Knee

Arthritis

Arthritis occurs when cartilage is damaged or decreased over time. Cartilage is the smooth covering over bones that allows joints to glide. This covering can become damaged due to traumatic injury or can just degenerate over time.

With severe and untreated arthritis the joint becomes inflamed and extra bone can form as your body attempts to protect the joint which causes even more pain.

Types

There are different types of arthritis. The primary reason for arthritis is “wear and tear,” and is caused over time. This is osteoarthritis. Other types of arthritis can occur due to trauma or illness such as rheumatoid arthritis or septic arthritis. Systemic psoriasis or lupus can also cause joint degeneration.

Symptoms:

  • Pain
  • Swelling
  • Loss of motion
  • Loss of strength
  • Grinding
  • Clicking
  • Pain with daily activities and motion

Diagnosis

  • Exam by your surgeon
  • X-rays
  • Possible MRI
  • Possible CT/CAT scan

Possible Treatment: Non-operative

  • Physical Therapy
  • Anti-inflammatory Medication
  • Injections
  • Nutritional Supplements

Possible Treatment: Operative

  • Joint Replacement
  • Removal of bone spurs
  • Removal of cartilage fragments
  • Osteochondral Allografts (replacing cartilage and/or damaged bone)
  • Joint replacement or partial replacement

Inflammation

Pre-patellar and Infra-Patellar Bursitis

Bursitis can occur from trauma to the front of the knee or from kneeling. Pre-patellar bursitis is also referred to as “housemaid’s knee,” since it is often seen in patients who kneel. Bursa acts as a cushion around structures in the knee. When it thickens or becomes inflamed it can cause pain.

Symptoms:

  • Swelling in the front of the knee
  • Infection
    • Fever
    • Drainage
    • Redness
    • Tender to touch

Diagnosis:

  • Exam by your surgeon
  • X-rays

Possible Treatment: Non-Operative:

  • Anti-inflammatory Medication
  • Cryotherapy
  • Draining
  • Compression Dressing
  • Knee Pads when kneeling

Possible Treatment: Operative:

  • Removal of bursa

Patellar Tendinitis

Patellar tendinitis can be the result of overuse or a blow to the knee. It is also known as “jumper’s knee,” and often occurs in athletes who jump. The patella or “kneecap” tendons can become inflamed and cause pain.

Symptoms:

  • Pain below kneecap
  • Pain while squatting
  • Pain while using stairs
  • Pain while running
  • Swelling

Diagnosis:

  • Exam by your surgeon
  • X-rays
  • MRI

Possible treatment: Non-operative:

  • Anti-inflammatory Medication
  • Cryotherapy
  • Modification of Activity
  • Injections
  • Brace/strap

Possible Treatment: Operative:

  • Microfracture to induce stem cell migration and healing

Quadriceps Tendinitis

Quadricep tendinitis often occurs from overuse or a blow to the knee. It can be common with athletes who must repetitively jump in their sport. The quadriceps tendon is in the front of the leg and attaches the kneecap to the thigh muscle. This tendon can become inflamed and painful.

Symptoms:

  • Pain above the kneecap
  • Pain while squatting
  • Pain while using stairs
  • Pain while running
  • Swelling

Diagnosis:

  • Exam by your surgeon
  • X-rays
  • MRI

Possible Treatment: Non-operative:

  • Anti-inflammatory Medication
  • Cryotherapy
  • Modification of Activity
  • Injections

Possible Treatment: Operative:

  • Microfracture to induce stem cell migration and healing

Pes Anserine Tendinitis

Pes anserine tenditis can occur due to overuse or direct trauma. The pes anserine are three tendons (sartorius, gracilis, and semitendinosus) located on the inside of the shin bone below the knee. These tendons can become inflamed and cause pain.

Symptoms:

  • Pain on the inside of the shin bone
  • Swelling

Diagnosis:

  • Exam by your surgeon
  • X-rays
  • MRI

Possible Treatment: Non-operative:

  • Anti-Inflammatory Medication
  • Cryotherapy
  • Physical Therapy
  • Modification of Activity
  • Injections

Possible Treatment: Operative

  • None

Instability

Patellar Dislocation/Subluxation

The patella is the triangular shaped “kneecap” bone and glides in a groove on the femur. It is held in place by tendons and ligaments that can sometimes become lax and allow the patella to move out of place. Dislocation/subluxation is often caused by trauma but can also be caused by genetic factors that allow the bone to move out of the groove.

