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Anatomy of Knee

Knee AnatomyThe knee is a joint made of four bones: the femur, tibia, fibula and patella. There are a series of muscles that also support the knee, including the quadriceps and hamstrings. finally, these are all joined together by a carefully woven set of ligaments, meniscus and tendons, with precious cartilage providing necessary cushioning for comfortable movement.

The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) are perhaps most critical for proper knee movement. The knee is also surrounded by fluid filled sacs called bursae that provide additional cushioning.

Knee pain should not be disruptive to activities and daily life. With the help of our experts there are a number of surgical and non-surgical options which may relieve you of your pain and disability.

The World Health Organisation (WHO) estimates that OA affects 9.6% of men and 18% of women older than 60 years of age (WHO Technical Report Series 2003). Increases in life expectancy and ageing populations are expected to make OA the fourth leading cause of disability by the year 2020 (Woolf et al 2003).

More than 1 million adults consult their GP each year with osteoarthritis (Royal College of General Practitioners – RCGP 2007) and it is the third most common diagnosis made by a general practitioner in older patients (McCormick et al 1995). It is estimated that 6 million people in the UK have painful osteoarthritis in one or both knees. Prevalence increases with age with 1 in 5 adults aged 50–59 to almost 1 in every 2 adults aged 80+ having painful osteoarthritis in one or both knees (Peat et al 2008). Before the age of 50, men have a higher prevalence and incidence of OA than women, presumably due to secondary changes due to trauma, while after the age of 50 women have a higher prevalence and incidence (Felson et al 1998).

More than 650,000 (12% of adults) in the UK have painful osteoarthritis in one or both hips, three quarters of whom are aged over 65 (Odding et al 1998). A further one and a half million have X-ray evidence of hip osteoarthritis (but may not have any symptoms) (Lanyon et al 2003).

There is a significant genetic component to the prevalence of knee OA, with heritability estimates from twin studies of between 39% and 65% independent of known environmental or demographic confounders (Spector et al 1996).

We regularly treat sports injuries of the knee including anterior cruciate and posterior cruciate ligament and meniscal tears and have extensive experience in meniscal and joint replacement surgery. Our specialist have worked with professional athletes to maintain and prolong their careers.

Like most injuries, the most important part of treatment is getting your knee injury correctly diagnosed.  We achieve this by conducting comprehensive examinations of the ligaments, cartilage, muscles and tendons in and around the knee joint. As part of our multi-disciplinary team, our specialists have access to MRI facilities and together with our specialist knee physiotherapists.

Throughout your diagnosis, treatment, and rehabilitation, dedicated team members will continue to work hard to ensure you can get back to enjoying life with the most comfort, mobility, and functionality possible.

Symptoms of Knee Injury

The location and severity of knee pain may vary, depending on the cause of the problem. Signs and symptoms that sometimes accompany knee pain include:

  • Pain
  • Swelling and stiffness
  • Redness and warmth to the touch
  • Weakness or instability
  • Popping or crunching noises
  • Inability to fully straighten the knee
  • Inability to weight bear on the knee

For patients suffering from knee pain, the first step to recovery is to receive a proper diagnosis so the cause of the symptoms can be determined.

If you feel you have a potential infection in the knee, urgent medical attention should be sought.

Causes of Knee Pain

There are a number of knee conditions which cause knee pain. It is important to make an accurate diagnosis of the cause of your symptoms so that appropriate treatment can be directed at the cause.

  • Meniscus Tear
    • Medial Meniscal Tear
    • Lateral Meniscal Tear
  • Anterior Cruciate Ligament (ACL) Injuries
  • Posterior Cruciate Ligament (PCL) Injuries
  • Knee Osteoarthritis
  • Patellofemoral OA
  • Rheumatoid Knee
  • Knee Psoriatic Arthritis
  • Arthritis of the Knee
  • Medial Collateral Ligament (MCL) Injuries
  • Lateral Collateral Ligament (LCL) Injuries
  • Patella Tendonitis (Jumper’s Knee)
  • Dislocated Knee/Patella
  • Iliotibial Band (ITB) Syndrome
  • Complex Regional Pain Syndrome (CRPS)
  • Osgood-Schlatter Disease
  • Patella Tendon Tear
  • Patellofemoral Pain Syndrome (PFPS)
  • Knee Instability
  • Patella Dislocation
  • Patella Instability
  • Quadriceps Tendon Tear
  • Shin Splints
  • Stress Fracture
  • Anterior Knee Pain
  • Pes Anserine (Knee Tendon)
  • Bursitis
  • Knee Bursitis
  • Prepatellar (Knee Cap) Bursitis
  • Osteonecrosis of the Knee
  • Osteochondritis Dissecans
  • Knee Sprain
  • Knee Tendonitis
  • Chondromalacia Patella
  • Plica Syndrome

