Knee
Knee Anatomy
The knee is a complex joint made up of different structures including bones, tendons, ligaments and muscles. They all work together to maintain normal function and provide stability to the knee during movement.
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Conditions
Knee Pain
The knee is one of the largest joints in the body, formed by the lower end of the femur, upper end of the tibia and the patella or knee cap. Several ligaments and muscles attach to the bones of the knee joint to maintain normal motion of the joint.
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Anterior Knee Pain
Anterior knee pain is a characterized by a chronic pain over the front and center of the knee joint. It is common in athletes, active adolescents (especially girls) and overweight individuals. Anterior knee pain refers to a variety of conditions which include runner's knee or patellar tendinitis and chondromalacia of the patella.
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Runner’s Knee
Runner's knee, also called patellofemoral pain syndrome refers to pain under and around your kneecap. Runner’s knee includes several medical conditions such as anterior knee pain syndrome, patellofemoral malalignment, and chondromalacia patella that cause pain around the front of the knee.
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Osgood Schlatter Disease
Osgood-Schlatter disease refers to a condition of an overuse injury that occurs in the knee region of growing children and adolescents. This is caused by inflammation of the tendon located below the knee cap (patellar tendon).
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Chondromalacia Patella
The patella, also called the kneecap is a small bone present on the front of your knee joint. The underside of the patella is covered by cartilage that allows smooth gliding of the knee with movement. Overuse or misalignment of the patella can cause wear and tear of the cartilage.
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Jumper’s Knee
Jumper’s knee, also known as “patellar tendinitis" is an inflammation of the patellar tendon that connects your kneecap (patella) to your shinbone. This tendon helps in extension of the lower leg.
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Bursitis
A bursa is a small fluid-filled sac found between soft tissues and bones. It lubricates and acts as a cushion to decrease friction between bones when they move. Bursitis refers to the inflammation and swelling of the bursa. Inflammation of the bursa in front of the kneecap (patella) is known as kneecap bursitis or prepatellar bursitis.
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Baker’s Cyst
The knee consists of a fluid called synovial fluid, which reduces friction between the bones of the knee joint while you move your leg. Sometimes this fluid is produced in excess, resulting in its accumulation in the back of your knee. A Baker’s cyst or popliteal cyst is a fluid-filled swelling that develops into a lump behind the knee.
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Iliotibial Band Syndrome
Iliotibial band syndrome is an overuse injury resulting from the inflammation of iliotibial band. Iliotibial band is a tough group of fibers that begins at the iliac crest of hip and runs along the outside of the thigh, to get attached to the outer side of the shin bone just below the knee joint.
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Lateral Patellar Compression Syndrome
Lateral patellar compression syndrome refers to pain under and around your kneecap. It is a common complaint among runners, jumpers, and other athletes such as skiers, cyclists, and soccer players.
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Osteochondritis Dissecans
Osteochondritis dissecans is a joint condition in which a piece of cartilage, along with a thin layer of the bone separates from the end of the bone because of inadequate blood supply. The separated fragments are sometimes called “joint mice”.
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Shin Splints
“Shin splints” is used to describe the pain and inflammation of the tendons, muscles and bone tissue around the tibia or shine bone (a large bone in the lower leg). It occurs because of vigorous physical activity such as exercise or sports. The condition is also referred to as medial tibial stress syndrome (MTSS).
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Knee Injury
Pain, swelling and stiffness are the common symptoms of any damage or injury to the knee. If care is not taken during the initial phases of injury, it may lead to joint damage that may end up destroying your knee.
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Unstable Knee
The knee joint is one of the largest joints in the body. This highly complex joint has several tissues supporting and stabilizing its movement:
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Goosefoot Bursitis of the Knee
A bursa is a small fluid-filled sac found between soft tissues and bones. It lubricates and acts as a cushion to decrease friction between bones when they move. Bursitis refers to the inflammation and swelling of the bursa.
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Knee Sprain
Knee sprain is a common injury that occurs from overstretching of the ligaments that support the knee joint. A knee sprain occurs when the knee ligaments are twisted or turned beyond its normal range causing the ligaments to tear.
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ACL Tears
The anterior cruciate ligament, or ACL, is one of the major ligaments of the knee that is located in the middle of the knee and runs from the femur (thigh bone) to the tibia (shin bone).
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MCL Tears
The medial collateral ligament (MCL) is the ligament that is located on the inner part of the knee joint. It runs from the femur (thighbone) to the top of the tibia (shinbone) and helps in stabilizing the knee. Medial collateral ligament (MCL) injury can result in a stretch, partial tear, or complete tear of the ligament.
