Knee, Leg & Hip

Knee

The knee is an incredibly important and complex joint as it connects to both the hip and leg. The femur (thigh bone) the patella (knee cap) and the tibia (shin bone) are bound together with an intricate array of tendons, muscles and ligaments that secure and hold the bones, with two sections of cartilage at the centre, offering a natural shock absorber to absorb impact, whilst also allowing freedom of movement.

Knee Dislocation

A dislocation of the knee occurs when the femur of the thigh and the tibia of the shin become misaligned from one another, often causing damage to the ligaments that bind the bones together too. A dislocation of the knee can be caused by a serious sports injury, fall or car crash. It will look instantly wrong, normally unnaturally bent and this will cause immediate acute pain and sometimes a loss of feeling below the knee.

How is it treated?

The first port of call is to relocate the knee into the correct position, this will be done by emergency responders or orthopaedic specialists. Once this is completed, the knee will be kept immobilised in a splint to prevent any further damage and heal correctly. Occasionally there is arterial damage and surgery will need to be done to repair the blood vessels. The ligaments often become damaged too, this can be solved with rest and painkillers.

Dislocated Kneecap

Not to be confused with a dislocation of the knee, a kneecap dislocation refers to the patella being forced out of alignment from its groove in the femur. The patella guards the front of the knee but upon serious impact or twisting the wrong way it can be forced from its position, also potentially tearing tendons and ligaments in the process. The kneecap will look out of place and this will cause immediate sharp pain. Often the kneecap will pop itself back into place but if not a doctor will forcibly put it back using ‘reduction’. Regardless, a knee should always be checked by a professional after a dislocation.

How is it treated?

If needed a doctor will realign the kneecap using reduction. Treatments that follow include over the counter painkillers, a removable splint to keep the kneecap immobilised and potentially physiotherapy too. For recurrent dislocation, there are new surgical techniques that can be employed to improve the stability and protect the knee cap joint.  

Knee Fracture

The knee can become fractured in many different ways, normally caused by a high impact accident or fall. A non-displaced fracture means that the bones have not become misaligned as well as broken, whereas a displaced fracture has and may require surgery. A fracture will cause swelling, bruising and will restrict the knee’s movement, as well as causing very noticeable pain.

How is it treated?

Similar to dislocations, if the fracture is nondisplaced, then a splint and crutches are needed to keep the knee immobilised, allowing it to heal correctly and safely. Over the counter painkillers are often recommended as well as physiotherapy as it can help repair the knee during the latter stages of the healing process.

Many joints across the body are cushioned by fluid-filled sacs called Bursae. They rest in between bone and tissue and assist in reducing friction, lubricating joints to allow motion and ease of movement. Bursitis is the inflammation of these sacs, the thin layer thickens as they fill with too much fluid, restricting space and pressing on nerve endings, causing swelling, lack of mobility and pain. Bursae are found in multiple sections of the knee but the most common area that causes trouble sits just behind the kneecap, often caused by the repetitive motion of kneeling.

If the bursae are infected then a course of antibiotics can be prescribed to calm the inflamed sacs. Protective knee braces can assist in kneeling and physiotherapy can also be beneficial by strengthening muscle and stretching the joint out. For more extreme and recurring cases, corticosteroid injections can medicate the pain or even further, surgery can remove the inflamed bursae. Regenerative medicine can also treat knee bursitis by injecting natural plasma-rich platelets (PRP) into the damaged bursae, repairing the damage and calming the inflammation, treating the root of the problem, rather than medicating the symptoms.

At the centre of the knee reside two cartilage pads that act as natural shock absorbers called the menisci. This cartilage allows the joint to move smoothly, cushioning any impact between the femur of the thigh and the tibia of the shin. If twisted wrong, or overloaded with too much impact, the menisci can tear and rip, causing pain, swelling and immobility.

The best medicine tends to be rest and recuperation with over the counter painkillers for most cases. Physiotherapy is also used to aid recovery, slowly strengthening the knee with professional assistance. If the tear to the cartilage is severe, reconstructive surgery may be required to repair the damage. A non-invasive alternative is regenerative medicine that uses advanced imaging technology to pinpoint the exact location of the cartilage damage, injecting natural plasma-rich platelets that repair the damage on a cellular level.

Patellar tendonitis is where the tendon that attaches the kneecap to the tibia (shin bone) becomes damaged and/or worn down with overuse. This is an affliction that is often associated with sports, nicknamed 'jumper's knee'. Symptoms differ from a muscular tear or rip which would cause instant pain, tendinitis grows over time, normally as a dull ache below the kneecap, that increases in ferocity with time.

To heal tendonitis and prevent further injury, it is important to recognise what is causing it in the first place. If sport-related, it is important to make sure that proper warm-up exercises are being undertaken and the correct technique is being used when playing. Further treatments include physiotherapy to help repair and strengthen the knee over time. For extreme cases where the tendon has ruptured, surgery will be needed to repair the damage. A non-invasive alternative for solving tendinitis, rather than medicating the symptoms is regenerative medicine. Plasma-rich platelets are used to repair the tendon right down to its cells.

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