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Contents

Causes

Symptoms

Exams and Tests

Treatment

Outlook (Prognosis)

When to Contact a Medical Professional

Anterior knee pain is pain that occurs at the front and center of the knee. It can be caused by many different problems, including:

·         Chondromalacia of the patella -- the softening and breakdown of the tissue (cartilage) on the underside of the kneecap (patella)

·         Runner's knee (sometimes called patellar tendinitis)

·         Lateral compression syndrome - the patella tracks more to the outside part of the knee

·         Quadriceps tendinitis - pain and tenderness at the quadriceps tendon attachment to the patella

·         Patella maltracking - instability of the patella on the knee

Causes

Your kneecap (patella) sits over the front of your knee joint. As you bend or straighten your knee, the underside of the patella glides over the bones that make up the knee.

Strong tendons help attach the kneecap to the bones and muscles that surround the knee. These tendons are called:

·         The patellar tendon (where the kneecap attaches to the shin bone)

·         The quadriceps tendon (where the thigh muscles attach to the top of the kneecap)

Anterior knee pain begins when the kneecap does not move properly and rubs against the lower part of the thigh bone. This may occur because:

·         The kneecap is in an abnormal position (also called poor alignment of the patellofemoral joint).

·         There is tightness or weakness of the muscles on the front and back of your thigh.

·         You are doing too much activity that places extra stress on the kneecap (such as running, jumping or twisting, skiing, or playing soccer).

·         You have flat feet.

Anterior knee pain is more common in:

·         People who are overweight

·         People who have had a dislocation, fracture, or other injury to the kneecap

·         Runners, jumpers, skiers, bicyclists, and soccer players who exercise often

·         Teenagers and healthy young adults, more often girls

Other possible causes of anterior knee pain include:

·         Arthritis

·         Pinching of the inner lining of the knee during movement (called synovial impingement or plica syndrome)

Symptoms

Anterior knee pain is a dull, aching pain that is most often felt:

·         Behind the kneecap (patella)

·         Below the kneecap

·         On the sides of the kneecap

One common symptom is a grating or grinding feeling when the knee is flexed (when the ankle is brought closer to the back of the thigh).

Symptoms may be more noticeable with:

·         Deep knee bends

·         Going down stairs

·         Running downhill

·         Standing up after sitting for awhile

Exams and Tests

The health care provider will perform a physical exam. The knee may be tender and mildly swollen. Also, the kneecap may not be perfectly lined up with the thigh bone (femur).

When you flex your knee, you may feel a grinding feeling below the kneecap. Pressing the kneecap when the knee is straightening out may be painful.

Your provider may want you to do a single leg squat to look at muscle imbalance and your core stability.

X-rays are very often normal. However, a special x-ray view of the kneecap may show signs of arthritis or tilting.

MRI scans are rarely needed.

Treatment

Resting the knee for a short period of time and taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or aspirin may help relieve pain.

Other things you can do to relieve anterior knee pain include:

·         Change the way you exercise.

·         Learn exercises to both strengthen and stretch the quadriceps and hamstring muscles.

·         Learn exercises to strengthen your core.

·         Lose weight (if you are overweight).

·         Use special shoe inserts and support devices (orthotics) if you have flat feet.

·         Tape your knee to realign the kneecap.

·         Wear the correct running or sports shoes.

Rarely, surgery for pain behind the kneecap is needed. During the surgery:

·         Kneecap cartilage that has been damaged may be removed.

·         Changes may be made to the tendons to help the kneecap move more evenly.

Outlook (Prognosis)

Anterior knee pain often improves with a change in activity, exercise therapy, and the use of NSAIDs.

When to Contact a Medical Professional

Call your health care provider if you have symptoms of this disorder.

Source: https://medlineplus.gov/ency/article/000452.htm

Contents

Symptoms

Causes

Risk factors

Complications

Diagnosis

Treatment

The meniscus is a C-shaped piece of tough, rubbery cartilage that acts as a shock absorber between your shinbone and thighbone. It can be torn if you suddenly twist your knee while bearing weight on it.

