The knee is a complex joint and a critical component in your mobility. When the knee doesn’t work correctly because of injury or disease, it can cause persistent pain and disability that can have a significant impact on your quality of life overall. Knee pain is a common complaint we hear at the Orthopaedic Institute of Ohio, from patients of all ages. Fortunately, there are many approaches to address knee pain, from conservative treatments like rest and ice to surgical correction. Our team will evaluate your situation, provide a comprehensive diagnosis and recommend the best treatment options for you.
At the Orthopaedic Institute of Ohio, we see patients with a variety of knee concerns:
The anterior cruciate ligament (ACL) extends from the shinbone to the thighbone. Though it is the smallest of the four main ligaments in the knee, it plays the most important role in maintaining the stability of the joint. When the ACL is torn or sprained, the knee becomes unstable and painful, and other structures in the knee are at higher risk of damage. These injuries often occur during sports or activities that require quick direction changes, such as basketball or soccer.
Two types of cartilage are found in the knee. One type (articular) covers the ends of the bones and allows them to glide over each other. The other type (Meniscus) provides shock absorption during movement. Cartilage can become damaged as a result of a sudden injury or gradual wear and tear, leading to decreased mobility, swelling, stiffness and persistent pain in many cases. Within the knee, a common type of cartilage injury is a meniscus tear. Minor cartilage injuries may improve on their own within a few weeks, but more extensive cartilage damage may require surgical intervention.
Tendons connect muscles to bone. Like cartilage, the patellar tendon and the quadriceps tendon in the knee can become damaged over time or due to injury. Tendonitis occurs when tendons become inflamed and painful. Tears can also occur, often in older adults who lead active lifestyles because tendons become more prone to injury over time. Small tears can make it difficult to walk and participate in other daily activities. This can usually be effectively treated with physical therapy. A large tear can be a disabling injury that often requires surgery and physical therapy to restore full knee function.
Ligaments connect bone to bone, stabilizing the knee joint. The ACL is not the only ligament in the knee that can suffer damage. The knee also contains three other ligaments — the lateral collateral ligament, the medial collateral ligament and the posterior cruciate ligament — that can tear due to sports injuries, falls or other trauma. Ligaments can also be injured through repeated stress, which causes them to lose their normal elasticity. Ligament injuries can be quite painful but can often heal without surgical intervention.
When fluid-filled sacs that cushion the knee become inflamed, pain and reduced mobility can result. These sacs are known as bursae, and the inflammation is called bursitis. Bursitis in the knee may be caused by tight hamstring muscles, insufficient stretching before exercise, arthritis, being overweight, arthritis, out-turning of the knee or lower leg. It is also common in people who kneel for long periods for work or hobbies, such as plumbers or gardeners. Bursitis is usually treated through nonsurgical methods.
A dislocation injury occurs when the bones in the knee shift out of place but are not fractured. The patella (kneecap), femur (thighbone) or tibia (shinbone) can be forced out of alignment by high-energy trauma, such as a motor vehicle crash, sports-related contact or a fall. Dislocations can also be caused by congenital abnormalities in the structure of the knee. This uncomfortable condition can often be addressed with bracing or physical therapy, although repeated dislocations may require surgical realignment.
The kneecap (patella) can be fractured, often by a direct blow. A kneecap fracture can be full or partial, and may break the bone into a few or many pieces. Sometimes, when the patella is fractured, the tendons or ligaments attached to it are sprained or torn. Fractures are most likely to occur during a motor vehicle accident or another event that places force on the front of the knee. These injuries usually require surgery to put the patella back in place and immobilization to allow the bone to heal.
Pain and swelling are the most common signs of damage to the knee. You may also notice that the joint is “catching” or “locking up” when you move. Many knee injuries cause the joint to become unstable, which creates the feeling that your knee is giving way. If your knee looks misaligned or deformed after a particularly forceful impact, don’t delay seeking medical advice. Immediate medical attention is also recommended if your knee injury is accompanied by sudden swelling, intense pain or an inability to bear weight. If you’ve had minor knee pain for a long time, make an appointment with an orthopaedic specialist if the pain is interfering with your ability to sleep or perform daily tasks.