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MCL Sprain
The medial collateral ligament (MCL), a band of tissue present on the inside of your knee joint, connects your thigh bone and shin bone (bone of your lower leg). The MCL maintains the integrity of the knee joint and prevents it from bending inward.
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Meniscal Injuries
The knee is one of the most complex and largest joint in the body, and is more susceptible to injury. Meniscal tears are one among the common injuries to the knee joint. It can occur at any age, but are more common in athletes playing contact sports.
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Meniscal Tears
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.
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Ligament Injuries
The knee is a complex joint which consists of bone, cartilage, ligaments and tendons that make joint movements easy and at the same time more susceptible to various kinds of injuries.
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Multiligament Instability
The knee is a complex joint of the body which is vital for movement. The four major ligaments of the knee are anterior cruciate ligament, posterior cruciate ligament, medial collateral ligament and lateral collateral ligament. They play an important role in maintaining the stability of the knee.
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Knee Arthritis
Arthritis is a general term covering numerous conditions where the joint surface or cartilage wears out. The joint surface is covered by a smooth articular surface that allows pain free movement in the joint.
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Patellar Dislocation/Patellofemoral Dislocation
Patella (knee cap) is a protective bone attached to the quadriceps muscles of the thigh by quadriceps tendon. Patella attaches with the femur bone and forms a patellofemoral joint.
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PCL Injuries
Posterior cruciate ligament (PCL), one of four major ligaments of the knee are situated at the back of the knee. It connects the thighbone (femur) to the shinbone (tibia). The PCL limits the backward motion of the shinbone.
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Chondral (Articular Cartilage Defects)
Articular or hyaline cartilage is the tissue lining the surface of the two bones in the knee joint. Cartilage helps the bones move smoothly against each other and can withstand the weight of the body during activities such as running and jumping. Articular cartilage does not have a direct blood supply to it so has less capacity to repair itself.
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Patellar Instability
Patellar (knee cap) instability results from one or more dislocations or partial dislocations (subluxations). Patella is the small piece of bone in front of the knee that slides up and down the femoral groove (groove in the femur bone) during bending and stretching movements.
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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.
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Patella Fracture
The knee cap or patella is the largest sesamoid bone in the body and one of the components of the knee joint, present at the front of the knee. The undersurface of the kneecap and the lower end of the femur are coated with articular cartilage, which helps in smooth movement of the knee joint.
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Recurrent Patella Dislocation
The patella (knee cap) is a small bone that shields your knee joint. It is found in front of your knee, in a groove called the trochlear groove that sits at the junction of the femur (thighbone) and tibia (shinbone).
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Quadriceps Tendon Rupture
Quadriceps tendon is a thick tissue located at the top of the kneecap. The quadriceps tendon works together with the quadriceps muscles to allow us to straighten our leg. The quadriceps muscles are the muscles located in front of the thigh.
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Patella Tendon Rupture
Patella tendon rupture is the rupture of the tendon that connects the patella (knee cap) to the top portion of the tibia (shin bone). The patellar tendon works together with the quadriceps muscle and the quadriceps tendon to allow your knee to straighten out.
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Lateral Meniscus Syndrome
The knee joint is formed by the union of two bones, namely the femur (thigh bone) and the tibia (lower leg bone). At the junction of these two bones is a cartilage called the meniscus, which acts as a shock absorber. There are two menisci – the lateral and medial menisci.
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Medial Meniscus Syndrome
Of the menisci within the knee, it is the medial that is more easily injured. Differences in the anatomical attachments of the medial meniscus compared to the lateral mean that the medial meniscus becomes distorted during combined flexion and rotation movements in a manner not experienced on the lateral side.
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Tibial Eminence Spine Avulsions
Tibial eminence spine avulsion fracture is avulsion (tear away) of the tibial eminence (an extension on the bone for attachment of muscles) which most commonly involves the anterior cruciate ligament (ACL) insertion site.
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Osteonecrosis of the Knee
Osteonecrosis is a condition in which death of a section of bone occurs because of lack of blood supply to it. It is one of the most common causes of knee pain in older women. Women over the age of 60 years of age are commonly affected, three times more often than men.
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Knee Angular Deformities
Angular deformities of the knee are common during childhood and usually are variations in the normal growth pattern. Angular deformity of the knee is a part of normal growth and development during early childhood.
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Procedures
Non-surgical Treatments
Pharmacological
The knee is a complex joint which consists of bone, cartilage, ligaments and tendons that make joint movements easy and at the same time more susceptible to various kinds of injuries. Knee problems may arise if any of these structures get injured by overuse or suddenly during sports activities.
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Viscosupplementation
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.
