What is the knee?
The knee is the central joint of the lower limbs. It is formed by the union of two very important bones: the femur and the tibia, in the proximal portion, and joins the thigh and the leg. In its interior it has a small bone, the patella, which articulates with the anterior and inferior portion of the femur, as well as two fibrocartilage discs, the menisci. Also, it is wrapped by a joint capsule and ligaments, which gives it stability. The most important ligaments are the external lateral ligament, the internal lateral ligament, the anterior cruciate ligament and the posterior cruciate ligament. In addition, important muscles that allow flexion and extension movements of the knee and leg are inserted in it.
The knee is a joint vulnerable to injury from trauma.
Function of the knee
The knee supports most of the weight of the body when the person is standing. The main movement it performs is flexion-extension, although it can also rotate slightly when it is flexed.
Pathologies that can suffer the knee
The knee is vulnerable to serious injuries due to blows and trauma, usually due to sports injuries. Osteoarthritis is also common in older people, being very disabling. The most common knee injuries are:
- Simple contusions: small trauma without damage to the main structures of the joint (meniscus, bone or ligaments). It is considered benign without complications and usually resolves in time, with conservative measures: anti-inflammatory drugs, rest and local cold applied to the joint.
- Ligament and meniscus injuries: these are common injuries in sports practice, as they involve stress on the joint. The most frequent injuries are meniscus, lateral ligament and cruciate ligament tears.
- Tendon injuries: the most frequently injured tendons are the quadriceps tendon, the patellar tendon, the goose foot tendon and the popliteus muscle tendon.
- Fractures: these can occur in the lower part of the femur, the upper part of the tibia or the patella. They are usually complex fractures that may involve several bones, menisci and ligaments and are usually caused by major trauma.
- Dislocations: Any injury that results in permanent loss of contact of the articular surfaces is considered a dislocation.
- Joint effusion: there is usually fluid in the joint space, which serves to nourish the cartilage and lubricate, decreasing the friction of the joint and its consequent wear. If this fluid accumulates, joint effusion occurs, causing pain and inability to move the knee.
- Gonarthrosis or knee osteoarthritis, being more common in women than in men, from the age of 50.
- Arthritis, which may be the result of gout, rheumatoid arthritis or infectious processes.
- Osgood-Schlatter disease: affectation of the cartilage of the tibia, which causes pain during physical exercise and improves with rest.
- Chondromalacia patella: it is frequent in young people and athletes. It is the degeneration of the cartilage between the patella and the femur.
- Hoffa’s disease: chronic inflammation of the fatty area located behind the patellar tendon and under the patella.
- Baker’s cyst: it is a protuberance that is given in the posterior part of the knee by chronic inflammatory processes, by a greater production of the synovial liquid.
- Bursitis: the knee has several serous bags or bursae, which are very vulnerable as a result of repeated trauma. These can cause chronic inflammation.
- Deformities
Treatments for knee pathologies
The treatment of knee injuries will depend on the type of injury and the severity of the injury. First of all, it is important for the patient to self-protect, under the acronym “PRICE”: Protection, Rest, Ice, Compression, Elevation. Also, the patient should avoid certain things after the injury, so as not to damage the knee further. These measures include not applying heat, not drinking alcohol, not running or performing other exercises and not massaging the injured knee, as it may become more inflamed.
Anti-inflammatory drugs may help with mild to moderate pain. If the pain becomes severe, the physician may prescribe the patient a stronger analgesic.
If the injury is severe, the specialist may recommend the patient to undergo physiotherapy, with a specific rehabilitation exercise program, appropriate to the type of injury and the patient.
In some cases it is possible that the injury requires surgery: if there is a tear of the external lateral ligament, if the patient has damaged the anterior cruciate ligament and practices a lot of sport or if there is a tear of the internal lateral ligament, which will require reconstructive surgery. Surgery will also be necessary if the injury involves several ligaments or if a patellar tendon has been torn.
Specialist who treats knee pathology
The specialist who treats the knee and knee joint injuries is the orthopedic surgeon. There are usually many orthopedic surgeons who specialize only in the knee, so they have a perfect command of the latest techniques for dealing with these injuries.