KNEE PAIN – FINDING THE CAUSES AND TREATING THEM SUCCESSFULLY

Knee instability occurs when the knee simply bends when walking. This is painful and can also be dangerous. Doctors cite three causes of knee instability.

1. Caused by isolated injuries or damage to the cruciate ligaments, collateral ligaments or menisci. This is the simplest form of knee instability.
2. Caused by a combination of injuries to several ligaments or menisci that are torn at the same time. This is a complex form of unstable knee.
3. Caused by older or repeated capsule-ligament injuries that can no longer be sutured. Specialists refer to this as chronic knee instability.

As the causes of knee instability are varied, a comprehensive and precise diagnosis is very important. In addition to a medical history, palpation and funcional tests, imaging procedures such as ultrasound, X-rays or MRI can help. A knee arthroscopy can also be idicated and is usually used for direct surgical treatment of the findings.

If there is damage, tears or injuries to the cruciate ligaments, collateral ligaments, menisci or cartilage, you and your specialist will decide which therapy is the most suitable. However, it is not only the type of knee injury that is decisive for your treatment concept, but also your lifestyle and your plans for the future. For example, conservative treatment in combination with physiotherapy may be indicated for torn collateral ligaments. In the case of complex ligament injuries, however, only surgery can usually help. A torn meniscus must also be treated surgically in many cases. However, minor tears or damage caused by wear and tear of the meniscus can also be treated conservatively.

The meniscus, or rather the two menisci in the knee, are multi-talented. They transfer the load from the thigh to the lower leg, stabilise the knee during all movements, distribute pressure to the joint surfaces and are also responsible for the mobility of the joint. Due to the diverse tasks of the meniscus, a tear or damage should be treated by a specialist particularly quickly. This is because a meniscus tear does not heal on its own. If left untreated, a damaged meniscus can even lead to osteoarthritis in the knee.

The symptoms of a meniscus tear vary. Blockages and severe pain can occur, but these can also disappear again temporarily. The knee often swells and an effusion forms. Whatever symptoms you experience with your knee pain, consult a doctor quickly for treatment. In many cases, an acute meniscus tear can still be sutured with minimally invasive surgery. However, if the meniscus tissue is already defective or worn, it must be removed or debrided. However, the rule of thumb for any operation is: the less that is removed, the better. This is because if there is wear and tear or an injury that affects more than half of the meniscus, the situation becomes critical. Today, it is also possible to use innovative implants to replace the meniscus in the knee.

Osteoarthritis of the knee often develops over several years and often goes unnoticed at first. In many cases, the cartilage disease is only recognised by the so-called initial pain. When getting up in the morning or after sitting for a long time, the knees need time to become mobile. In addition, the knee often swells with osteoarthritis. Osteoarthritis of the knee can be triggered by excessive strain caused by increased body weight or sports activities that are performed incorrectly or to an excessive degree. Untreated ligament, meniscus and cartilage injuries, inflammation and infections or circulatory disorders are also common triggers of knee osteoarthritis. Knee osteoarthritis can be treated conservatively, but cannot be cured. Conservative therapies help to reduce pain and alleviate the irritation. They make it possible to move better again and alleviate swelling.

Depending on your lifestyle, the following tips can be helpful:

• Reducing body weight
• Balanced diet and avoidance of nicotine and alcohol
• Physiotherapy or manual therapies to build up muscles and for mobilisation
• Physical therapies in the form of cold and heat therapies, electrotherapy, aqua aerobics
• Insoles to correct misalignments and relieve pressure on the joints Anti-inflammatory and pain-relieving medication
• Injections of hyaluronic acid, cortisone, local anaesthetics or the body’s own plasma

An unstable kneecap is characterised by the fact that the kneecap can pop out even during normal movements, usually when the knee is hyperextended. Girls and young women in particular are affected by an unstable kneecap. The reason for this is that weak muscle tissue in combination with weak connective tissue and often a valgus configuration of the leg favours kneecap instability. It is also often the case that the groove on the femur, in which the kneecap is guided, is extremely shallow in affected people.

There are very good conservative therapies for treating an unstable kneecap. Isometric posture exercises are used to strengthen the muscles that guide the kneecap. Stabilisation exercises can also be very helpful. However, if the conservative measures do not work, it is necessary to treat the unstable kneecap surgically. This is because, if left untreated, it can cause osteoarthritis of the knee. An arthroscopy of the knee joint provides good information about the inside of the joint and is often used to directly correct the damage. This minimally invasive procedure allows the specialist to fix a tendon from the hollow of the knee between the kneecap and the thigh, thereby preventing the kneecap from popping out.