Symptoms:

  • Knee “giving out”
  • Pain
  • Deformity (patella is out of place, usually toward inside of the leg)
  • Decreased range of motion

Diagnosis:

  • Exam by your surgeon
  • X-ray
  • MRI to check ligament

Possible Treatment: Non-operative:

  • Physical Therapy to strengthen muscles surrounding patella
  • Brace
  • Anti-inflammatory Medication
  • Cryotherapy
  • Rest

Possible Treatment: Operative:

  • Surgery to address secondary injuries
    • Cartilage debridement
    • MPFL repair
    • Trochleoplasty
    • Tibial Tubercle Osteotomy

Knee Dislocation

Knee dislocation is a medical emergency. Blood vessels and nerves behind the knee may become damaged during knee dislocation. This is different than a patellar dislocation and must be treated immediately. A knee dislocation is when the femur (thigh bone) and tibia (shin bone) dislocated from one another. Usually this also means that there are torn ligaments in the knee. A knee dislocation typically occurs due to trauma such as a vehicle accident, collision sports, or a fall from some height.

Symptoms:

  • Immediate pain
  • Immediate loss of leg function
  • Possible shock from trauma
  • Swelling
  • Numbness
  • Tingling
  • Cold Sensation

Diagnosis

  • Exam by your surgeon or emergency room physician
  • X-rays
  • Nerve and blood flow exam
  • MRI

Possible Treatment: Non-operative:

  • None

Possible Treatment: Operative:

  • Immediate surgery for knee stabilization
  • Nerve and/or blood vessel repair
  • Ligament reconstruction
    • ACL
    • PCL
    • ALL
    • MCL

Knee Tears

Anterior Cruciate Ligament (ACL) Tear

The ACL is responsible for preventing the shin bone from sliding forward and rotating on the thigh bone. ACL tears are usually caused by twisting or overextending the knee. Athletes that suddenly pivot, decelerate when running, or traumatically fall may suffer from ACL tears. Trauma to the back of the knee can also cause an ACL tear. ACL tears will not heal themselves and choosing non-operative treatment increases probability for further injury such as arthritis and meniscal tears.

Symptoms:

  • Pain
  • Swelling
  • Pop inside the knee
  • Inability to stand on leg initially
  • Loose feeling or feeling like the knee is “giving out”
  • Over time: loss of motion

Diagnosis:

  • Exam by your surgeon
  • X-rays
  • MRI

Possible Treatment: Non-operative: (Often prescribed prior to surgery)

  • Anti-inflammatory Medication
  • Cryotherapy
  • Modification of Activity

Possible Treatment: Operative:

  • Repair of ligament using screws, suture, and/or buttons
  • ACL graft reconstruction (allograft or autograft)

Posterior Cruciate Ligament (PCL) Tears

The PCL is the ligament that prevents the shin bone from sliding backwards and rotating on the femur. PCL tears are usually caused by trauma or a fall. Athletes that have sustained a collision injury with a backward force onto the tibia may suffer from a PCL tear. Vehicle accidents where the knee hits the dashboard can cause a PCL tear. The PCL will not heal itself however some patients opt to avoid surgery and wear a knee brace to stabilize the knee.

Symptoms:

  • Pain
  • Swelling
  • Pop
  • Inability to walk on knee initially
  • Feeling that the knee is loose or will “give out”
  • Over time: loss of motion

Diagnosis:

  • Exam by your surgeon
  • X-rays
  • MRI

Possible Treatment: Non-operative

  • Anti-inflammatory Medication
  • Physical Therapy
  • Cryotherapy
  • Modification of Activity
  • Brace

Possible Treatment: Operative:

  • PCL repair with screws, suture, and/or buttons
  • PCL reconstruction with graft (allograft or autograft)

Medial Collateral Ligament (MCL)

MCL tears are often caused by trauma such as a blow to the outside of the knee. Overuse can also lead to MCL tears especially in athletes that fall to the knees and stand quickly. The MCL prevents the knee from buckling inward (valgus/knock-knee).

Symptoms:

  • Pain
  • Swelling
  • Pop
  • Feeling like your knee might “give in”

Diagnosis:

  • Exam by your surgeon
  • X-rays
  • MRI

Possible Treatment: Non-operative:

  • Brace
  • Anti-inflammatory Medication
  • Physical Therapy
  • Cryotherapy
  • Modification of Activity

Possible Treatment: Operative:

  • Repair with screws, suture, and/or buttons
  • Reconstruction with graft (allograft or autograft)

Lateral Collateral Ligament (LCL) Tears

LCL tears on their own are not common and are usually in conjunction with another injury. LCL tears often occur due to trauma such as a force to the inside of the knee. Football athletes are susceptible to LCL tears. Other trauma such as vehicle accidents can cause LCL tears. The LCL keeps your knee from giving way outwardly (varus knee, bowed knee).

