
Knee
The knee joint
The knee joint is one of the most complex and important joints in the human body. It functions as a hinge joint with a rotational component and has different joint radii on the inner and outer parts of the joint.
Knee joint complaints
Cartilage Damage / Cartilage Wear
Symptoms of cartilage damage in the knee joint can present as pain during activity, clicking noises, and restricted mobility. A precise diagnosis is made using imaging techniques such as magnetic resonance imaging (MRI). Depending on the extent of the damage, an individual treatment plan is developed, which may include strengthening the muscles around the knee as well as modern therapies such as cartilage regeneration injections and administration of ACP (autologous conditioned plasma). In advanced cases, cartilage smoothing procedures may be necessary before the above treatments are applied.
Torn cruciate ligament
A tear of the cruciate ligament in the knee is a common injury caused by sudden, abrupt movements under load. Symptoms include severe knee pain, especially when going downhill or climbing stairs, and sometimes a restriction in mobility. Treatment depends on the severity of the tear, the time since the injury, and the patient’s activity level. In some cases, conservative therapy—consisting of physiotherapy, physical treatments, and targeted injections—may be sufficient. In other cases, surgery may be necessary.
Dislocation of the kneecap (patellar dislocation)
A dislocation of the kneecap is a painful experience caused by the kneecap slipping out of its joint groove. This can result from misalignment of the leg axis or a lax ligament system and leads to extreme pain and inability to walk, unless the kneecap immediately slips back into its correct position.
A dislocation of the kneecap requires careful diagnosis, which is conducted through X-rays of the leg axis and an MRI scan. Depending on the type and cause of the injury, treatment may require surgery, although in rare cases intensive physiotherapy can also be successful.
Meniscus tear
A tear of the meniscus in the knee joint can cause sudden and sharp pain, especially during twisting or weight-bearing movements such as walking downhill or climbing stairs. In rare cases, a meniscus tear can also impair the mobility of the knee joint.
The treatment of a meniscus tear depends on the extent of the injury and is determined after a thorough diagnosis using magnetic resonance imaging. Possible treatment methods include conservative therapies such as physiotherapy and arthroscopic procedures like sewing or removing the meniscus. An individual therapy plan is created depending on the injury pattern and degree of damage.
Patellar tendinopathy (Jumper’s Knee)
Patellar tendinopathy, also known as Jumper’s Knee, is caused by excessive strain on the knee’s extensor tendon, which can lead to inflammation of the tendon plate. This can cause pain and limitations in the knee area, similar to tennis elbow or golfer’s elbow.
Successful treatment of patellar tendinopathy and Jumper’s Knee includes active stretching exercises that specifically relieve the affected area. Supportive braces can be used to ease the strain on the tendon insertions. A particularly effective therapy is shockwave treatment, which quickly provides relief in the affected area.
Collateral ligament tear / collateral ligament sprain
A collateral ligament tear or sprain in the knee can cause severe pain and instability. To ensure the best possible treatment, it is important to determine the severity of the injury through diagnostic imaging using magnetic resonance imaging (MRI). Depending on the severity of the injury, treatment may involve immobilisation, infiltration with autologous conditioned plasma (ACP), or, in severe cases, surgery.
Osteoarthritis / Joint Wear and Tear
Osteoarthritis is a degenerative disease of the joint cartilage that mostly develops over the course of life and is often diagnosed in the knee joint. It is a condition caused by excessive wear and tear of the joint cartilage. This can result from unfavorable biomechanical conditions, such as misalignment of the limb axis, or from overloading of the joint.
The symptoms of osteoarthritis in the knee can vary greatly, ranging from mild discomfort to severe pain and limited mobility.
Symptoms of osteoarthritis depend on the severity and extent of the damage. One of the most common symptoms is pain, which is often most noticeable as ‘start-up pain’ (pain during the first steps after getting up) and can worsen throughout the day. Other symptoms may include stiffness and restricted movement of the affected joint, pain during activity, inflammation of the joint, and progressive joint deformity due to increased cartilage wear and overstretching or contracture of the ligaments supporting the joint. In advanced stages, bony growths (osteophytes) can develop, which rub against the joint lining and cause sharp pain in addition to the typical arthritic pain.
Treatment of osteoarthritis primarily focuses on strengthening the muscles surrounding the affected joint to reduce joint load and alleviate pain.
The treatment approach depends on the degree of damage and its cause. After a thorough diagnosis using X-rays and possibly MRI, an individual treatment plan is devised. Unfortunately, surgical treatment is often necessary and may involve the implantation of a total knee replacement or partial knee replacement (unicompartmental knee arthroplasty).
Baker’s cyst
The symptoms of a Baker’s cyst often indicate osteoarthritis or a meniscus tear, which causes joint fluid to leak into the popliteal fossa. This can lead to a protrusion of the joint capsule where fluid accumulates. This fluid buildup can impair the mobility of the knee joint and cause pain.
Treatment of a Baker’s cyst depends on the cause and size of the cyst. After a thorough diagnosis using ultrasound and possibly magnetic resonance imaging, the cyst is either drained by aspiration or surgically removed. Promising therapy can also be supported by the use of ACP injections. These treatment options are discussed with the patient to ensure the best possible care.
Joint effusion
Symptoms of a joint effusion can present as a sudden swelling of the affected joint, which may result from unusually intense strain, cartilage damage, or an injury. This leads to an increase in fluid within the joint, impairing mobility.
Treatment of a joint effusion depends on the cause. In most cases, conservative therapies such as rest, pain relief, and physiotherapy are sufficient to restore joint mobility. In rare cases, however, aspiration of the effusion may be necessary to remove the fluid from the joint and improve mobility.
Bursitis (inflammation of the bursa)
Symptoms of bursitis, also known as inflammation of the bursa, manifest as pain, swelling, and redness at the affected sites, which can be caused by overuse, infections, or misalignments.
Treatment of bursitis begins with a thorough diagnosis to determine the exact cause of the inflammation. In many cases, aspiration of the bursa is performed to drain the fluid and relieve the inflammation. Immobilization and anti-inflammatory measures, such as infiltration therapy, can help reduce pain and speed up healing.
In cases of recurrent bursitis or advanced damage to the bursa, surgical removal of the bursa may be necessary to provide long-term relief of symptoms and restore mobility of the affected joint.
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Diagnosis & Treatment
Bei der Abklärung einer Kniegelenksarthrose wird einerseits eine ausführliche klinische Untersuchung des Knies durchgeführt.
In früheren Stadien der Kniegelenksarthrose, also wenn der Kniegelenksknorpel noch nicht fortgeschritten abgenutzt ist, kann ich Ihnen mit einer Vielzahl an konservativen, also nicht operativen, Therapiemöglichkeiten helfen.
Mögliche Therapien beinhalten:
- Physiotherapy
- Oral medication therapies
- Injections (or Infiltrations)
- Surgery
