The Joint Handbook FROM SOUTHERN BONE & JOINT SPECIALISTS FINDING YOUR WAY BACK TO AN ACTIVE LIFE WITH JOINT REPLACEMENT FIND OUT WHAT’S CAUSING YOUR KNEE PAIN HOME EXERCISES THAT RELIEVE JOINT PAIN ROBOTIC SURGERY AND ADVANCES IN HIP, KNEE & SHOULDER REPLACEMENT TREATING KNEE PAIN It’s estimated that 25% of us experience in shock absorption. Considering the What is causing your knee pain? the inside. knee pain. The good news is that many meniscus layer is only about one-fourth Pain is broken down into two • Pain from tendon problems: Inflamed times, the cause can be soft tissue strain of an inch thick, this padding does a categories: acute or chronic. If you fall tendons that connect the knee cap to the or injury and can be treated with a minor remarkable job of softening impact and down and hurt your knee or twist your shin bone can cause pain. procedure. The key is to understand vibration when our feet hit the ground knee, that is called “acute” knee pain. what may be causing your knee pain and when walking, running and jumping. This Chronic pain is something that occurs When knee surgery is necessary how the amazing knee joint enables us to underscores the importance of injury more gradually over time, often getting When nonsurgical treatment walk, run, jump and turn. prevention when it comes to the knee. worse as weeks, months and years go by. options – like therapy, injections and anti- The knee joint is comprised of four Once you damage the shock absorber, Unlike acute pain which can be linked inflammatory medications – fail to relieve bones. The largest of these is the femur, you are that much more susceptible to to a specific accident – like when you fall or pain symptoms, the only way to heal a or thigh bone. Also found in the knee arthritis and damage to the joint. twist your knee – chronic pain is more like knee problem may be through surgery. is the tibia, sometimes called the shin When we are young, the meniscus an ache that is not linked to any event. Also, when joint surfaces have eroded bone. Alongside the tibia, on the outside is tough. But it can tear as a result of During your visit to Southern Bone away because of arthritis, then knee of the leg, is the fibula. The fourth a sports injury. As we reach our 50s, and Joint Specialists, the knee specialist surgery may be unavoidable. About 20% bone found in the knee is the patella or meniscus can tear with just a slight twist will ask when and how your pain started of knee patients require surgery. kneecap. It’s cradled within the patellar of the knee. During arthroscopic surgery to learn more about the potential cause of tendon, and lies directly in front of of the knee, the knee surgeon can pain. Next, the the knee surgeon will use Surgery to repair a torn ACL the femur. The patella assists in knee repair and remove the torn part of the his hands to move the knee joint to test One of the most common knee extension, increasing leverage by lifting meniscus, while at the same time trying for stability. Diagnostic test like X-rays will injuries is a torn ACL. The Anterior the quadriceps and patellar tendons to preserve as much of it as possible. provide a visual of your knee joint. Cruciate Ligament (ACL) works a lot like a away from the joint. guide wire that keeps the femur and the Both the lower end of the femur and Knee pain from ligament injury The most common cause of knee pain tibia stable. When an athlete tears their upper end of the tibia are covered with Ligaments connect one bone to Use the knee pain flow chart in this ACL, usually it is from a sudden twist on articular cartilage, a smooth rubbery another. They are made up of tough handbook to self diagnose your knee pain. the knee joint. This can cause an audible material, which allows one surface to collagen fibers that straighten when force Most causes of acute knee pain fall into pop or at least a great deal of pain. The glide one upon the other with minimal is applied and permits the ligaments to the following categories: main hallmark signs of a torn ACL is the friction. Sandwiched between the two endure large internal stresses during • Knee cap pain: Pain from a knee cap audible pop, a feeling of instability in the joints are meniscus tissue, which acts as normal joint motion. The four major usually becomes most noticeable when knee, nausea and swelling. an additional cushion for the joint. ligaments of the knee are: walking up stairs, going down stairs, Torn ACLs are one of the most In addition to the meniscus, there 1. the anterior cruciate ligament running or sitting. common problems associated with is articular cartilage