Knee Problems & Treatments

 

The type of surgery you have depends on the nature of your tear. Your surgeon may use arthroscopy, a method that sends video images from inside your knee. Arthroscopy only requires small incisions, and you can usually go home the same day as surgery. During surgery, you may have local anesthesia, a regional block (numbing your from the waist down), or general anesthesia. General anesthesia means you'll be "asleep."

Pre-Op Checklist

  • Don't eat or drink 10 hours before surgery.

  • Arrange for someone to drive you home after surgery.

  • Tell your doctor if you take medications, supplements, or herbal remedies.

Repair

For certain tears, your surgeon will try to repair the meniscus. Torn edges are sutured so they can heal properly. Or special fasteners are used to repair damage. In some cases, repairs may require another incision at the back or side of your knee.

Removal

In most cases, your surgeon will remove the damaged part of your meniscus. The meniscus won't completely grow back, so as little tissue as possible is removed. The articular cartilage will take over the role as shock absorber for your knee joint.

After Surgery

You'll spend some time in recovery and can go home when you've recovered from the anesthesia. Your knee will be bandaged, and you may have stitches, steri-strips, or staples. You may need crutches and may have a splint for support.

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Pre-Op Checklist

  • Stop taking aspirin and other medications as advised by your doctor 7 days before surgery.

  • Arrange to get crutches to use during recovery.

  • Don't eat or drink 10 hours before surgery.

  • Arrange for someone to drive you home after surgery.

There are two options for treating an MCL injury: nonsurgical and surgical. Nonsurgical treatment is used more often. With either option, rehabilitation will be part of your treatment.

Nonsurgical Treatment

This treatment starts with rest, icing, and elevation. This relieves pain and swelling. In the next stage, you begin exercises designed to increase your knee's range of motion, strength, and flexibility. Using crutches or a brace rests your joint, helping it to heal.

Your doctor may secure the ligament to the bone with screws.

Your doctor may secure the ligament to the bone with screws.

 
Your doctor may stitch or staple your ligament together.

Your doctor may stitch or staple your ligament together.

 

Surgery

Surgery is seldom used to repair an MCL injury. But sometimes it is advised, especially if another part of your knee is damaged. Open surgery is used to screw, staple, or stitch the MCL back into place. Depending on their location, other knee injuries may be repaired using arthroscopy. With arthroscopy, a tiny camera lets your doctor see inside the joint. Tools inserted through small incisions are used to repair the joint.

After Surgery

Right after surgery, you'll spend a few hours in a recovery unit. Your knee will be bandaged and your leg elevated. Your knee will also be iced and put in a brace to keep it from bending. Depending on the procedure, your physical therapy may begin shortly after surgery. This may include light exercises.

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At home, you play a major role in your recovery. The better you care for your knee, the faster you may heal. And the faster you heal, the sooner you can resume your normal activities. Follow your doctor's instructions about how to care for your knee after surgery.

Elevating and icing your knee decrease pain and swelling.

Elevating and icing your knee decrease pain and swelling.

Home Recovery

  • Apply a bag of ice to your knee and elevate your knee above heart level as directed.

  • For the first few days, your doctor may recommend that you not bear weight on your knee. Use a cane, crutches, or walker as advised by your doctor.

  • Your doctor may also prescribe pain medications or anti-inflammatories.

  • To prevent infection, keep your incisions dry by using a plastic bag when icing your knee or taking a shower.

Strengthening Your Knee

You may be instructed to do exercises, possibly using weights. To help strengthen your knee, follow these tips:

  • Start out slowly, then increase repetitions as recommended.

  • Take short, frequent walks each day. Ask your doctor how long your walks should be and how often you should take them.

  • Physical therapy may also be recommended to help you strengthen your knee and increase its range of motion.

Talk with your health care provider about what exercise program is best for you. Always tell your health care provider if an exercise causes new or lasting pain.

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Your surgeon may prescribe physical therapy. This can help relieve pain, increase range of motion, and improve strength. Your physical therapist will design a program for you based on your knee problem and recovery goals.

Working with Your Physical Therapist

Your physical therapist can help you set goals and work toward them. But a successful recovery depends on you. Follow instructions and keep your appointments.

