Knee Procedures
ACL Reconstruction
ACL (anterior cruciate ligament) reconstruction is a commonly performed surgical procedure. With recent advances in arthroscopic surgery, it can now be performed with minimal incision and low complication rates.
Arthroscopic Debridement
Arthroscopic debridement or a clean-up is a surgical procedure performed using an arthroscope. In this procedure, the cartilage or the bone that is damaged is removed using surgical instruments and the edges of the articular cartilage that are rough will be smoothened. A washout or joint lavage is done using a special tool to spray jets of fluid to wash and suck out to remove the remaining debris around the joint.
Knee Arthroscopy
Knee arthroscopy is a common surgical procedure performed using an arthroscope, a viewing instrument, to diagnose or treat a knee problem. It is a relatively safe procedure and you will usually be discharged from the hospital on the same day of surgery.
Unicompartmental/Partial Knee Replacement
Unicompartmental knee replacement is a minimally invasive surgery in which only the damaged compartment of the knee is replaced with an implant. It is also called a partial knee replacement.
Minimally Invasive Knee Joint Replacement
Total knee replacement is a very successful surgical treatment for knee arthritis. Over the years, minimally invasive knee replacement surgical techniques have been developed to lessen tissue trauma and improve patient outcomes. This minimally invasive approach involves much smaller incisions than the usual 10-12 inch incisions used in the traditional knee replacement and spares the quadriceps muscle and tendon, which control bending of the knee, from being cut to access the knee joint.
Meniscal Surgery
Meniscal surgery is a surgical procedure employed for the treatment of torn or damaged meniscal tissues in the knee. It is mostly performed as a minimally invasive keyhole procedure.
Knee Cartilage Restoration
Knee cartilage restoration is a surgical technique to repair damaged articular cartilage in the knee joint by stimulating new growth of cartilage or by transplanting cartilage into areas with defects in order to relieve pain and restore normal function to the knee.
Patellar Tendon Repair
Patellar tendon repair is the surgery performed to reattach the torn tendon to the kneecap and to restore normal function in the affected leg.
Quadriceps Tendon Repair
Quadriceps tendon is a thick tissue located at the top of the kneecap. The quadriceps tendon works together with the quadriceps muscles to allow us to straighten our leg. The quadriceps muscles are the muscles located in front of the thigh.
Knee Conditions
ACL Tears
The anterior cruciate ligament (ACL) is one of the major ligaments of the knee. It is located in the middle of the knee and runs from the femur (thighbone) to the tibia (shinbone). The ACL prevents the tibia from sliding out in front of the femur. Together with the posterior cruciate ligament (PCL), it provides rotational stability to the knee.
Iliotibial Band Syndrome
An iliotibial band is a tough group of fibers that runs from the iliac crest of the hip along the outside of the thigh, till the outer side of the shinbone, just below the knee joint. Its function is to coordinate with the thigh muscles and provide stability to the knee joint.
Knee Arthritis
The joint surface is covered by a smooth articular surface that allows pain-free movement in the joint. Arthritis is a general term covering numerous conditions where the joint surface or cartilage wears out. This surface can wear out for several reasons; often the definite cause is not known. Arthritis often affects the knee joint. When the articular cartilage wears out, the bone ends rub on one another and cause pain. The most common type of arthritis is osteoarthritis. It occurs with aging and use.
Knee Fracture
A fracture is a condition in which there is a break in the continuity of the bone. In younger individuals, these fractures are caused by high energy injuries, as from a motor vehicle accident. In older people, the most common cause is a weak and fragile bone.
Knee Pain
Knee pain is a common condition affecting individuals of various age groups. It not only affects movement but also impacts your quality of life. An injury or disease of the knee joint or any structure surrounding the knee can result in knee pain. A precise diagnosis of the underlying cause is important to develop an appropriate treatment plan.
Knee Sports Injuries
Trauma is any injury caused during physical activity, motor vehicle accidents, electric shock, or other activities. Sports trauma or sports injuries refer to injuries caused while playing indoor or outdoor sports and exercising. Sports trauma can result from accidents, inadequate training, improper use of protective devices, or insufficient stretching or warm-up exercises. The most common sports injuries are sprains and strains, fractures, and dislocations.
Knee Sprain
Knee sprain is a common injury that occurs from overstretching of the ligaments that support the knee joint. A knee sprain occurs when the knee ligaments are twisted or turned beyond its normal range, causing the ligaments to tear.
Kneecap Bursitis
A bursa is a small fluid-filled sac found between soft tissues and bones. It lubricates and acts as a cushion to decrease friction between bones when they move.
Patellofemoral Instability
Patellofemoral instability means that the patella (kneecap) moves out of its normal pattern of alignment. This malalignment can damage the underlying soft structures such as muscles and ligaments that hold the knee in place.