A torn meniscus is one of the most common knee injuries. Any activity that causes you to forcefully twist or rotate your knee, especially when putting your full weight on it, can lead to a torn meniscus.

Each of your knees has two menisci — C-shaped pieces of cartilage that act like a cushion between your shinbone and your thighbone. A torn meniscus causes pain, swelling and stiffness. You also might feel a block to knee motion and have trouble extending your knee fully.

Conservative treatment — such as rest, ice and medication — is sometimes enough to relieve the pain of a torn meniscus and give the injury time to heal on its own. In other cases, however, a torn meniscus requires surgical repair.

Symptoms

If you've torn your meniscus, you might have the following signs and symptoms in your knee:

·         A popping sensation

·         Swelling or stiffness

·         Pain, especially when twisting or rotating your knee

·         Difficulty straightening your knee fully

·         Feeling as though your knee is locked in place when you try to move it

When to see a doctor

Contact your doctor if your knee is painful or swollen, or if you can't move your knee in the usual ways.

Causes

A torn meniscus can result from any activity that causes you to forcefully twist or rotate your knee, such as aggressive pivoting or sudden stops and turns. Even kneeling, deep squatting or lifting something heavy can sometimes lead to a torn meniscus. In older adults, degenerative changes of the knee can contribute to a torn meniscus with little or no trauma.

Risk factors

Performing activities that involve aggressive twisting and pivoting of the knee puts you at risk of a torn meniscus. The risk is particularly high for athletes — especially those who participate in contact sports, such as football, or activities that involve pivoting, such as tennis or basketball. The risk of a torn meniscus also increases as you get older, due to wear and tear on your knees.

Complications

A torn meniscus can lead to knee instability, inability to move your knee normally or persistent knee pain. You might be more likely to develop osteoarthritis in the injured knee.

Diagnosis

A torn meniscus often can be identified during a physical exam. Your doctor might move your knee and leg into different positions, watch you walk and ask you to squat to help pinpoint the cause of your signs and symptoms.

Imaging tests

·         X-rays. Because a torn meniscus is made of cartilage, it won't show up on X-rays. But X-rays can help rule out other problems with the knee that cause similar symptoms.

·         MRI. This uses radio waves and a strong magnetic field to produce detailed images of both hard and soft tissues within your knee. It's the best imaging study to detect a torn meniscus.

Arthroscopy

In some cases, your doctor might use an instrument known as an arthroscope to examine the inside of your knee. The arthroscope is inserted through a tiny incision near your knee.

The device contains a light and a small camera, which transmits an enlarged image of the inside of your knee onto a monitor. If necessary, surgical instruments can be inserted through the arthroscope or through additional small incisions in your knee to trim or repair the tear.

Treatment

Initial treatment

Treatment for a torn meniscus often begins conservatively, depending on the type, size and location of your tear.

Tears associated with arthritis usually improve over time with treatment of the arthritis, so surgery usually isn't indicated. Many other tears that aren't associated with locking or a block to knee motion will become less painful over time, so they also don't require surgery.

Your doctor might recommend:

·         Rest. Avoid activities that aggravate your knee pain, especially any activity that causes you to twist, rotate or pivot your knee. If your pain is severe, using crutches can take pressure off your knee and promote healing.

·         Ice. Ice can reduce knee pain and swelling. Use a cold pack, a bag of frozen vegetables or a towel filled with ice cubes for about 15 minutes at a time, keeping your knee elevated. Do this every four to six hours the first day or two, and then as often as needed.

·         Medication. Over-the-counter pain relievers also can help ease knee pain.

Therapy

Physical therapy can help you strengthen the muscles around your knee and in your legs to help stabilize and support the knee joint.

Surgery

If your knee remains painful despite rehabilitative therapy or if your knee locks, your doctor might recommend surgery. It's sometimes possible to repair a torn meniscus, especially in children and young adults.

If the tear can't be repaired, the meniscus might be surgically trimmed, possibly through tiny incisions using an arthroscope. After surgery, you will need to do exercises to optimize knee strength and stability.

Source: http://www.mayoclinic.org/diseases-conditions/torn-meniscus/home/ovc-20262344