Types of Physical Therapy

To help you heal, your physical therapist may use one or more of the following:

  • Manual therapy. This may include stretching or massage to reduce stiffness and make your joints more flexible. You may also work your muscles against pressure to make them stronger.

  • Weight machines. These machines work and strengthen specific muscle groups.

  • Closed kinetic chain exercises. These help make your joints stronger and more stable by keeping one part of the body still while the rest of the body is moving. Squats are an example of these exercises.

  • Aerobic exercises. These include biking and walking. They strengthen the leg muscles as well as the heart and lungs.

  • Electric stimulation (as needed). This uses a painless electric current to relieve pain, decrease swelling, and rebuild muscles.

  • Ultrasound (as needed). This uses sound waves to help heal injured tissue.

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If the kneecap is "off track" even slightly (a tracking problem), it can cause uneven pressure on the back of the kneecap. This can cause pain and difficulty with movements, such as walking and going down stairs. Below are some common causes of kneecap pain.

Cartilage Damage Sometimes the cartilage on the back of the kneecap or in the groove of the thighbone is damaged. Damaged cartilage can't spread pressure evenly. Uneven pressure wears down the cartilage even further.

Cartilage Damage

Sometimes the cartilage on the back of the kneecap or in the groove of the thighbone is damaged. Damaged cartilage can't spread pressure evenly. Uneven pressure wears down the cartilage even further.

Dislocation Sometimes a muscle or ligament in the knee is pulled the wrong way. Or the kneecap may be pushed too hard. Then the kneecap may move partly out of the groove (subluxation). It may even move completely out (dislocation).

Dislocation

Sometimes a muscle or ligament in the knee is pulled the wrong way. Or the kneecap may be pushed too hard. Then the kneecap may move partly out of the groove (subluxation). It may even move completely out (dislocation).

Patellar Tendinitis Patellar tendinitis ("jumper's knee") occurs when the quadriceps muscles are overused or tight. During movement, the patellar tendon absorbs more shock than usual. The tendon becomes irritated or damaged.

Patellar Tendinitis

Patellar tendinitis ("jumper's knee") occurs when the quadriceps muscles are overused or tight. During movement, the patellar tendon absorbs more shock than usual. The tendon becomes irritated or damaged.

Plica Band Syndrome Plica bands are tissue fibers that some people have near the kneecap. They usually cause no problems. But sometimes they can become irritated or inflamed.

Plica Band Syndrome

Plica bands are tissue fibers that some people have near the kneecap. They usually cause no problems. But sometimes they can become irritated or inflamed.


Whatever your goals, your doctor may recommend that you see a physical therapist to help you reach them. Whenever possible, the goal of your 3-stage rehab program is to get you back to your normal activities. This is done by helping you knee heal and by exercising your knee and its supporting muscles.

Stage 1: Starting to Heal

You'll work with your physical therapist or doctor to reduce pain and swelling. Then you can begin to increase your knee's pain-free range of motion.

Stage 2: Improving Your Knee's Function

You'll begin flexibility and strengthening exercises. This helps build up the muscles around your knee.

Stage 3: Practicing Everyday Moves

You'll get your knee and leg ready for everyday activities. You'll work to relearn movements and improve your ease and quickness.

 


Many treatments can help reduce pain and swelling in your knee. Your doctor or physical therapist may suggest one or more of the following treatments.

  • Icing your knee helps reduce swelling. You may be asked to ice your knee once a day or more.

  • Keeping your leg raised above your heart helps excess fluid flow out of your knee joint. This reduces swelling.

  • Compression means wrapping an elastic bandage or neoprene sleeve snugly around your knees. This keeps fluid from collecting in your knee joint.

  • Electrical stimulation can help reduce excess fluid in your knee joint.

  • Anti-inflammatory medicines may be prescribed by your doctor. You may take pills or receive injections in your knee.

  • Isometric (contracting) exercises strengthen the muscles that support your knee joint. They also help reduce excess fluid in your knee.

  • Massage helps fluid drain away from your knee.

Icing, elevation, and electrical stimulation can help reduce inflammation.

Icing, elevation, and electrical stimulation can help reduce inflammation.