that joins the kneecap (patella) to the thighbone (femur). Ligaments are fibrous connective tissue that attach bones to other bones. The MPFLis attached to the inside of the patella and helps stabilize it and position it in a groove at the lower end of the femur called the trochlea. Trauma or a blow to the knee may cause a tear in the ligament.

Knee Pain

Knee pain is a common condition affecting individuals of various age groups. It not only affects movement but also impacts your quality of life. An injury or disease of the knee joint or any structure surrounding the knee can result in knee pain. A precise diagnosis of the underlying cause is important to develop an appropriate treatment plan.

Unstable Knee

Damage to any of these supportive structures causes instability of the knee joint. An unstable knee can be caused by the sudden twisting of the knee, tears of the meniscus, ligament or capsule, osteoarthritis of the knee (wear and tear of the cushioning cartilage tissue between the bones) and sports injuries. When these tissues get injured, the patella or kneecap can move out of its groove in the knee joint and lead to instability.

Patellar Dislocation/Patellofemoral Dislocation

Patellar dislocation occurs when the patella moves out of the patellofemoral groove, (trochlea) onto the bony head of the femur. If the kneecap partially comes out of the groove, it is called subluxation; if the kneecap completely comes out, it is called dislocation (luxation).

Patella dislocation is commonly observed in young athletes between 15 and 20 years and commonly affects women because the wider pelvis creates a lateral pull on the patella.

Chondral or Articular Cartilage Defects

The articular or hyaline cartilage is the tissue lining the surface of the two bones in the knee joint. Cartilage helps the bones move smoothly against each other and can withstand the weight of your body during activities such as running and jumping. Articular cartilage does not have a direct blood supply to it, so has less capacity to repair itself. Once the cartilage is torn it will not heal easily and can lead to degeneration of the articular surface, leading to the development of osteoarthritis.

Quadriceps Tendon Rupture

The quadriceps can rupture after a fall, direct blow to the leg and when you land on your leg awkwardly from a jump. Quadriceps tendon rupture most commonly occurs in middle-aged people who participate in sports that involve jumping and running. Other causes include tendonitis (inflammation of quadriceps tendon), diseases such as rheumatoid arthritis, diabetes mellitus, infection and chronic renal failure, which weaken the quadriceps tendon. Use of medications such as steroids and some antibiotics also weakens the quadriceps tendon.

Patellar Tendon Rupture

The patellar tendon works together with the quadriceps muscle and the quadriceps tendon to allow your knee to straighten out. Patella tendon rupture is the rupture of the tendon that connects the patella (kneecap) to the top portion of the tibia (shinbone).

A patellar tendon tear most commonly occurs in middle-aged people who participate in sports that involve jumping and running. It can rupture due to a fall, direct blow to the knee or landing on your foot awkwardly from a jump. The other causes may include patellar tendonitis (inflammation of patellar tendon), diseases such as rheumatoid arthritis, diabetes mellitus, infection, and chronic renal failure.

Lateral Meniscus Syndrome

Lateral meniscus syndrome is characterized by an injury caused by the tearing of the cartilage tissue or a rare case of a congenital abnormality called a discoid meniscus, which results in knee pain.

Lateral meniscus syndrome often occurs due to excessive weight-bearing and twisting motions to the knee. This occurs usually due to sports activities such as football, basketball and snow skiing, which require a lot of changes in directions and twisting movements. It can also occur due to the gradual wear and tear of tissues that occurs over time.

Knee Angular Deformities

Angular deformities of the knee are variations in the normal growth pattern during early childhood and are common during childhood.The condition usually becomes more evident when your child is 2 to 3 years old and normally corrects itself by 7 or 8 years. However, if the condition is not corrected, it could be a sign of an underlying problem that requires treatment.

The diagnosis of bow legs or knock knees is made through a physical examination. In addition, X-rays may be ordered if your child is older than 2 ½ years and has symmetrical legs.

Osteochondral Defect of the Knee

An osteochondral defect, also commonly known as osteochondritis dissecans, of the knee refers to a damage or injury to the smooth articular cartilage surrounding the knee joint and the bone underneath the cartilage. The degree of damage may range from a rupture of the cartilage to a slight crack of the bone to a piece of the bone breaking off within the joint. These pieces may vary in size and depth and may remain stable or unstable within the joint. These may occur from an acute traumatic injury to the knee or an underlying disorder of the bone. Osteochondral defect is more common among young athletes who actively take part in sports and most commonly affects the femoral condyles in the knee.

Knee Dislocation

Knee dislocation is a condition that occurs when the bones that form the knee joint, namely the femur or thigh bone get separated from the shin bone. This can cause serious damage to the nerves, blood vessels, and ligaments surrounding the knee, leading to a decline in strength and overall health of the leg.

Dislocation of the knee is rare. When it does occur, it is usually caused due to high impact injuries from automobile accidents, severe falls, or sports.

Patellar Tracking Disorder/Patellar Maltracking

Patellar tracking disorder, also known as patellar maltracking, is a condition in which the kneecap (patella) moves sideways from its groove when the leg is bent or straightened.

Diagnosis of patellar tracking disorder is difficult as the symptoms may be similar to many other conditions.

Loose Bodies in the Knee

Loose bodies are fragments of detached cartilage or bone inside the knee joint. These fragments may be free floating (unstable) or may be trapped (stable) within the joint. Depending on the severity, you may have one or more loose bodies in your knee joint.

It is important to treat the condition early to prevent cartilage damage. In less severe cases, non-surgical options such as physical therapy and anti-inflammatory pain medications may help to keep your knee joint flexible. However, in most cases, surgical removal of the loose bodies is required.

Patellar Tendinitis

Patellar tendinitis, also known as "jumper's knee", is an inflammation of the patellar tendon that connects your kneecap (patella) to your shinbone. This tendon helps in extension of the lower leg.

Patellar tendinitis usually results from repetitive trauma or overuse, particularly from sports activities involving jumping such as basketball or volleyball. Therefore, this condition is also known as jumper’s knee. Rarely, this condition may also occur because of an acute injury to the tendon that has not healed properly.

Anterior Knee Pain

Anterior knee pain is characterized by chronic pain over the front and center of the knee joint. It is common in athletes, active adolescents (especially girls) and overweight individuals. Anterior knee pain refers to various conditions, which include runner's knee or patellar tendinitis, and chondromalacia of the patella. There is an inter-individual variation in the duration and presentation of pain.

Runner's Knee

Patellofemoral pain syndrome also called runner’s knee refers to pain under and around your kneecap. Patellofemoral pain is associated with a number of medical conditions such as anterior knee pain syndrome, patellofemoral malalignment, and chondromalacia patella. Patellofemoral pain is a common complaint among runners, jumpers, and other athletes such as skiers, cyclists, and soccer players; thus the common name, runner’s knee.

Osgood-Schlatter Disease

Osgood-Schlatter disease refers to an overuse injury that occurs in the knee of growing children and adolescents. This is caused by inflammation of the tendon located below the kneecap (patellar tendon). Children and adolescents who participate in sports such as soccer, gymnastics, basketball, and distance running are at a higher risk of this disease.