Angie's LIST Guide to
Knee and leg orthopedics

Some orthopedic doctors specialize in problems related to the bones, muscles and tendons of the knee and the leg. These musculoskeletal issues include fractures, tears, sprains, injuries, diseases and syndromes.

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Diseases of the knee and leg

Your knee comprises a complex intersection of bones, muscles, joints and tendons. As such it's vulnerable to many syndromes and diseases.

Most commonly, orthopedic doctors treat arthritis in elderly patients. Arthritis comes in three different forms:

Osteoarthritis. Also called degenerative arthritis, this disease starts with inflammation in the joints that leads to breakdown and loss of cartilage.
Rheumatoid arthritis (RA). RA is an autoimmune disease causing chronic inflammation to the joints and eventual deterioration and deformity.
Post-traumatic arthritis. This type of joint wear and tear comes as a direct result of physical injury or trauma to the cartilage or bone.

The most common symptoms of arthritis are pain, stiffness and swelling, which often worsen after activity. Many people experience a locking of the knee or an inability to move the knee at all. They may also experience a buckling effect where their knee joint collapses, putting them at risk of falling. Patellofemoral pain syndrome affects the kneecap and causes the cartilage to weaken and wear thin. The most obvious symptoms of patellofemoral arthritis are pain and an audible cracking in the knee.

Kneecap bursitis, or prepatellar bursitis, cause the fluid-filled sac in the kneecap, the bursa, to become swollen and inflamed. This can occur because of rheumatoid arthritis, gout, kneeling a great deal and landing directly on your knee when falling, as happens in sports. With bursitis, your knee will appear swollen and warm, and you'll often experience pain during activity.

Many athletes suffer from runner's knee, which causes pain in the front of the knee due to an increase in activity. Often with this condition, your kneecap is often out of alignment, strained, injured, dislocated or weak. You'll experience an achy sensation in the kneecap.

Osgood-Schlatter disease is a common injury among older children and teens that occurs due to swelling and tenderness where your large tendon under the kneecap attaches to your shinbone.

Injuries to the knee or leg

Knee and leg orthopedics must address fractures, tears and injuries, which are very common among athletes.

These injuries often afflict young people because of their high levels of energy and activity. They also affect the elderly as their bones weaken with age.

An open fracture will puncture the skin, but a closed fracture will not. Two types of fractures include comminuted fractures, where the bones shatter, and transverse fractures, which have a clean break. Symptoms of a fracture include pain, swelling, bruising, tenderness and misshapen appearance. Sprains can come in degrees of injury: from grade 1 to grade 3, with grade 3 being the most severe.

A meniscal tear, or torn cartilage, is a very common sports injury. The meniscus is the curved cartilage that cushions the area between the shinbone and the thighbone. When you injure the meniscus, you'll hear a popping noise. Pain, swelling, locking up, giving out and decreased motion are typical results. If not addressed, the meniscus can break off and travel into the joint.

A very common tear, in sports especially, involves one of the four ligaments of your knee: the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), lateral collateral ligament (LCL) and medial collateral ligament (MCL). The cruciate ligaments cross within you knee, and the collateral ligaments help fasten your upper leg bone to your lower leg bones. You'll find sprains or tears most commonly occurring to the ACL or MCL.

Treatment for knee problems

Treatment for ailments involving knee and leg injuries can vary from case to case. Sometimes two people with the same injury will undergo a different treatment. A nonsurgical form of treatment known as conservative therapy involves medications to decrease the swelling, as well as ice, rest, elevation, physical therapy, splinting or casting.

You may undergo a common procedure known as arthroscopy, where the surgeon makes a small incision in your knee and inserts a pencil-tip-sized tool, known as an arthroscope, to observe the damage. Surgeons usually perform arthroscopy as an outpatient procedure that still requires the usual physical examination and anesthesia. If the orthopedic surgeon needs to perform repairs or clean out the area, you'll undergo arthroscopic surgery.

In only the most serious cases, orthopedic surgeons perform replacement knee surgery. This extensive surgical procedure removes the damaged knee joint and replaces it with an artificial joint, or prosthesis, made of metal, plastic or a combination. Recovery time from the surgery tends to need six to eight weeks, followed by months of physical therapy. After you recover from this surgery, you often can move more easily and without pain.

Check with the American Academy of Orthopaedic Surgeons when seeking an orthopedic doctor and contact your health insurance provider to determine what your policy covers for the procedure you'll need. Depending on your insurance plan, you may need a referral from your primary care physician in order for your policy to pay for treatment.

Read through the listing of orthopedic doctors in the provider directory available from your health insurance company. Carefully research the orthopedic doctors you are considering. Verify their qualifications, education, continuing education, accepted insurance plans and affiliated hospitals by consulting Angie's List, where you can also see member reviews and rankings.

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Knee and leg orthopedics

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