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Cortisone Injection
Cortisone is a corticosteroid released by the adrenal gland in response to stress and is a potent anti-inflammatory agent. Artificial preparations containing cortisone are injected directly into the affected joint to relieve pain and reduce inflammation. The effects may last for several weeks and cortisone injections are recommended in injuries that cause pain & inflammation and those don’t require surgical treatment.
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Physiotherapy
Physiotherapy or physical therapy is an exercise program that helps you to improve movement, relieve pain, encourage blood flow for faster healing, and restore your physical function and fitness level. The main aim of physical therapy is to make your daily activities such as walking, getting in and out of bed, or climbing stairs easier.
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Surgical Treatment
Knee Arthroscopy
Knee Arthroscopy is a common surgical procedure performed using an arthroscope, a viewing instrument, to consider the knee joint to diagnose or treat a knee problem. It is a relatively safe procedure and most the patient’s discharge from the hospital on the same day of surgery.
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Knee Replacement and Reconstruction
Knee Osteotomy
Knee Osteotomy is a surgical procedure in which the upper shinbone (tibia) or lower thighbone (femur) is cut and realigned. It is usually performed in arthritic conditions affecting only one side of your knee and the aim is to take pressure off the damaged area and shift it to the other side of your knee with healthy cartilage.
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High Tibial Osteotomy
High tibial osteotomy is a surgical procedure performed to relieve pressure on the damaged site of an arthritic knee joint. It is usually performed in arthritic conditions affecting only one side of your knee and the aim is to take pressure off the damaged area and shift it to the other side of your knee with healthy cartilage.
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Tibial Tubercle Osteotomy
Tibial tubercle osteotomy is a surgical procedure which is performed along with other procedures to treat patellar instability, patellofemoral pain, and osteoarthritis. This is a quite safe procedure and provides excellent access and surgical exposure during a difficult primary or revision total knee arthroplasty.
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Unicompartmental 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.
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Patellofemoral Knee Replacement
Patellofemoral Knee Replacement surgery may be recommended by your surgeon if you have osteoarthritis contained to the patellofemoral compartment and you have not obtained adequate relief with conservative treatment options.
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What is new in Knee Replacement
For a patient considering knee replacement surgery, there are new developments under study which can help enhance their quality of life.
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Computer Navigation for Total Knee Replacement
A total knee replacement surgery is the last resort to relieve pain and restore function in knee damaged by arthritis or an injury when non-surgical treatments do not relieve the condition.
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Total Knee Replacement (TKR)
Total knee replacement, also called total knee arthroplasty, is a surgical procedure in which the worn out or damaged surfaces of the knee joint are removed and replaced with artificial parts.
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Revision Knee Replacement
Revision knee replacement surgery involves replacing part or all your previous knee prosthesis with a new prosthesis. Although total knee replacement surgery is successful, sometimes the procedure can fail due to various reasons and require a second revision surgery.
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Robotic Assisted Partial Knee Surgery
Revision knee replacement surgery involves replacing part or all your previous knee prosthesis with a new prosthesis. Although total knee replacement surgery is successful, sometimes the procedure can fail due to various reasons and require a second revision surgery.
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Medial Patellofemoral Ligament Reconstruction
Medial patellofemoral ligament reconstruction is a surgical procedure indicated in patients with more severe patellar instability. Medial patellofemoral ligament is a band of tissue that extends from the femoral medial epicondyle to the superior aspect of the patella.
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Distal Realignment Procedures
Distal realignment procedures, also known as TTT or tibial tubercle transfer procedures are performed to reposition the kneecap by realigning the tendon under the kneecap to the underlying tibial tubercle.
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Arthroscopic Reconstruction of the Knee for Ligament Injuries
The knee is the most complex joint in the body and is formed by the articulation between the thigh bone (femur) and the shinbone (tibia). A knee cap is present over the front of the joint to provide extra protection. These bones are held together by four strong rope like structures called ligaments.
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PCL Reconstruction
Posterior cruciate ligament (PCL), one of four major ligaments of the knee are situated at the back of the knee. It connects the thighbone (femur) to the shinbone (tibia). The PCL limits the backward motion of the shinbone.
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LCL Reconstruction
Lateral collateral ligament (LCL) is a thin set of tissues present on the outer side of the knee, connecting the thighbone (femur) to the fibula (side bone of lower leg). It provides stability as well as limits the sidewise rotation of the knee. Tear or injury of LCL may cause instability of the knee that can be either reconstructed or repaired to regain the strength and movement of the knee.
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ACL Reconstruction
The anterior cruciate ligament is one of the major stabilizing ligaments in the knee. It is a strong rope like structure located in the center of the knee running from the femur to the tibia.
