Treated Knee Conditions
Dr. Anthony Quinn, Dr. Brent Milner, Dr. Brian Laman, Dr. Justin Steinert, and Dr. Jeremy Zebroski comprise the Knee Team at Sheridan Orthopedic Associates. This team is one of the most respected in all of Wyoming and combines decades of experience in both non-surgical and surgical treatments for conditions of the knee. The Knee Team at Sheridan Orthopedic Associates collaborates on each patient’s diagnosis to establish the most effective treatment plan.
Arthritis
Arthritis of the knee is a common condition in the aging population. Traditionally, arthritis of the knee takes three forms: Osteoarthritis, Rheumatoid Arthritis and Post-traumatic Arthritis- with Osteoarthritis being the most common.
Osteoarthritis
Osteoarthritis (OA) is usually a form of arthritis that progresses slowly. As we age, the joint cartilage of the knee tends to degenerate as a result of long-term wear and tear and degeneration. This degeneration can cause bones in the knee to rub together resulting in pain and bone spurs.
Rheumatoid Arthritis
Rheumatoid Arthritis (RA) is an inflammatory arthritis that slowly destroys the cartilage of the knee. RA can occur at any age and the likelihood of RA is based on a combination of genetic and environmental factors. Those with RA most often experience the condition in both knees.
Post-traumatic Arthritis
Similar to OA, Post-traumatic Arthritis occurs over a longer period of time. In most instances, the degeneration occurs as a result of a previous injury to the cartilage, ligaments or unhealed fracture. Symptoms may not arise until years after the initial injury occurs.
Signs and Symptoms of Knee Arthritis can vary depending on type:
● Swelling of the knee
● Stiffness of the knee
● Sensitivity to touch
● “Locking” or “buckling” of the joints
● Increased pain when walking, climbing or after periods of activity
Meniscus Tear
The Posterior Collateral Ligament is located behind the knee and is one of several ligaments that connect the femur to the tibia. The PCL’s primary role is ensuring the tibia from moving too far backward. Significant force needs to be applied to damage the PCL, such as falling onto a bended knee or a direct blow to the front of the knee.
Signs and symptoms of a PCL Tear can include:
• Pain after injury
• Swelling after injury
• Difficulty bearing weight on the knee
• Difficulty walking
• Feeling of instability or “giving out” of the knee
ACL Tear
The ACL (Anterior Cruciate Ligament) is one of the ligaments of the knee that keeps the knee stable and flexible. The ACL extends diagonally through the middle of the knee and forms an X with the Posterior Cruciate Ligament (PCL). These ligaments provide the pivoting motion of the knee.
An ACL injury occurs when this ligament becomes torn due to overexertion or hyperextension. This is one of the more common injuries in soccer, football, basketball, baseball and other sports.
ACL injuries often occur in athletes as a result of a hyperextension or sudden impact such as:
● A quick change in direction
● A sudden stop while running
● Impact to the ligament such as from a foot or helmet
● Jumping or landing improperly
Injuries can range from:
Grade 1: The ACL has been stretched or mildly damaged but is still able to provide support to the knee.
Grade 2: The ACL has been stretched to the point where it becomes loose and unable to provide support to the knee. This is also commonly referred to as a “partial ACL tear”.
Grade 3: The ACL has been has been completely torn and is no longer one complete ligament. The ligament has become detached from the bone and is no longer able to provide any support to the knee. This is also commonly referred to as a “complete ACL tear”.
If you suspect that an ACL injury has occurred it is important to seek medical attention as soon as possible. Continued activity on the injured ligament may exacerbate the injury and increase the grade of injury.
Signs and symptoms of an ACL injury can include:
● Hearing a “popping” sound at the moment of injury
● Swelling within 24 hours
● Pain on the outside or the back of the knee
● Limited range of motion
● Inability to bear weight on the injured knee
● Feeling of the knee “buckling” or “giving out” while walking
● Tenderness on the outside or back of the knee
● Bruising
MCL Tears
The Medial Collateral Ligament (MCL) is the ligament located on the inner side of the knee responsible for connecting the shinbone to the thigh bone. A strain or sprain most often occurs if excessive directional force is applied to the ligament.
MCL injuries are a common occurrence in sports, more specifically, contact sports. Direct force is often, unintentionally, applied by the opponent to the outside of the leg directly above the knee. This force causes the ligaments to be stretched past their intended capacity causing injury.
Another common incidence for this injury is shoes or cleats getting stuck in the grass or turf. As the player attempts to change direction the foot remains planted and sudden excessive force is applied to the ligament causing damage.
MCL Injuries are generally classified by the degree of the injury:
A first-degree sprain is damage to only a few ligament fibers.
A second-degree sprain is damage to more ligament fibers but the ligament still remains intact.
A third degree sprain occurs when the ligament is completely ruptured.
As a result of the excessive force needed to cause a third degree injury, other knee elements such as the Meniscus or the Anterior Cruciate Ligament (ACL) may be damaged. For third degree sprains it is important to evaluate the entire knee to assess the damage to the entire structure.
MCL injuries are a common occurrence in sports, more specifically, contact sports. Direct force is often, unintentionally, applied by the opponent to the outside of the leg directly above the knee. This force causes the ligaments to be stretched past their intended capacity causing injury.
Another common incidence for this injury is shoes or cleats getting stuck in the grass or turf. As the player attempts to change direction the foot remains planted and sudden excessive force is applied to the ligament causing damage.
Signs and symptoms of a MCL Tear can include:
• Pain after injury
• Swelling after injury
• Difficulty bearing weight on the knee
• Difficulty walking
• Feeling of instability or “giving out” of the knee
Patella Instability
The patella (more commonly known as the “kneecap”) connects the muscles in the tibia to the knee and is able to shift within the femoral groove as the knee is bent or extended. However, if this groove is damaged, too shallow or uneven the patella will slide out of the groove causing instability.
Trauma to the kneecap, such as a fall or traumatic force, can cause this condition.
Signs and symptoms of Patella Instability can include:
• Feeling of the knee buckling
• Kneecap slips off to the side
• Difficulty bearing weight on the knee
• Knee “catches” when going from sitting to standing
• Pain in the front of the knee that increases with activity
• Pain when sitting
• Stiffness
• Creaking or cracking sound during activity
• Swelling in the front of the knee