covering the ends 2. the posterior cruciate ligament • Pain from a torn meniscus: If the sports. It is important to understand your of the femur and tibia, and the back of 3. the medial collateral ligament meniscus is torn, stretched or out of place, options if you have a torn ACL. the patella. Articular cartilage is found 4. the lateral collateral ligament pain may occur when the joint is moved. Repairing the torn ACL does NOT throughout the body anywhere two The stability of the knee is largely due You often get mechanical symptoms involve sewing two torn ends together. bones meet and glide against each other. to how all four ligaments work together. of clicking, popping or locking with a Instead, think of your ACL as a rubber They are the structures that ultimately meniscal tear. band. Once it snaps, it can not be sewn Knee pain from meniscus injury hold the tibia and femur together, while • Pain from ligament tears: When the ACL together. Instead, you have to replace Our knees are fortified with an extra permitting motion. is torn, it is often because the leg rotates the rubber band completely. And that layer of cartilage just between the femur The anterior cruciate ligament (ACL) while the foot stays planted on the ground. is exactly what the knee surgeon does. and tibia. Meniscus tissue protects the is deep within the knee. It crisscrosses Often times an ACL tear is accompanied They harvest a ligament from another articular cartilage by spreading out the the posterior cruciate ligament (PCL) and by a loud popping sound from the knee area of your body, attach one end to your forces placed on the joint surfaces during keeps the tibia from sliding too far forward and the support of the knee gives way. A shin, thread it through your knee and movement. To imagine how valuable this in relation to the femur. The PCL does the posterior cruciate injury happens when anchor the other end to your femur. function is, consider that forces on the opposite. It prevents the tibia from sliding the knee is forced backwards or when it Some knee surgeons use a knee range from about twice our body excessively backwards. The ligaments that receives a hard impact. A medial collateral patellar tendon while most others use weight during normal walking, to more provide sidewise stability to the knee are ligament injury most commonly occurs a hamstring ligament. There are pros than four times our body weight when the medial collateral ligament (MCL) and when the knee is hit from the outside and cons to each. Harvesting a patellar running, twisting or jumping. lateral collateral ligament (LCL). These while a lateral collateral ligament injury tendon from the front of the knee makes The meniscus also plays a role ligaments limit side-to-side motion. occurs when the knee is impacted from for a more painful recovery and painful Page 2 • SouthernBoneandJoint.com SouthernBoneandJoint.com • 3 TREATING KNEE PAIN TREATING KNEE PAIN 3688 Veterans MeMorial Dr. Hattiesburg, Ms 39401 appointMents, referrals & 2nD opinions: 601-554-7400 online encyclopeDia about spine & ortHopeDics at: soutHernboneanDJoint.coM joint, which can be complex surgery, and months or a year for full recovery to involve removing more healthy bone. activity. Consequently, before even considering knee replacement surgery Who Is A Candidate? as an option, generally an orthopedic Knee replacement is typically a surgeon will try to find other ways of procedure reserved for those who are relieving knee pain symptoms. over 50 years of age who are in relatively For instance, physical therapy, good health. In fact, 70 percent of knee anti-inflammatory medication, steroid replacements are done on those over the medication and walking aids may be used age of 65. for knee pain stemming from arthritis. Knee replacement candidates will However, when other treatments fail to find it comforting to know that they provide pain relief, knee replacement will be able to resume some athletics surgery may be the only option left. following surgery such as hiking, biking, Artificial knee joint replacement swimming, doubles tennis and golf. surgery typically lasts less than two Also, those who are overweight are hours. The knee is opened up and the not good candidates as the artificial joint kneecap is moved out of the way. The (just as the natural knee) is designed knee surgeon then shaves off the bottom to carry a weight in proportion to the of the femur and the top of the tibia. The person’s body. Too much weight on the prosthesis is then fitted and glued to the artificial joint can cause it to be damaged bones with surgical cement.