Angie's LIST Guide to
Knee Orthopedics

Some orthopedic doctors specialize in the bones, muscles and tendons of the knee, from treating ACL tears and arthritis to performing knee replacement surgery.

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knee doctor
If you have a knee injury or pain, see an orthopedic doctor. (Photos courtesy of NorthShore University HealthSystem)

Osteoarthritis, other knee problems

Your knee, which is a complex intersection of bones, muscles, joints and tendons, is vulnerable to many syndromes and diseases, including arthritis. It's quite common that orthopedic doctors, or orthopedists, would treat this problem in older patients.

Arthritis comes in three main forms:

Osteoarthritis — also called degenerative arthritis — starts with inflammation in the joints that leads to breakdown and loss of cartilage. The most common form of arthritis, osteoarthritis plagues millions of Americans.

Rheumatoid arthritis involves an autoimmune disease that causes chronic inflammation to the joints and eventual deterioration and deformity.

Post-traumatic arthritis, a type of joint wear and tear, results from physical injury or trauma to the cartilage or bone.

Orthopedic doctors who specialize in knees and hips say common symptoms of arthritis in these joints include 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 — the patella — 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.

From ACL tears to bone fractures

Tears, like those generally seen in active patients, often involve one of the four ligaments of the knee: the anterior cruciate ligament, or ACL; posterior cruciate ligament, or PCL; lateral collateral ligament, or LCL; and the medial collateral ligament, or MCL.

The cruciate ligaments cross within your knee, and the collateral ligaments help fasten your upper leg bone to your lower leg bones. Sprains or tears most commonly occurring to the ACL or MCL.

Depending on the degree of injury — from a stretched ligament, or slight sprain, to a complete tear — one may experience anything from relatively minor discomfort and little or no instability to the joint to severe pain with the knee "giving out" and surgical reconstruction of the ligament recommended.

Commonly when a person tears a ligament they may also tear cartilage, or connective tissue, at the knee joint. This can occur independent of other injuries as well and can also involve significant pain and swelling.

In addition, patients young and old, active and sedentary, can experience fractures — albeit from a fall or playing sports. As with other knee injuries, this can cause serious pain, swelling and tenderness, in addition to shattered or broken bones. 

Seeing an orthopedic doctor

Treatment for problems involving the knee vary. Sometimes two people with the same injury will undergo a different treatment, such as surgery versus medication and physical therapy.

In certain cases, orthopedic surgeons who specialize in knees and hips will perform a procedure known arthroscopy, sending a tiny camera through a small incision in the knee to observe damage, such as torn cartilage, before determining how to proceed.

Orthopedic surgeons may, in certain instances, recommend knee replacement surgery where serious knee pain and problems, such as arthritis and mobility limitations, arise. This surgical procedure removes the damaged knee joint and replaces it with an artificial joint, or prosthesis, made of metal, plastic or a combination.


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