The knee is a very mobile joint with a complex interplay of three bone with strong muscles and ligaments. In the young patient the knee presents usually with pain and or instability. The instability can affect the patellofemoral joint or the tibiofemoral joint. The Anterior Cruciate Ligament is the most commonly injured ligament of them all. It commonly leads to instability that requires surgical reconstruction. The pain can come from articular cartilage damage, meniscal injury or ligament injury or tendinopathy.
In the middle age to elderly the knee often wears out leading to pain and stiffness. This is initially managed with a variety of non-operative modalities but when these fail there are surgical solutions.
Meniscal Injury most common indication for knee surgery.
Higher risk in ACL deficient knees.
A condition characterized by a local collection of synovial fluid within or adjacent to the meniscus.
Abnormal development of the meniscus leads to a hypertrophic and discoid shaped meniscus.
Discoid meniscus is larger than usual.
Also referred to as "popping knee syndrome".
Rupture to the Anterior Cruciate Ligament. Often causes ongoing instabilty and swelling in the knee.
Ruptures to the Posterior Cruciate ligament may be isolated or combined and often go undiagnosed in the acutely injured knee.
MCL Knee Injuries
The medial collateral ligament is both a primary and secondary valgus stabilizer of the knee. It is the most commonly injured ligament around the knee.
LCL Injury of the Knee
Injury to the Lateral Collateral Ligament (LCL) also referred to as fibular collateral ligament isolated injury extremely rare. 7-16% of all knee ligament injuries when combined with lateral ligamentous complex injuries particularly posterolateral corner (PLC) injury.
Posterolateral Corner Injury
Approximately 7-16% knee ligament injuries are to the lateral ligamentous complex.
Isolated injuries to PLC are rare PLC structures.
LCL (most anterior structure inserting on the fibular head),popliteus tendon, popliteofibular ligament, lateral capsule, arcuate ligament (variable), fabellofibular ligament (variable).
Biceps femoris (inserts on the posterior aspect of the fibula posterior to LCL), popliteus muscle, iliotibial tract.
Lateral head of the gastrocnemius.
Proximal Tib-Fib Dislocation
Often a missed diagnosis. The proximal fibula articulates with a facet of the lateral cortex of the tibia, distinct from the articulation of the knee.
Activity-related anterior knee pain associated with focal patellar-tendon tenderness. Also known as "jumper's knee".
Inflammation of the suprapatellar tendon of the quadriceps muscle.
Inflammation of the semitendinosis tendon. Predominately affects athletic males in early thirties.
(Housemaid's Knee) Swelling and inflammation of the anterior knee. The most common bursitis around the knee.
Iliotibial Band Friction Syndrome
A condition characterized by excessive friction between the iliotibial band and the lateral femoral condyle.
Can be classified into the following;
Lateral Patellar Compression Syndrome
Improper tracking of patella in trochlear groove. Caused by tight lateral retinaculum.
Idiopathic Chondromalacia Patellae
Condition characterized by idiopathic articular changes of the patella term is now falling out of favor
Quadriceps Tendon Rupture
Rupture of the quadriceps tendon leading to disruption in the extensor mechanism.
Patella Tendon Rupture
Disruption of the tendon attaching the patella to the tibial tubercle (the patella is a sesamoid bone making this a tendon, not a ligament.
Articular Cartilage Defects of Knee
Spectrum of disease entities from single, focal defects to advanced degenerative disease of articular (hyaline) cartilage.
Osteonecrosis of the Knee
Two distinct entities including;
Cartilage degeneration of the knee. It can affect the patellofemoral joint (PFJ) and/or the tibiofibular joint. It manifests itself as stiffness and pain.
A pathologic lesion affecting articular cartilage and subchondral bone with variable clinical patterns.
Osgood Schlatter's Disease
(Tibial Tubercle Apophysitis) Osteochondrosis or traction apophysitis of tibial tubercle.
Overuse injury causing anterior knee pain at the inferior pole of patella.
Also known as Jumper's Knee.