Knee pain is one of the most common complaints that an orthopedic surgeon sees in the office. It can occur from a variety of causes such as a sports injury, overuse, arthritis and obesity. The pain can occur when a patient is weight bearing, but it also can occur with stair climbing or standing after sitting. Mechanical symptoms often present with locking, catching or giving out. If an athlete injures their knee and has immediate swelling then there is concern that something is torn.
When a patient is first seen the history will often give us the diagnosis. Xrays are done to determine if there is any structural damage to the bone as well as to see if there is arthritis. If there is concern that the patient may need surgery then an MRI is ordered. MRI's will show soft tissue: ligaments, meniscus and cartilage surfaces that can help to pin down the diagnosis.
Arthritis usually will present with complaints of pain that increases with weightbearing activities. The patient will be limit how far a person can walk before they have to stop and rest. Obesity is one of the main causes of knee pain and it is progressive. It will not improve unless the patient reduces their weight, increases their knee strength or has some type of interventional procedure.
The most common problem that I see in the office for knee pain is a torn meniscus. The meniscus is the gristle like material between the femur and tibia. It can tear and cause pain with locking, catching, popping or giving out. We usually will order an MRI since the meniscus is not visible on xrays. If the tear is large enough then surgery may be necessary. ACL tears are also seen, but they usually present with an injury and patients will also have swelling of the knee.
Lastly one of the most common reasons for knee pain is inflammation of the patella tendon. This is also called jumper's knee and is most often seen in younger patients. The pain is in the front portion of the knee and can be sharp in character. It is usually related to activities where there is jumping, but can also occur with stairs and going from sitting to standing.
These are just some of the highlights of knee pain that can occur. Most of the time conservative treatment such as ice, rest, anti-inflammatory medication and physical therapy will relieve the symptoms.