Symptoms:

  • Pain over outside of the knee
  • Swelling
  • Feeling that the knee might “give out”

Diagnosis:

  • Exam by your surgeon
  • X-rays
  • MRI

Possible Treatment: Non-operative:

  • Brace
  • Anti-inflammatory Medication
  • Cryotherapy
  • Modification of Activity

Possible Treatment: Operative:

  • Repair with screws, suture, and/or buttons
  • Reconstruction with graft (allograft or autograft)

Posterolateral Corner Injury (PLC)

PLC injuries are a result of trauma such as vehicle accidents, sports collisions, and falls from height. PLC injuries often occur in conjunction with knee dislocations. The posterolateral corner is a series of tendons and ligaments on the outer back side of the knee (lateral collateral ligament- LCL, popliteaofibular ligament – PFL, lateral capsular ligament, biceps femoris tendon – hamstring, and the popliteus tendon.

Symptoms:

  • Pain
  • Swelling
  • Inability to stand on leg
  • Knee dislocation causing
    • Numbness
    • Tingling
    • Cold Sensation

Diagnosis:

  • Exam by your surgeon
  • X-rays
  • MRI

Possible Treatment: Non-operative:

  • None

Possible Treatment: Operative:

  • Reconstruction with grafts
  • Fixation of grafts with screws and buttons

Anterolateral Ligament (ALL) Tears

The ALL is usually torn in conjunction with the ACL and caused by twisting or overextension of the knee. Pivoting suddenly, decelerating during running, or falls are also causes of an ALL/ACL tear. A blow to the back of the knee can also cause an ALL/ACL tear. The ALL is on the front outside of the knee. It assists the ACL in preventing the shin bone from rotating on the thigh bone. The ALL will not repair itself and will need surgery for repair.

Symptoms:

  • Pain
  • Swelling
  • Pop
  • Initial inability to stand on leg
  • Feeling that the knee may “give out”
  • Decrease in motion over time

Diagnosis

  • Exam by your surgeon
  • X-rays
  • MRI

Possible Treatment: Non-Operative

  • Anti-inflammatory Medication
  • Cryotherapy
  • Modification of Activity

Possible Treatment: Operative

  • ACL reconstruction with ALL reconstruction

Quadriceps Tendon Rupture

The quadriceps tendon attaches the kneecap to the muscle on the front of your thigh. This tendon allows you to extend your knee. A quadriceps tendon tear is often caused by a fall or jump from a height.

Symptoms:

  • Pain
  • Swelling
  • Deformity in the front of the leg
  • Inability to stand on leg
  • Pop
  • Bruising during first day
  • Inability to walk on own

Diagnosis:

  • Exam by your surgeon
  • X-rays
  • MRI

Possible Treatment: Non-operative:

  • None

Possible Treatment: Operative:

  • Tendon repair using suture, anchors, and/or screws

Patellar Tendon Rupture

The patellar tendon helps you to extend your leg. It attaches the kneecap to the shin bone. Patella tendon tears can occur from a fall or jump from a height.

Symptoms:

  • Pain
  • Swelling
  • Deformity to the front of the leg
  • Inability to stand on leg
  • Pop
  • Bruising on the first day
  • Inability to walk

Diagnosis:

  • Exam by your surgeon
  • X-rays
  • MRI

Possible Treatment: Non-operative:

  • None

Possible Treatment: Operative:

  • Patella tendon repair using sutures, anchors, and/or screws

Meniscal Tear

The meniscus is made of cartilage and it surrounds the knee joint to serve as a shock absorber. Each knee has two menisci, the medial meniscus (on the inside of the knee), and the lateral meniscus (on the outside of the knee). Medial meniscal tears are more common than lateral tears. The lateral meniscus may tear along with an ACL injury. Meniscal injuries may lead to other changes in the knee such as arthritis. The meniscus can tear due to a twisting or pivoting of the knee joint. The meniscus tends to degenerate with age and can be more easily damaged as patient age increases.

Symptoms:

  • Pain over the side of damaged meniscus
  • Swelling
  • Bruising
  • Loss of movement
  • Loss of strength
  • Clicking/catching while walking
  • Increased pain when twisting the foot
  • Locked knee

Diagnosis:

  • Exam by your surgeon
  • X-rays
  • MRI

Possible Treatment: Non-operative:

  • Anti-inflammatory Medication
  • Physical Therapy
  • Cryotherapy
  • Modification of Activity
  • Injections

Possible Treatment: Operative:

  • Removal of torn meniscus tissue
  • Meniscal repair with sutures

Office Location

Gitelis Orthopedics office

Hoffman Estates

1800 McDonough Road
Suite 202
Hoffman Estates, IL 60192

Located in the Ashton Center for Day Surgery building.

(847) 807-7770
fax: (847) 807-7771

Hours

Monday 7:30am-4:00pm
Tuesday 7:30am-4:00pm
Wednesday 7:30am-4:00pm
Thursday 7:30am-4:00pm
Friday 7:30am-12:00pm
Saturday Closed