Knee pain is a common complaint that affects people of all ages.The most common causes of knee pain are related to aging, injury or overuse or repeated stress on the knee.
Anatomy overview of the knee
Knee is largest joint of your body. The knee is a vulnerable joint that bears a great deal of stress from everyday activities, such as lifting and kneeling, and from high-impact activities, such as jogging and aerobics.
The knee is formed by the following structures:
Tibia- This is the shin bone or largest bone of the your body.
Femur- This is the thighbone.
Patella- This is the kneecap.
Cartilage- Each bone end is covered with a layer of cartilage that absorbs shock and protects the knee.
Ligaments- Ligaments are elastic bands of tissue that connect bone to bone. Some ligaments on the knee provide stability and protection of the joints, while other ligaments limit forward and backward movement of the tibia (shin bone).there are two types of ligaments in your knee
- Cruciate ligaments- These ligaments found inside of your knee. These are anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL)
- Collateral ligaments- These are found on the sides of your knee. One is on the inside (MCL) and one is on the outside (LCL).
Meniscus- These are two wedge-shaped structures that act as shock absorbers between your shinbone and thighbone. The medial meniscus is on the inner side of the knee joint.
The lateral meniscus is on the outer side of the knee. The meniscus helps to cushion and stabilise the joint, which is why they are tough and rubbery. When people say they have locking and popping in the knee, they are usually talking about torn meniscus.
Basically, the knee has 2 long leg bones held together by muscles, ligaments, and tendons.
There are 2 groups of muscles involved in the knee, including the quadriceps muscles or extensor muscles (located on the front of the thighs), which straighten the legs, and the hamstring muscles or flexor muscles (located on the back of the thighs), which bend the leg at the knee.
Tendons- Tendons are tough cords of tissue that connect muscles to bones.most important tendon around knee joint are quadriceps tendon and patellar tendon.
What you feel (symptoms)
The location and severity of knee pain may vary, depending on the cause of the problem. Symptoms that sometimes accompany knee pain include:
- Swelling and stiffness (tightness) or heaviness
- Redness and warmth to the touch
- Not able to bear weight
- Weakness or instability
- Popping or crunching noises
- Inability to fully straighten the knee
- Locking of knee joint
Many types of minor knee pain respond well to self-care measures but what are alarming symptoms and sign
- When you have marked knee swelling
- When you are unable to fully extend or flex your knee
- When you see an obvious deformity in your leg or knee
- When you have a fever, in addition to redness, pain and swelling and increase local temperature of your knee
- When you have severe knee pain that is associated with an injury
- When you not able to bear weight on your knee or feel as if your knee is unstable (gives out)
Causes of knee pain
Knee pain may be the result of an injury, such as a ruptured ligament or torn cartilage. Or may be due to a medical conditions — rheumatoid arthritis, gout and infections or due to chronic (aging) or any overuse activities like osteoarthritis, bursitis.
Injuries (Trauma)
A knee injury can affect any structure of knee like ligaments, tendons or fluid-filled sacs (bursa) that surround your knee joint as well as the bones, cartilage and ligaments that form the joint itself. Some of the more common knee injuries include:
Fracture around knee joint- Most common injuries around knee joint is fracture of any bones of knee joint either single bone or all three bones. All fractures need immediate medical attention. Fractures occur due do RTA ( Road traffic accident) or falls. When fracture lines go in to your knee joint then it is known as intraarticular fractures.intraarticular fracture should be treated by experienced knee surgeon because if not treated perfectly it will cause very early osteoarthritis of knee joint. In osteoporosis (weaken bones) fractures can occur due to trial injuries like slip or wrong step.
Dislocation- The knee joint can be dislocated, which is a medical emergency that requires immediate attention. Knee dislocation can compromise blood flow to the leg and have other related problems. This injury often occurs during a motor-vehicle accident when the knee hits the dashboard.
ACL injury- An ACL tear is most common ligament injury of knee joint. An ACL injury is a tear of the anterior cruciate ligament (ACL). An ACL injury is particularly common in people who play basketball, soccer or other sports that require sudden changes in direction.
Meniscus tear– It can be easily torn if you suddenly twist your knee while bearing weight on it like in dancing or motor bile slip or during playing
Other ligaments injuries- PCL tear can occur either as an isolated PCL tear or more commonly with other ligament tear either with MCL or LCL or with ACL multiligaments injuries are also not very uncommon.
