How is the knee joint structure?

The knee joint is one of the most complex joints in the body. It consists of bones, ligaments, and muscles. The knee is made up of the femur (thigh bone), the tibia (shin bone), and patella (kneecap). The meniscus, a soft cartilage between the femur and tibia, serves to cushion the knee and helps it absorb shock during motion.

The stability and strength of the knee joint is maintained by four ligaments: the medial collateral ligament, lateral collateral ligament, anterior cruciate ligament, and posterior cruciate ligament.

When any of these structures are injured you may have knee pain and difficulty in walking. You may hear a popping or snapping sensation at the time of the injury or you may feel like your knee is giving way. You may also have swelling, limping, and inability to move the knee. If care is not taken during the initial phases of injury it may lead to joint damage that may end up destroying your knee.

What are the common causes of knee injury?

Common causes of knee injury are

• Fracture of femur (thigh bone), tibia and fibula (leg bones)
• Torn ligament (either anterior or posterior cruciate ligament)
• Rupture of blood vessels following a trauma that leads to accumulation of extra fluid or blood in the joint
• Dislocation of knee cap (patella)
• Torn quadriceps or hamstring muscles
• Patellar tendon tear

Arthritis is the most common cause of knee pain. Arthritis literally means inflammation of a joint, but is generally used to describe any condition in which there is damage to the cartilage. Osteoarthritis is also called as degenerative joint disease; this is the most common type of arthritis, which occurs often in older people. This disease affects cartilage, the tissue that cushions and protects the ends of bones in a joint. With osteoarthritis, the cartilage starts to wear away over time. In extreme cases, the cartilage can completely wear away, leaving nothing to protect the bones in a joint, causing bone-on-bone contact. Bones may also bulge, or stick out at the end of a joint, called a bone spur.

What is the diagnosis for knee pain?

For proper diagnosis and treatment plan, your doctor will ask about your symptoms and history of any injury and then perform a physical examination of your knee. Several tests are performed to evaluate the ligaments of the knee. Your doctor may also order other tests such as MRI, CT scan, and X-ray to help diagnose more complicated or severe injuries.

Know your options for knee pain treatment

Immediately following a knee injury and before being evaluated by a medical doctor, you should initiate the R.I.C.E. method of treatment:

• Rest: Rest the knee, as more damage could result from putting pressure on the injury.
• Ice: Ice packs applied to the injury will help diminish swelling and pain.  Ice should be applied over a towel to the affected area for 15-20 minutes four times a day for several days.  Never place ice directly over the skin.
• Compression: Wrapping the knee with an elastic bandage or compression stocking can help to minimize the swelling and support your knee.
• Elevation: Elevating the knee above heart level will also help with swelling and pain. 

Conservative Treatment Options

Initial treatment for arthritis is conservative, consisting of rest, avoidance of vigorous weight bearing activities, and the use of non-narcotic analgesic and/or anti-inflammatory medications. With worsening symptoms, a cane or a brace may be helpful. For more severe symptoms, an injection of cortisone into the joint is frequently advised and can be quite helpful. When conservative measures have been exhausted, and are no longer helpful, and the arthritis has become disabling, surgery may be recommended.

Total knee replacement

Total knee replacement is considered a treatment option if your knee pain cannot be managed any longer by conservative treatment. Total knee replacement is a surgical procedure in which the worn, damaged surfaces of the knee joint are removed and replaced with new artificial parts. If you find difficulty in performing simple activities such as walking or climbing stairs because of your severe arthritic knee pain, then total knee joint replacement may be considered. It is a safe and effective procedure to relieve pain, correct leg deformity, and help you resume normal activities.