With all knee conditions the most important part of treatment is getting your knee injury correctly diagnosed.  We achieve this by conducting comprehensive examinations of the ligaments, cartilage, muscles and tendons in and around the knee joint.

As part of our multi-disciplinary team, our specialists have access to MRI facilities and together with our specialist knee physiotherapists.

Investigation for Knee Pain and Injury

Like every joint evaluation, the start to a diagnosis is a consultation followed by a physical examination. Your specialist will inspect your knee for swelling, pain, tenderness, warmth and visible bruising. A visual assessment is followed by evaluation of the movement and specific orthopaedic tests to determine integrity.

After a provisional diagnosis is made by your specialist, it may be suggested you have the joint imaged by:

  • X-ray
  • MRI Scan
  • CT Scan
  • Ultrasound

If your specialist suspects an infection, gout or pseudogout, you’re likely to have blood tests and sometimes arthrocentesis, a procedure in which a small amount of fluid is removed from within your knee joint with a needle and sent to a laboratory for analysis.

Treatments for Knee Pain

Throughout your diagnosis, treatment, and rehabilitation, dedicated team members will continue to work hard to ensure you can get back to enjoying life with the most comfort, mobility, and functionality possible.

Healthplus Clinics has assembled a group of Knee Pain Specialists to provide complete surgical and non-surgical treatments. Our team of Knee Specialists includes: Knee Surgeons, Pain Specialists and specially trained Knee Physiotherapists.

Non-Surgical Knee Treatments and Procedures

  • Gait Analysis and Biomechanical Assessment
  • AposTherapy®
  • Shockwave Therapy
  • Knee Acupuncture
  • Orthotic Prescription
  • Specialist Knee Physiotherapy
  • Electrotherapy

Knee Pain Management Procedures

  • Knee Joint Injection
  • Geniculate Nerve Block
  • Geniculate Radiofrequency Neurotomy
  • Lumbar Sympathetic Block
  • Lumbar Dorsal Root Ganglion Pulsed Radiofrequency

Surgical Knee Treatments and Procedures

  • Knee Arthroscopy
  • Ligament Reconstruction (ACL and PCL)
  • Meniscal Cartilage Transplantation
  • Osteotomy Around the Knee
  • Partial Knee Replacement (Oxford Knee)
  • Custom Knee Replacement
  • Patello-Femoral Replacement
  • Total Knee Replacement (TKR)
  • Revision Knee Replacement
  • Unicompartment Knee Replacement
  • Plica Excision
  • Patella Tendon Repair
  • Lateral Knee Release
Complications of Knee Pain and Injury

The knee joint bears the weight our bodies as we run, jump, walk and go about our daily lives. Made up of delicate ligaments, cartilage and fluids, the knee is vulnerable to injury and chronic pain. Any imbalance or restriction in the function of the joint can cause pain. When the knee fails to function correctly, surrounding muscles, tendons and ligaments can become inflamed and painful. The effect is something of a vicious cycle. Dysfunction in the joint causes inflammation in the surrounding soft tissue which leads to more dysfunction in the joint.

Over half a million people receive Disability Living Allowance (DLA) as a result of arthritis (representing more than 18 per cent of all DLA claimants); that’s more than the total for heart disease, stroke, chest disease and cancer combined. It is the most common condition for which people receive DLA (Department for Work and Pensions 2008).

Most patients will not encounter problems after orthopaedic surgery. As with any surgery, however, there are potential risks, including: reaction to anesthesia, bleeding, infection, blood clots, nerve damage, lack of full range of motion, development of arthritis, scar formation, or re-injury of the joint or soft tissue.

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