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Knee Pain Clinic

Are you frustrated with your knee pain that is not getting better? Are you experiencing Knee discomfort after prolong walking, squatting or running? You are in the right place! We certainly able to help with our innovative and non-invasive (non-surgical) form of treatment. Get your knee check today. Call us at (65) 64712744 or SMS to (65) 92357641 to schedule for an appointment

Knee Pain

Knee pain refers to pain that occurs in and around your knee joint. Knee pain can be caused by problems with the knee joint itself, or it can be caused by conditions affecting the soft tissues, ligaments, tendons, or bursae that surround the knee.

The severity of knee pain can vary widely. Some people may feel only a slight twinge, while others may experience debilitating knee pain that interferes with their day-to-day activities. In most cases, self-care measures can help you cope with knee pain.

The knee consists of two long leg-bones held together by muscles, ligaments, and tendons. Many knee problems are a result of the aging process and continual wear and stress on the knee joint. Other knee problems result from injury or a sudden movement that stiffens the knee.

Some common conditions of Knee Problem include:

  • ARTHRITIS – Knee pain is a common problem in Asia, especially in individuals above the age of 40. The most common cause of knee pain is degenerative osteoarthritis. Women are more prone to the disease. It is characterized by mild to debilitating pain.

  • LIGAMENT INJURIES – Ligament injuries in the knee; such as an anterior cruciate ligament (ACL) are dreaded by professional and amateur athletes alike. They can be painful and debilitating. They can even permanently change your lifestyle.

  • MENISCAL TEAR – The meniscus is a small “c” shaped cartilage that acts as a cushion in the knee joint. They sit between the femur and the tibia bone, one on the outside and one on the inside of the knee.

  • PATELLAR TENDONITIS – Patellar tendinitis is a common overuse injury. It occurs when repeated stress is placed on the patellar tendon. The stress results in tiny tears in the tendon, which the body attempts to repair.

  • CHONDROMALACIA PATELLA – Chondromalacia patella is a common cause of kneecap pain or anterior knee pain. Often called “Runner’s Knee,” this condition often affects young, otherwise healthy athletes.

  • DISLOCATING KNEECAPS – Kneecap dislocation occurs when the triangle-shaped bone covering the knee (patella) moves or slides out of place. The problem usually occurs toward the outside of the leg.

  • BAKER’S CYST – A Baker cyst is swelling caused by fluid from the knee joint protruding to the back of the knee. The back of the knee is also referred to as the popliteal area of the knee

  • BURSITIS – A bursa is a closed fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body.

  • PLICA SYNDROME – Often called “synovial plica syndrome,” this is a condition that is the result of a remnant of fetal tissue in the knee. The synovial plica are membranes that separate the knee into compartments during fetal development.

  • OSGOOD-SCHALLATER DISEASE – Osgood-Schlatter disease is a disorder of the lower front of the knee where the large tendon under the kneecap (patellar tendon) attaches to the bone of the leg below.

  • OSTEOCHONDRITIS DISSECANS – Osteochondritis dissecans is a joint condition in which a piece of cartilage, along with a thin layer of the bone beneath it, comes loose from the end of a bone.

  • GOUT – Gout is a rheumatoid form of arthritis that causes the inflammation, joint pain and swelling especially in the toe, knee and ankle, also reducing their mobility.

  • SHIN SPLINT – Shin splints are a member of a group of injuries called “overuse injuries.” Shin splints occur most commonly in runners or aggressive walkers

When do you need to call us about your knee pain?

If you are unsure of the cause of your symptoms, or if you do not know the specific treatment recommendations for your condition, you should seek medical attention. Treatment of knee pain must be directed at the specific cause of your problem. Some signs that you should be seen by a doctor include:

  • Inability to walk comfortably on the affected side

  • Injury that causes deformity around the joint

  • Knee pain that occurs at night or while resting

  • Knee pain that persists beyond a few days

  • Locking (inability to bend) the knee

  • Swelling of the joint or the calf area

  • Signs of an infection, including fever, redness, warmth

  • Any other unusual symptoms

Treatments for Knee Pain

Treatment of knee pain depends entirely on the cause of the problem. Therefore, it is of utmost importance that you understand the cause of your symptoms before embarking on a treatment program. If you are unsure of your diagnosis, or the severity of your condition, you should seek medical advice before beginning any treatment plan.

Read more about patient guide to knee pain

Read more about knee pain while running

Read more about knee pain causing by heavy weight

Read more about 9 tips to avoid knee pain and injuries

Read more about Meniscus Cartilage Tear

Who is Knee Specialist?

Knee specialist is an orthopaedic surgeon specialise in disorders of the knee. They deal with conditions such as knee arthritis, and damage to the knee ligaments. The operations and treatments that knee specialists offer include total and partial knee replacement, arthroscopic knee surgery, and knee ligament reconstruction (including anterior cruciate ligament reconstruction).

CURE YOUR KNEE PAIN TODAY. GET A KNEE SPECIALIST TO RULE OUT THE CAUSES AND CURE OF YOUR KNEE PAIN. CALL US +65 64712744 OR EMAIL INFO@BONECLINIC.COM.SG TO SCHEDULE FOR AN APPOINTMENT

Meniscal Injury

The meniscus is important for transmitting loads across the knee. The menisci increase the surface area of contact and fill the gaps between differently shaped articulating surfaces: the round femoral condyles, the relatively flat tibial plateau on the medial side, and the convex tibial plateau on the lateral side.