Patellar Tendinitis
Patellar tendinitis, also known as "jumper's knee", is an inflammation of the patellar tendon that connects your kneecap (patella) to your shinbone. This tendon helps in extension of the lower leg.
Quadriceps Tendon Rupture
The quadriceps can rupture after a fall, direct blow to the leg and when you land on your leg awkwardly from a jump. Quadriceps tendon rupture most commonly occurs in middle-aged people who participate in sports that involve jumping and running. Other causes include tendonitis (inflammation of quadriceps tendon), diseases such as rheumatoid arthritis, diabetes mellitus, infection and chronic renal failure, which weaken the quadriceps tendon. Use of medications such as steroids and some antibiotics also weakens the quadriceps tendon.
Patellar Tendon Rupture
The patellar tendon works together with the quadriceps muscle and the quadriceps tendon to allow your knee to straighten out. Patella tendon rupture is the rupture of the tendon that connects the patella (kneecap) to the top portion of the tibia (shinbone).
Shin Splints
Shin splints are pain and inflammation of the tendons, muscles and bone tissue along the tibia or shinbone (lower leg). It occurs because of vigorous physical activities such as exercise or sports. The condition is also referred to as medial tibial stress syndrome (MTSS).
Knee Anatomy
The knee is a complex joint made up of different structures - bones, tendons, ligaments, and muscles. They all work together to maintain the knee’s normal function and provide stability to the knee during movement.
Having a well-functioning healthy knee is essential for our mobility and ability to participate in various activities. Understanding the anatomy of the knee enhances your ability to discuss and choose the right treatment procedure for knee problems with your doctor.
Bones of the Knee
The knee is a hinge joint made up of two bones, the thighbone (femur) and shinbone (tibia). There are two round knobs at the end of the femur called femoral condyles that articulate with the flat surface of the tibia called the tibial plateau. The tibial plateau on the inside of the leg is called the medial tibial plateau and on the outside of the leg, the lateral tibial plateau.
The two femoral condyles form a groove on the front (anterior) side of the knee called the patellofemoral groove. A small bone called the patella sits in this groove and forms the kneecap. It acts as a shield and protects the knee joint from direct trauma.
A fourth bone called the fibula is the other bone of the lower leg. This forms a small joint with the tibia. This joint has very little movement and is not considered a part of the main joint of the knee.
Articular Cartilage and Menisci of the Knee
Movement of the bones causes friction between the articulating surfaces. To reduce this friction, all articulating surfaces involved in the movement are covered with a white, shiny, slippery layer called articular cartilage. The articulating surface of the femoral condyles, tibial plateaus and the back of the patella are covered with this cartilage. The cartilage provides a smooth surface that facilitates easy movement.
To further reduce friction between the articulating surfaces of the bones, the knee joint is lined by a synovial membrane that produces a thick clear fluid called synovial fluid. This fluid lubricates and nourishes the cartilage and bones inside the joint capsule.
Within the knee joint, between the femur and tibia, are two C-shaped cartilaginous structures called menisci. Menisci function to provide stability to the knee by spreading the weight of the upper body across the whole surface of the tibial plateau. The menisci help in load-bearing i.e. it prevents the weight from concentrating onto a small area, which could damage the articular cartilage. The menisci also act as a cushion between the femur and tibia by absorbing the shock produced by activities such as walking, running and jumping.
Ligaments of the Knee
Ligaments are tough bands of tissue that connect one bone to another bone. The ligaments of the knee stabilize the knee joint. There are two important groups of ligaments that hold the bones of the knee joint together, collateral and cruciate ligaments.
Collateral ligaments are present on either side of the knee. They prevent the knee from moving too far during side to side motion. The collateral ligament on the inside is called the medial collateral ligament (MCL) and the collateral ligament on the outside is called the lateral collateral ligament (LCL).
Cruciate ligaments, present inside the knee joint, control the back-and-forth motion of the knee. The cruciate ligament in the front of the knee is called anterior cruciate ligament (ACL) and the cruciate ligament in the back of the knee is called posterior cruciate ligament (PCL).
Muscles of the Knee
There are two major muscles in the knee - the quadriceps and the hamstrings, which enable movement of the knee joint. The quadriceps muscles are located in front of the thigh. When the quadriceps muscles contract, the knee straightens. The hamstrings are located at the back of the thigh. When the hamstring muscles contract, the knee bends.
Tendons of the Knee
A tendon is a tissue that attaches a muscle to a bone. The quadriceps muscles of the knee meet just above the patella and attach to it through a tendon called the quadriceps tendon. The patella further attaches to the tibia through a tendon called the patella tendon. The quadriceps muscle, quadriceps tendon, and patellar tendon all work together to straighten the knee. Similarly, the hamstring muscles at the back of the leg are attached to the knee joint with the hamstring tendon.