Tendon tear- Quadriceps tendon tear also a common injury and may occur due to sudden quadriceps contractions. Patellar tendon tear can also occur as an isolated tendon tear or may be combined with ligaments or meniscus tear.
Medical conditions
Rheumatoid arthritis- The most debilitating form of arthritis, rheumatoid arthritis is an autoimmune condition that can affect almost any joint in your body, including your knees. Although rheumatoid arthritis is a chronic disease, it tends to vary in severity and may even come and go.It can cause severe pain and disability, as well as swelling.
Gout- This type of arthritis occurs when uric acid crystals build up in the joint. While gout most commonly affects the big toe, it can also occur in the knee. Gout tends to flare up and is extremely painful during the acute episodes. When there is no flare-up, the knee can be pain free.
Pseudogout- Often mistaken for gout, pseudogout is caused by calcium-containing crystals that develop in the joint fluid. Knees are the most common joint affected by pseudogout.
Septic arthritis- Sometimes your knee joint can become infected, leading to swelling, pain and redness. Septic arthritis often occurs with a fever, and there’s usually no trauma before the onset of pain. Septic arthritis can quickly cause extensive damage to the knee cartilage. If you have knee pain with any of these symptoms, see your doctor right away. Septic arthritis is an emergency.
Overuse or other common chronic conditions
Osteoathritis (OA)- Most common cause of knee pain is osteoarthritis and most common form of arthritis which occurs due to aging and degeneration of cartilage in knee joint. When we talk about pain in old age knee is mostly due to osteoarthritis. After age of 50 yrs your knee wear and tear increase so you feel pain while standing from sitting or stairs up or down and this pain increase with age due to increase cartilage damage of knee joint. This age related osteoarthritis is most common cause of TKR (total knee replacement) or Partial knee replacement (Unicondylar knee replacement surgery)
Loose body- Sometimes a traumatic injury or degeneration of bone or cartilage (OCD) can cause a piece of bone or cartilage to break off and float in your knee joint space. This may not create any problems and you can feel or catch it when it is float in supra patellar pouch, when loose body interferes with knee joint movement, then it cause locking of knee joint or if left untreated it may cause cartilage damage and progression to osteoarthritis of knee.
Iliotibial band friction syndrome- This occurs when your iliotibial band (tough band of tissue that extends from the outside of your hip to the outside of your knee) so tight that it rubs against the outer portion of your distal femer at knee joint. ITB syndrome can cause catching and pain on outer aspect of you knee which may be unbearable. Overuse activity like cycling and running can cause iliotibial band syndrome.
Recurrent dislocation patella (dislocation of knee cap)- When your knee cap (patella) that covers the front of your knee slips out of place, usually to the outside of your knee is known as recurrent dislocation patella. In some cases, the your kneecap may displace outside of knee in every bending of knee joint and you’ll be able to see the dislocation then it is known as habitual dislocation of patella. In recurrent dislocation of patella causes may be traumatic rupture of MPFL (medial patellofemoral ligament) or due to some other non traumatic like valgus knee and or increase TT-TG distance which increase the Q angle of patellar tendon.
Hip or foot pain- If you have pain in your hip of lower leg, you may change the way you walk to spare these painful joints. So it altered your normal gait pattern and can place more stress on your knee joint and make your knee painful.
Chondromalacia patellae- It is a condition which can cause anterior knee pain in your knee. In this condition your knee cap cartilage become soft and when pressure increases on knee cap it hurt your knee like in standing from sitting position or in stair ups and down or when you lift your leg straight without knee bending. It is very common resion of knee pain in young adult
Bursitis around knee- Some knee injuries cause inflammation in the bursae, but mostly it is due to overused or repetitive activities. brush is the small sacs of fluid that cushion the outside of your knee joint so that tendons and ligaments glide smoothly over the joint. It can be pre patellar bursitis or pes anserinus bursitis.
Patellar and quadriceps tendinitis- Tendinitis is irritation and inflammation of one or more tendons. Runners, cyclists, and those involved in jumping sports and activities may develop inflammation in the patellar tendon and or quadriceps tendon.
Why Dr. Anil Sharma for knee injuries
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Dr. Anil Sharma is best orthopedic doctor in Jaipur and he has vast experienced of fracture and trauma cases also as he worked in SMS hospital for many years. So if your your knee is painful and you are searching best knee joint surgeon in Jaipur then Dr. Anil Sharma is best doctor for you.
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