Normal Medial Meniscus
Normal medial meniscus

Removing the menisci increases the contact pressure between the femur and the tibial articular surfaces and may predispose to early arthritis. On the medial side, load is shared equally between the medial meniscus and the articular surface. However, the lateral meniscus must bear most of the lateral side load transmission alone. It seems that degenerative changes are more likely after partial lateral meniscectomies than after partial medial meniscectomies.

The meniscus has been shown to play a vital role in load transmission across the knee joint. Biomechanical studies have demonstrated that at least 50% of the compressive load of the knee joint is transmitted through the meniscus in extension, and 85% of the load is transmitted in 90 degrees of flexion. In the meniscal deficient knee the contact area is reduced approximately 50%, which results in articular cartilage damage. Partial meniscectomy has also been shown to increase contact pressures significantly. Another proposed function of the meniscus is that of schock absorption, although it seems that the menisci do not play a significant role in shock absorption. The menisci are also believed to contribute to joint stability, especially in ACL deficient knees. Finally, the menisci may serve as proprioceptive structures providing a feedback mechanism for joint position sense.

Meniscal Injury

Turning or twisting of the knee may cause tearing of the meniscus. When the torn part is mobile, flexion and extension of the knee can displace the fragment out its normal position. Typical signs and symptoms are clicking, catching or snapping. A knee effusion may or may not be present, but most patients will have jointline tenderness.

Radial Medial Meniscal Tear
Flap Tear of the Medial Meniscus
Radial meniscal tear
Large meniscal flap tear

 

Giving way and locking are also frequent symptoms of a meniscal injury. Displaced bucket handle tears, which usually go with chronic ACL deficiency, will cause the knee to lock in flexion. Anteromedial pain with mechanical block to extension reflects a displaced bucket-handle tear or ACL tear.

Longitudinal tear
Bucket handle tear

 

Medial meniscal tears are more often symptomatic than lateral meniscal tears. Most tears occur in the posterior load-bearing area, causing medial and posteromedial jointline pain and effusion. Pain in the anterior third is not from a meniscal tear, because no weightbearing occurs there, and anterior medial meniscal tears are extremely rare. However, patients with a displaced bucket-handle medial meniscal tear may complain of anteromedial pain with a mechanical block to extension, which is often followed by an effusion.

Early clinical and MRI diagnosis, and appropriate treatment of meniscal tears, especially in people younger than 40, are very important for the longevity of the knee joint.

Meniscal Cysts

Meniscal cysts were first described by Ebner in 1904. They are often associated with a specific complex type of meniscal tear called a horizontal cleavage tear, usually of the lateral, rarely the medial meniscus. However, isolated cysts without meniscal pathology have also been reported. Clinically, meniscal cysts look like a small lump, usually at the level of the lateral joint line. The size of the lump often correlates to activity level and the chronicity and the complexity of the meniscal tear. They are encapsulated, hernia-like structures, and they contain viscous synovial, often gel-like, fluid which penetrates through the torn meniscus and accumulates under the skin.

Several theories have been proposed regarding cyst aetiology, including traumatic and degenerative origins. Histology shows a meniscal cyst formation which originates by influx of synovial fluid through microscopic and gross tears in the substance of the meniscus. A meniscal tear with a horizontal component, as well as a tract that provides an exchange of fluid between the joint and the cyst, is often seen. Meniscal cysts are multilocular and lined with synovial endothelial tissue.

Meniscal cysts can be drained with a needle (although this can be difficult because of the viscosity of the content of the cyst) but they will often come back, because a tear in the meniscus will allow further penetration of the synovial fluid into the cyst. The management of a meniscal cyst usually involves an MRI scan of the knee to determine the presence of a meniscal tear and the location of the cyst. In the presence of a meniscal tear, partial arthroscopic meniscectomy followed by arthroscopic cyst decompression is the treatment of choice. If a tear is not confirmed at the time of arthroscopy open decompression of the cyst, performed through a mini-arthrotomy, combined with “outside-in” meniscal repair is the best treatment option. Recurrent meniscal cysts are not uncommon and open cystectomy may be required. In any case, the peripheral meniscal body should be preserved and the meniscus should not be excised under any circumstances.

Medial Meniscal Cyst and Horizontal Tear
Medial meniscal cyst

Lateral Meniscal Cyst and Horizontal Tear
Lateral meniscal cyst

Clinically lateral meniscal cysts are far more common than the medial ones. However, MR imaging reveals a different pattern. A retrospective review of 2572 knee MRI reports, for the presence of meniscal tears and cysts, revealed that meniscal cysts occur almost twice as often in the medial compartment as in the lateral compartment! Medial and lateral tears occur with the same frequency. These findings, when viewed in the context of the historical literature on meniscal cysts, suggest that MR imaging detects a greater number of medial meniscal cysts than physical examination or arthroscopy, and that MR imaging can have an important impact on surgical treatment of patients.

Stop the pain and Get your Knee checked! Call +65 6471 2744 or SMS to +65 9235 7641 / Email to: info@boneclinic.com.sg