Effective treatment begins with an accurate diagnosis of the problem. When you visit the Orthopaedic Institute of Ohio with a knee condition or injury, a physician will perform a physical examination and talk to you about the symptoms you are experiencing. If necessary, your physician will order tests to confirm the diagnosis. Our onsite diagnostic services include CT scans, MRI exams, radiology and arthroscopic examinations. Treatment for knee pain depends on the cause of the pain and its severity, your age, your activity level and your general health.
Because many injuries can occur to the knee, we offer numerous treatment options that can be undertaken alone or in combination. In most cases, conservative treatment is recommended first, and if it does not produce the desired relief, surgery may be advised. Nonsurgical treatments at the Orthopaedic Institute of Ohio might include:
Pain relievers and steroid injections can be used to manage knee discomfort and may help you delay or avoid surgery. These treatment options work by reducing inflammation in the joint, which also alleviates pain so you can move and sleep without discomfort. Although the relief tends to be temporary, it can be the right amount of treatment while the joint heals.
A brace or cast may be placed over the knee to support the joint and restrict mobility, allowing full healing to take place without interruption. This approach is commonly recommended after a fracture and may also be used for other types of knee injuries. Crutches may be provided to prevent weight from being placed on the joint as it heals.
Specific exercises performed under the guidance of a licensed therapist can promote healing of an injured knee while helping you regain strength and range of motion in the joint. Physical therapy may be prescribed as part of a rehabilitation plan after surgery or it may be recommended in place of surgery to restore mobility to the knee without an operation.
While knee surgery is considered a last resort, it may be the only treatment that can provide optimal results for advanced damage to the joint. Our surgeons perform a variety of surgical procedures on the knee, depending on the type and severity of the injury:
This surgical procedure is a less invasive method of identifying and treating joint conditions. Using a lighted scope inserted through a small incision, our surgeon can view the area inside the knee on a video monitor to make a diagnosis. Minor corrections can also be done arthroscopically using miniature surgical instruments. Arthroscopy involves less pain, faster healing and minimal scarring compared to the extensive incisions and lengthy recovery of traditional surgery.
Minor ACL injuries may heal with rest and rehabilitation. In the event of a complete ACL tear, allowing the ligament to heal on its own may result in recurrent instability in the joint. Surgery may be necessary to repair severe damage and restore a maximum level of function to the knee. During ACL reconstruction, the torn ligament is removed and replaced with other tissue, typically from the same knee. Rehabilitation is usually needed after surgery to restore strength and function to the joint. ACL reconstruction is often the best option for younger and highly active patients.
The knee joint consists of multiple parts, or “compartments.” Unicondylar knee replacement, also known as a partial or unicompartmental knee replacement, is an alternative to total knee replacement for patients with damage that is confined to only one compartment of the knee joint. In most cases, this technique means smaller incisions can be used and more healthy, normal tissue is left behind. Unicondylar knee replacement reduces postoperative pain, risk and recovery time.
Total knee replacement surgery is highly effective in relieving knee pain and restoring mobility to the joint. Knee implants consist of a metal femoral component that attaches to the femur, a tibial component that connects to the end of the tibia and a plastic spacer that sits between the bone components. Within that basic structure, there are a variety of different implants that your surgeon can choose from to customize the procedure for your needs. Total knee replacement is more commonly performed than partial knee replacement to ensure the best possible result. At OIO we offer a variety of total knee replacement surgeries in including robotic assisted total knee.
Chronic knee pain can keep you from enjoying your life to the fullest. Don’t suffer any longer. Contact the Orthopaedic Institute of Ohio in Lima today at (419) 222-6622 to find out how we can help.