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Outpatient Total Knee Replacement
Total knee replacement is the surgical treatment for knee arthritis, where the damaged knee is removed and replaced with an artificial knee implant. Traditionally performed as an inpatient procedure, total knee replacement surgery is now being conducted on an outpatient basis, allowing patients to go home the same day of the surgery.
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Tricompartmental Knee Replacement
Tricompartmental knee replacement, also called total knee arthroplasty, is a surgical procedure in which the worn out or damaged surfaces of the knee joint are removed and replaced with artificial parts. The knee is made up of the femur (thigh bone), the tibia (shin bone), and patella (kneecap).
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After Knee Replacement
Knee replacement is a surgery performed to replace parts of a diseased knee joint with an artificial prosthesis. The goal of knee replacement is to eliminate pain and return you to your normal activities.
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Patient Specific Knee Options
Custom Fitted Total Knee Arthroplasty
Custom fitted total knee arthroplasty is a newer technology in total knee replacement surgery. It is an advanced procedure using an individualized patient-specific knee implant for replacement of all three components of the knee.
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Signature Knees
The knee joint, made up of the ends of the femur (thigh bone) and tibia (shin bone) is cushioned by a spongy tissue called cartilage. Damage and wear and tear of the cartilage causes painful rubbing of the joint bones, leading to disability.
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Knee Implants
Knee implants are artificial devices that form the essential parts of the knee during a knee replacement surgery. The knee implants vary by size, shape, and material. Implants are made of biocompatible materials that are accepted by the body without producing any rejection response.
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Cartilage Restoration
Patellar Tendon Repair
Patella (knee cap) is a protective bone attached to the quadriceps muscles of the thigh by quadriceps tendon. Patella attaches with the femur bone and forms a patellofemoral joint.
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Knee Ligament Reconstruction
The knee is the most complex joint in the body and is formed by the articulation between the thigh bone (femur) and the shinbone (tibia). A knee cap is present over the front of the joint to provide extra protection. These bones are held together by four strong rope like structures called ligaments.
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Cartilage Replacement
Cartilage replacement is a surgical procedure performed to replace the worn-out cartilage with the new cartilage. It is usually performed to treat patients with small areas of cartilage damage usually caused by sports or traumatic injuries. It is not indicated for those patients who have advanced arthritis of knee.
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Cartilage Repair and Transplantation
Articular Cartilage is the white tissue lining the end of bones where these bones connect to form joints. Cartilage acts as cushioning material and helps in smooth gliding of bones during movement. An injury to the joint may damage this cartilage which cannot repair on its own.
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OATS
OATS is “osteochondral autograft transfer system”. It is one of the two types of cartilage transfer procedures and the other procedure is “Mosaicplasty”. Cartilage transfer procedures involve moving healthy cartilage from a non-weight bearing area of the knee to a damaged area of the cartilage in the knee.
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Resurfacing
Bicompartmental Knee Resurfacing
The knee can be divided into three compartments: Patellofemoral, the compartment on the front of the knee which contains the knee cap, medial compartment, the compartment on the inside of the knee, and lateral compartment which is the area on the outside of the knee joint.
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Partial Knee Resurfacing
Partial knee replacement is an alternative to total knee replacement in patients with arthritis on only one side of the knee. Partial knee replacement is a surgical procedure which involves resurfacing and replacement of only the diseased surface of the joint instead of the entire joint.
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Others
Autologus Chondrocyte Implantation
Autologous chondrocyte implantation (ACI) is a procedure to treat the articular cartilage defects of the knee. This procedure is effective for treating small areas of cartilage damage that causes pain and swelling and restricts the range of motion.
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Subchondroplasty
Knee osteoarthritis (OA) is a common form of arthritis that causes joint pain and stiffness. It is a progressive disease in which the joint cartilage gradually wears away and may lead to disability.
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Partial Meniscectomy
Partial meniscectomy is a surgical procedure to remove the torn portion of the meniscus from the knee joint. Meniscus is the C-shaped cartilage located in the knee that lubricates the knee joint, acts as shock-absorber, and controls the flexion and extension of joint.
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Meniscal Surgery
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.
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Ilizarov Circular Fixator – Limb Deformity Correction
Coming soon
Limb Lengthening
Limb lengthening is a reconstructive procedure where the deformed bone is straightened or missing bone is replaced. It is performed in children and adults who have variations in their leg length because of diseases, injuries or birth defects.
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Ellipse Precici Limb Lengthening
Coming soon
Taylor Spatial Frame Correction
Coming soon
TrueLok Hex Frame Correction
Coming soon