The Knee Pain: Anatomy, Injuries, Disease | Treatment Propositions
Anatomy of the Knee and Its Function
The knee is a complex joint of our body. To get a clearer picture of why knee problems happen, it’s good to have a basic knowledge of knee anatomy. Seven categories divide the anatomy of the knee:
- Bones
- Muscles
- Nerves
- Joints
- Ligaments
- Blood vessels
The knee is a joint where the femur and the tibia meet. The kneecap is made of bone and sets in front of the knee. Ligament capsules enclose synovial joints and contain synovial fluid that lubricates the joint.
The two round bones rest on the upper surface of the tibia. A joint has around outside a joint capsule. Inside the joint capsule, we have a synovial membrane. Collateral ligaments connect bones at joints. They make the knee stable in daily activities. The cruciate ligaments control the movements of the hip and shin and honor the knee joint.
Knee Pain
The Knee's Synovial Membrane and Synovial Fluid
The synovial joint connects two bones. The synovial membrane in the synovial joint produces synovial fluid. The synovial membrane surrounding bones and the synovial fluid inside provides cushioning.
Synovial fluid is the lubrication for the joints. When patients have inflammation in the joint, there is more synovial fluid-filled swelling.
Articular Cartilage of the Knee
Articular cartilage covers the ends of the bones of the joint. The articular cartilage absorbs shocks. It also makes movement smooth. It has a function of shock absorption. It's slippery. It lets surfaces slide without damage.
Muscles and Tendons in the Knee
Very often, knee pain is a muscle disorder. The muscles in the knee connect with the tendons. The quadriceps tendon connects the quadriceps muscles to the kneecap. This tendon continues across the patella and blends into the patellar tendon. The patellar tendon connects the patella to the tibia.
The four quadriceps muscles contract and straighten the knee joint. The hamstring muscles are the largest in the back of the thigh. When muscles contract, the knee bends. They have their tendons – hamstring tendons. Surgeons use these tendons as grafts to replace torn ligaments in the knee joint.
Ligaments of the Knee
Ligaments are responsible for the stability of the knee joint. The lateral collateral ligament limits the left-right mobility of the knee, and the cruciate ligaments (anterior cruciate ligament) keep the bones from moving back and forth.
The lateral ligaments of the knee joint include the medial collateral ligament (MCL) and lateral collateral ligaments (LCL). A tear of the lateral ligaments of the knee joint is a common sports injury that an orthopedic surgeon treats.
After full recovery, you should use a supportive knee brace during physical activity. Preventive exercise can help strengthen your knee ligaments and prevent possible knee injury.
Posterior Cruciate Ligament (PCL)
The PCL attaches to the back of the shin bone, runs forward through the notch, and attaches to the front of the knee. It stops the shin bone from moving too far backward on the thigh bone. It also provides stability for rotation. A force hitting the front of the shin bone and pushing it backward on the thigh bone injures the PCL.
Good news! Most PCL injuries don't need surgery. It's essential to get an accurate diagnosis. Other knee ligaments are associated with severe injuries to the PCL. A good physical exam and special X-ray help identify the ligament injury pattern.
Anterior Cruciate Ligament (ACL)
The ACL's job is to keep the knee stable. It prevents twisting or bending in different directions. The ACL attaches to the front of the knee. It keeps the shin bone from moving too far forward on the thigh bone and provides rotation stability.
One of the common knee injuries is an ACL injury. The ACL is the easiest to injure of all ligaments in the knee. The ACL is in the middle. Twisting or forceful injury can tear it. The ACL can be a partial or complete tear if it is torn. Common ACL symptoms include:
Feel pop
A lot of swelling
It isn't easy putting weight on the leg
Unable to walk
Partial tears generally aren't operated. The doctor will offer you physical therapy to strengthen the muscles. If you are in complete tears, unfortunately, you will need surgery.
Anterior cruciate ligament (ACL) injuries are diagnosed with a physical exam and MRI confirmation. It is good to remember that ACL is commonly associated with other injuries.
Symptoms of Meniscus Tear
For minor injuries, you may not feel anything. But typically, what is present is a pain. Depending on the damage level, you can feel knee pain, popping, or clicking inside your knee. It is localized to the inside or outside of the knee. It can feel like sharp, stable knee pain when you twist, squat, and perform other movements.
