Pain Management All About Your Knees

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DR. SUNIL RAJAN
Head of Department Apollo Institute of
Orthopaedics, Apollo Hospitals, Indore M.S
Orthopedics, Specialization Joint Replacement
Surgery
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Pain Management All About Your Knees
Knee
The biggest joint in your body is sort of like a
Swiss Army knife. It helps you sit, stand, lift,
walk, run, and jump. It also has lots of parts
that can get injured tendons, ligaments,
cartilage, and bones that you can crack, tear,
dislocate, and more.
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Bones
Four bones meet to form your knee your thighbone
(femur), shinbone (tibia), the smaller bone that
runs alongside it (fibula), and kneecap
(patella). Any of them could crack (fracture) or
break. Or a small piece might break off. You may
also dislocate or move one of these bones out of
place, especially your kneecap.
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Ligaments
These tough, fibrous, stretchy cords connect one
bone to another. They also help strengthen and
bind joints together. They allow movement in some
directions but prevent it in others. The knee has
two main types. Collateral ligaments control
sideways motion and keep your knee from moving in
the wrong way. Cruciate ligaments are inside the
joint and help it move forward and backward.
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Tendons
These thick, fibrous cords connect muscle to bone
so you can move your limbs. Your quadriceps
tendon links your kneecap to the muscles on top
of your thigh. Your patellar tendon continues
down the leg and ties your knee to your shin.
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Meniscus
When the doctor says you've torn cartilage in
your knee, it's most likely these two
triangle-shaped pieces. They work as shock
absorbers between your thighbone and your
shinbone, two of the biggest bones in your body.
That's why they're more rubbery than other
cartilage you have, including the rest of what's
in your knee.
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Articular Cartilage
This slippery stuff covers the ends of your thigh
and shin bones. It even lines the back of your
kneecap. That ensures all those parts slide
smoothly across each other as you bend, lift, and
straighten your legs. Injury, inflammation,
infection, and diseases like arthritis can damage
this cartilage and cause pain and swelling in
your knee.
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Patella Fracture
You can crack or break any of the bones in your
knee, but the kneecap, or patella, is the most
common. Injuries here usually result from a
sudden fall or a car accident. You'll have pain
and swelling in the front of the knee, and you
may not be able to straighten your leg or even
walk. The kneecap breaks more easily as you age,
especially if you have brittle bones
(osteoporosis).
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Patella Fracture Repair
Treatment depends on the type of break. If the
pieces are close to each other and lined up like
a jigsaw puzzle, you may just need a splint to
help them to grow back together. But when there
are lots of bone bits, or they're too far apart,
your doctor might suggest surgery. He might need
to use screws and plates to put it back together.
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Dislocation
There's a V-shaped notch at the end of your
thighbone. It holds your kneecap and gives it a
groove to move through. If it's oddly shaped or
not deep enough, your kneecap can slide out. You
may even notice it's moved to the side. A hard
hit or fall also could do it. Your knee might
buckle or catch when you walk. You'll have pain
in the front of the joint that gets worse when
you use it. You might hear creaking or cracking
sounds.
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Dislocation Treatment
The first step is to get the kneecap back in the
groove at the bottom of your thighbone. Your
doctor will call this reduction. Sometimes it
happens on its own. If not, your doctor may be
able to push it back in place. If it's only
partly dislocated, splints, braces, or
strengthening exercises could get it back where
it belongs. If the dislocation damages the end of
your thighbone or the back of your kneecap, you
may need minor surgery to repair it.
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Cruciate Ligament Tear
This usually happens in the anterior cruciate
ligament, or ACL, which runs crosswise in the
middle of your knee. You can tear it with a
sudden jump or change of direction, often in
high-intensity sports like skiing, football,
basketball, or tennis. You might hear a pop when
it happens and notice pain and swelling. It can
also damage other parts of the knee like tendons,
bones, or other ligaments.
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Cruciate Ligament Treatment
A torn ACL requires surgery to repair. The
surgeon doesn't stitch the ligament back
together, but replaces it with tissue from
elsewhere, often your hamstring. If you're older
or less active, the doctor might suggest you skip
surgery and manage your symptoms with exercises,
braces, and splints. Either way, physical therapy
can lessen pain and improve motion.
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Collateral Ligament Tear
This usually happens in one of two ways Either
something hits the outside of your knee, which
damages the medial collateral ligament, or
something hits the inside of the knee, which
injures the lateral collateral ligament (this is
less common). You'll have pain and swelling. The
joint may feel weak or unstable.
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Collateral Ligament Treatment
These injuries rarely require surgery. Ice the
area for 15-20 minutes at a time, with at least
an hour between sessions. Your doctor can help
you brace your knee to avoid the motion that
caused the injury in the first place. You may
also need to change your daily routine and
exercise habits. You might have to use crutches
to keep weight off the joint for a while.
Physical therapy could also help.
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Meniscus Tear
This common knee injury often happens along with
others, like a torn ACL. Contact sports make it
more likely, as when you squat and twist in a
football tackle, but it can happen to anyone. As
you get older, the cartilage wears away, and you
can tear it when you do something as simple as
getting up from a chair. Along with pain and
swelling, you might feel a pop as it tears and a
catch when you try to move it.
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Meniscus Treatment

• Start with RICE
• Rest
• Ice (for 20 minutes at a time)
• Compression (elastic bandage wrap)
• Elevation (keep your knee above your heart)
• It's a good first step for any knee injury, and
  in this case, it might be all you need to heal.
  Nonsteroidal anti-inflammatory drugs (NSAIDs)
  like ibuprofen can also help. In more serious
  cases, your doctor may suggest surgery to either
  repair or cut away bits of the damaged cartilage.

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Tendon Tear
It's more likely to happen if you're middle-aged
and take part in sports in which you run or jump.
An awkward landing, fall, or direct hit to the
knee makes it more likely. You might have pain,
bruising, and even cramps. If the patellar tendon
rips in two, your kneecap could drift up into
your thigh. It normally takes a lot of force to
tear a tendon, but age and conditions like
inflammation, arthritis, lupus, and diabetes can
weaken them, so they tear more easily.
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Tendon Treatment
Small tears don't usually need surgery, but
you'll likely need a brace for 3 to 6 weeks and
possibly crutches. For larger tears, especially
if the tendon is torn completely in two, you'll
need surgery to reattach it to the kneecap. In
general, the quicker you repair it, the better
the outcome.
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Dr Sunil Rajan is a one of the best doctors for
knee pain in Indore and Dr. Rajan is the founder
of Knee Clinic. Dr. Sunil Rajan is one of the top
10 orthopaedic surgeons of MP, he is a world
renowned joint replacement surgeon specializing
in joint replacement, hip, knee replacement,
shoulder replacement. In the last 20 years, Dr.
Rajan has performed more than 10,000 knee
replacement surgery. Book an appointment today,
call us on 9826200015 and visit online for more
information - https//www.drsunilrajan.com
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