Knee

Normal Anatomy of the Knee Joint

The knee is made up of four bones. The femur or thighbone is the bone connecting the hip to the knee. The tibia or shinbone connects the knee to the ankle. The patella (kneecap) is the small bone in front of the knee and rides on the knee joint as the knee bends. The fibula is a shorter and thinner bone running parallel to the tibia on its outside. The joint acts like a hinge but with some rotation.

Ligaments

Ligaments are soft tissue structures that connect bone to bone. In the knee joint, there are four ligaments that connect the thigh bone to the shin bone, and act as stabilizers to the knee joint. The medial (MCL) and lateral (LCL) collateral ligaments stabilize the knee from side to side. The anterior (ACL) and posterior (PCL) cruciate ligaments give the knee stability with rotation. When a ligament is torn, there is noticeable instability or giving way with certain movements that stress the injured ligament. There will almost always be swelling associated with pain and instability. After a few days, pain may subside and function may improve, but giving way symptoms will remain.

Knee fracture

A fracture is a condition in which there is break in the continuity of the bone.  In younger individuals, these fractures are caused from high energy injuries, as from a motor vehicle accident. In older people the most common cause is weak and fragile bone.

Meniscus Tear

Meniscus tear is the commonest knee injury in athletes, especially those involved in contact sports. A suddenly bend or twist in your knee cause the meniscus to tear. This is a traumatic meniscus tear. Elderly people are more prone to degenerative meniscal tears as the cartilage wears out and weakens with age. The two wedge-shape cartilage pieces’ present between the thighbone and the shinbone are called meniscus. They stabilize the knee joint and act as “shock absorbers”.

Patellofemoral Instability

The knee can be divided into three compartments: patellofemoral, medial and lateral compartment. The patellofemoral compartment is the compartment in the front of the knee between the knee cap and thigh bone. The medial compartment is the area on the inside portion of the knee, and the lateral compartment is the area on the outside portion of the knee joint. 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.

Non-Operative Treatments for Osteoarthritis

There are many non-operative treatments that can be considered before a patient undergoes a joint replacement surgery. Dr. Durkin likes to exhaust conservative measures before performing surgery on a patient. Once conservative measures fail the patient would be a candidate for a joint replacement.

Knee Arthroscopy

A knee arthroscopy is an option for patients with pain, locking, and/or giving way symptoms that interfere with normal daily activities and recreational activities. In certain situations, conservative treatment could be considered first. However, meniscus and cartilage tears, and most ligament tears do not heal themselves, so an arthroscopy is the most reliable solution for resolving mechanical symptoms or instability. Multiple cartilage or ligament injuries can occur in the same event of injury. More than one tear may need to be addressed in an arthroscopic procedure.

MAKOplasty® Total Knee Replacement

The most common need for a knee replacement is osteoarthritis. Knee joint osteoarthritis is a degenerative disease resulting in the wearing away of the lubricating cartilage of the knee joint. This causes the end of the thigh and shin bones to rub together, resulting in pain with standing, walking, stairs, and activity. Sometimes, a bow-legged or knock-kneed appearance of the leg may develop. Pain can be felt all over the knee, or be localized to certain areas, depending on where in the joint the arthritis is. Degeneration can occur in three areas of the knee joint: the medial (inner) knee, the lateral (outer) knee, and behind the knee cap. Patients with end stage osteoarthritis, or osteoarthritis in two or more areas of the knee joint, could be considered candidate for a total knee replacement.

Uni condylar 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. The knee can be divided into three compartments: patellofemoral, the compartment in front of the knee between the knee cap and thigh bone, medial compartment, on the inside portion of the knee, and lateral compartment which is the area on the outside portion of the knee joint.

MAKOplasty ® Partial Knee Replacement

The most common need for a partial knee replacement is osteoarthritis affecting only a portion of the knee joint. Knee joint osteoarthritis is a degenerative disease resulting in the wearing away of the lubricating cartilage of the knee joint. This causes the ends of the thigh and shin bones to rub together, resulting in pain with standing, walking, stairs, and activity. Sometimes, a bow-legged or knock-kneed appearance of the leg may develop. Degeneration can occur in three areas of the knee joint: the medial (inner) knee, the lateral (outer) knee, and behind the knee cap. Patients with end stage osteoarthritis and pain localized to one specific area of the knee, with an otherwise healthy knee joint, could be considered a candidate for a partial knee replacement.

Articular Cartilage Surgery

Cartilage repair is a surgical grafting procedure that replaces damaged cartilage with healthy cartilage from a non‐weight bearing joint. Cartilage repair is performed to correct joint deformities and restore the weight‐bearing capability of the affected joint.

Meniscus Repair

Meniscus tear is the commonest knee injury in athletes, especially those involved in contact sports. A suddenly bend or twist in your knee cause the meniscus to tear. This is a traumatic meniscus tear. Elderly people are more prone to degenerative meniscal tears as the cartilage wears out and weakens with age. The two wedge-shape cartilage pieces present between the thighbone and the shinbone are called meniscus. They stabilize the knee joint and act as “shock absorbers”.

Cortisone Injection

Cortisone is a hormone released by the adrenal gland in response to stress. It is a potent anti-inflammatory agent. Synthetically produced cortisone is more potent and longer acting than natural cortisone and is used for diagnosis as well as treatment of a variety of musculoskeletal conditions such as tendinopathy, bursitis and arthritis.

Synvisc Injection

Viscosupplementation refers to the injection of a hyaluronan preparation into the joint. Hyaluronan is a natural substance present in the joint fluid that assists in lubrication. It allows smooth movement of the cartilage covered articulating surfaces of the joint.

  • Hinsdale Orthopaedics
  • American Academy of Orthopaedic Surgeons
  • DuPage County Medical Society