Knee conditions

Ligamentous sprain or tear

Ligamentous sprain or tear from either the collateral or cruciate ligaments. The collateral ligaments are at the sides of the knee, the lateral collateral being on the outside of the knee, and the medial collateral being on the inside of the knee joint. They give the joint stability from side-shifting and rotating. Medial collateral ligament sprains are usually caused by a sideways impact, and because of the anatomy of the knee joint, the impact forces the medial side of the knee to 'gap' and so sprain the ligament e.g. in a football tackle.

Also, skiing often results in a medial collateral injury.

The cruciate ligaments cross over inside the knee joint and stabilise the knee from forward and backward motion.

Anterior cruciate ligament tears or ruptures occur commonly in sports such as football, as a result of a tackle, or from suddenly changing direction. The injury occurs when the foot is on the ground, and the knee rotates.

Typical collateral ligament injury is from skiing.

As with any tears, pain and swelling will result. Complete rupture may require surgery.

Meniscal tears - (tearing of cartilage)

Commonly the result of a strain or a twisting injury. It often occurs with other injuries to the knee e.g. with sprained ligaments. The knee 'locks' when a piece of the torn cartilage jams up in the knee joint. There may be immediate pain and swelling, or the swelling may occur several hours later.

Baker''s cyst

it is always due to an underlying problem with the knee with long- term synovial effusion ie an irritant produces more fluid in the knee joint than normal. A meniscal tear, (torn cartilage), may precipitate this condition. It is often also found in runners, and is often associated with rheumatoid arthritis.

Treatment is to the underlying condition, rather than to the cyst itself.

Pre-patellar bursitis - (housemaid's knee

Inflammation of the bursa, ( the connective tissue surrounding a joint), in front of the kneecap. It is caused by friction, especially from people who kneel a lot e.g plumbers and electricians. The joint itself is unaffected, but the irritation causes an effusion, (more fluid in the joint than normal), producing swelling, and lasts for as long as there is friction here causing the irritation.

If there is an infection in the bursa, a suppurating form of bursitis may occur. This is obviously more serious than the previously described form, and the patient may need to have the bursa drained, followed by a course of antibiotics.

Osgood-Schlatter's Disease

This is a strain of the tibial tubercle, the 'bump' just below the knee, which then becomes enlarged. Typically seen in young boys who have been playing a lot of football while the tibial tubercle has been developing, as young bones are softer than mature ones.

Osteoarthritis of the knee -(wear and tear)

The knee is the most affected joint in the body. It is a gradual degeneration of the joint, where the cartilage is worn away until articulation is just bone on bone, and very painful.

Please note

Knee pain may be referred from the hip and ankle.

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