KNEE

Cartilage, ligaments, and bones that make up the knee joint get damaged and worn down after years of physical activity such as walking, running, playing, and working.  One of the many forms of arthritis may occur in the knee joint and cause pain and lack of mobility.  As described in the knee joint picture below, there are four levels of cartilage damage Dr. Royce can treat appropriately depending on the patient.

Causes of Knee Pain
Knee pain is often caused by damage to the cartilage. Cartilage is tissue that is found throughout the body and helps provide support and cushioning for the body ín different structures.

The Function of Knee Cartilage
The cartilage that is found in the knee serves three major purposes.

• Minimize friction between the bones of the knee.
• Help distribute the load that is placed on the knees.
• Enhance the range of movement across the knee joint.

Types of Injuries to Cartilage of the Knee
Knee cartilage can be injured in a variety of ways. The most common types of injuries are:

• Chondromalacia of the patella (knee cap) — damage to the cartilage that cushions and supports the knee cap.
• Osteochondral injury — an injury to the cartilage directly covering the bones in the knee.
• Meniscal tear — a tear of the cartilage cushioning pads, the meniscus pads, that are located between the two main bones of the knee, the tibia (shin bone) and femur ( thigh bone).
• Combined injury (meniscal and ligament tear) — a tear to the meniscus pads as well as to one of the four main knee ligaments which connect the knee bones.

Signs Your Knee Cartilage may be Injured
The following symptoms may indicate that you have damaged your knee cartilage:

• Knee pain that can be pinpointed to a particular area.
• Swelling of the knee.
• Pain when weight is put on the knee.
• Locking or “giving away” of the knee.
• Pain or weakness when using the quadricep muscles (the front thigh muscles).

How to Determine if Cartilage is Injured
To determine if there has been a cartilage injury, your physician will perform a detailed physical examination. In most cases, your knee will also be x-rayed. If necessary, a MRI (magnetic resonance imaging) will be ordered. This special x-ray can view the knee cartilage and ligaments to determine the extent of any damage.

Treatments for Knee Cartilage Injury
Depending on the severity of the injury, there are a variety of treatments for damaged knee cartilage. Your physician can help you determine which of the following treatments is the best option for you.

• Rehabilitation that may include physical therapy and an exercise program
• Anti-inflammatory medications.
• Alternative treatments such as the nutritional supplements Glucosamine and Chondroitin Sulfate.
• Steroid (cortisone-like) injections.
• Hyaluronic acid injections - Hyaluronic acid is a lubricating oil that exists naturally in the knee's cartilage. Replacement Hyaluronic acid is derived synthetically or from chickens.
• Arthroscopy — a minimally invasive surgery using a small scope.
• Reconstructive procedures to replace damaged cartilage or bone.