Diagnosis of a meniscus tear is performed only with the help of an MRI. The tear does not heal on its own. You can try physical therapy, icing the knee, taking anti-inflammatories, or getting cortisone shots to heal. This type of treatment may work for minor injuries.
Suppose you have a big tear that comes in and out of the joint cartilage; the best treatment - is arthroscopy. It's a procedure in which doctors trim out the torn piece.
Weight distribution by the menisci protects articular cartilage from excessive forces.
Sore Knee Injuries
The cruciate ligaments may lose control if your knee is unstable because of torn cartilage or injured ligaments. The ortopaedic surgery can help restore knee joint function and relieve pain.
Knee patellofemoral syndrome. Attended by patellofemoral pain, it leads to weakness of the muscles and a lot of strain on the connective tissue. Regular exercise can help prevent this problem.
Knee ligament tears caused by injury or sports activity. It may require orthopaedic surgery.
Arthritis and knee osteoarthritis can also irritate joint pain.
Knee bursitis is an inflammation of the mucous sacs causing sharp pain in the knee. You may need medical intervention to relieve the condition.
The most common knee injuries are:
- Unstable knee torn cartilage
- Sprain and tear of the medial or lateral ligament
- Fractures of bones (external and internal) and patella (triangular bone)
- Kneecap torn ligament
- Knee arthritis and bursitis
Knee Pain: Rheumatoid Arthritis vs Osteoarthritis
Acting as a shock absorber, the knee minimizes the impact on the body during movements. Knee pain can be challenging. It often comes from factors like knee injuries and the overall health of the knee joint.
Knee Osteoarthritis: Understanding and Treatment
Osteoarthritis is a type of arthritis. It happens when articular knee cartilage is gradually lost over time. Osteoarthritis causes inflammation between bones. It triggers knee pain in the joint space's nerve endings. It happens in synovial joints. It's a mix of overuse, injury, and genetic factors in the joint.
Risk factors include:
Obesity
Age
Trauma to the joint
Family history of arthritis
Osteoarthritis symptoms:
Joint pain and stiffness
Deformation of the joints
Instability
Reduced functions in the joints
The management and treatment of osteoarthritis:
Losing weight, which helps reduce the pressure on the knee joint
Physiotherapy to strengthen the joints
Occupational therapy to maximize the function of the joints
Doctors use nonsteroidal anti-inflammatory drugs to control symptoms. In severe pain cases, they may use intra-articular steroid injections or joint replacement.
Rheumatoid Arthritis and Its Impact on the Knee Joints
Rheumatoid arthritis is an autoimmune disorder. The body's immune cells attack fluid secrets that lubricate and reduce bone erosion. Inflammation can occur in soft tissue (ligaments, muscles, tendons).
It feels like pain, swelling in those areas, and joint stiffness. The stiffness is worse in the morning.
Rheumatoid arthritis treatment includes:
Nonsteroidal anti-inflammatory drugs (NSAID)
Corticosteroids
Disease-modifying anti-rheumatic drugs (DMAR)
Treatment for Knee Injury and Pain
Statistically, every third person aged 30+ has triggered knee problems at least once. The knee pain can start from mild discomfort and worsen without treatment.
In most cases, treatments are conservative:
Wearing a special orthosis with lateral stability
Local cold
Knee raised position
Limiting the load on the injured limb for four weeks
The first and most important thing in treating knee injuries is to visit your doctor for a diagnosis. This will allow him to choose the best treatment for you. Treatment for knee pain depends on the cause of the pain.
Here are some general recommendations to reduce and prevent knee pain.
Get more rest and reduce the load on your legs. Allow your knee ample time to recover. Use an ice pad to reduce inflammation and relieve pain.
Use a cane or knee brace to reduce pressure on your sore knee.
Take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, under your doctor's supervision.
Physical therapy for weak muscles. Complete exercises to strengthen the muscles around the knee and restore mobility to the joint.
Massages and gentle stretches can help reduce tension in the connect bone, allowing knee and lower leg flexibility.
Losing weight isn't just about looks. It helps lighten the load on knee joints. It prevents discomfort and supports natural hinge joint movement.
To avoid triggering knee diseases, focus on controlling the cruciate ligaments and strengthening the muscles around the joint.
Based on the symptoms and clinical exam, an orthopedic surgeon may prescribe tests like X-ray, knee MRI, and ultrasound diagnostics (US).
