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Knee Conditions

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Knee Conditions

Here are some common knee pain conditions that we specialise in

The knee joint comprises cartilage, bone, and ligaments that work together with tendons and muscles that allow us mobility. The knee joint is one of the most common body parts to be injured with its regularity of use; it’s more prone to be overused, leading to wear-and-tear. 

Knee conditions are common, and even without an active lifestyle, the joint can still experience pain or discomfort due to wear or disease. Here we can help differentiate between the common types of knee pain and conditions and the best course of action and treatment available for each.

What Is an ACL Tear?
CAUSES  |  SYMPTOMS  |  TREATMENT OPTIONS

The Anterior Cruciate Ligament (ACL) is a ligament that provides stability to the knee joint. 

An ACL tear commonly occurs when pivoting or landing badly from a jump. ACL injuries are common among people who engage in highly demanding physical activities, especially high-intensity sports.

ACL injuries can result in a loose knee that prevents them from participating in regular sports, even with an extended period of physiotherapy and rehabilitation.
.

What Causes an ACL Tear?

ACL tears are associated with sporting or fitness activities that put too much strain on the knee joint. In most cases, the ligament stretches instead of twists to firmly ground the foot. 

Some causes include:

  • A sudden change of direction while engaging in an intense physical activity
  • Trying to pivot while a foot is planted-firmly
  • Landing incorrectly while jumping or stopping abruptly while running
  • The knee is being hit or injured in a collision
    .

ACL tears can also result from non-movement-related causes such as:

  • Poor conditioning of the knee
  • Wearing footwear that does not fit properly 
  • Playing on artificial turf surfaces 
  • Using poorly maintained sports equipment, causing the knee to sprain
    .

What are the Symptoms of an ACL Tear?

After the time of injury, you may experience some of these common symptoms of a torn ACL:

  • A loud pop or popping sensation at the knee 
  • Severe, abrupt pain to the knee while engaging in physical activity 
  • Rapid swelling of the knee
  • Being unable to stand, walk or move the knee
    .

After an ACL tear, you may experience a sensation of the knee giving way when playing or pivoting.
.

ACL Tear Treatment

Non-surgical treatment is a preferred option for less severe cases. Patients who do not often participate in intense activities such as running, jumping, or pivoting can particularly benefit from non-surgical treatment.

Depending on the severity of the damage on the ACL, a patient can benefit from surgery to reconstruct or repair an injury. However, surgery remains beneficial for people who engage in intense physical activities often. 

Reconstruction involves using a tendon graft to replace the torn ACL. Most patients will receive nine months of physiotherapy after surgery before they can return to sports.

Non-Surgical Treatment of an ACL Tear

  • Physiotherapy:
    Non-surgical treatment with physiotherapy is a preferred option for less active patients who do not participate in intense activities such as running, jumping, or pivoting.
    .

Surgical 

  • Customised ACL Treatment:
    Every ACL injury is different. The benefit of such a tailored approach is that the Orthopaedic Surgeon can utilise the remaining ACL to improve the knee’s final function after surgery.
    .
  • All-Inside ACL Reconstruction:
    In this procedure, the new ACL is secured into sockets that are drilled into the bones of the knee.
    .
  • ACL Preservation Surgery:
    This surgery allows a patient to avoid a full ACL Reconstruction. The Orthopaedic Surgeon will repair part of the ACL and augment the irreparable component with a tendon graft.
    .

This is done to avoid removing the entire ACL and replacing it with a new one. ACL repair changes the treatment of ACL injuries by employing surgical devices and techniques to repair the original, torn ligament. 

Only an estimated 20-30% of ACL tears are repairable, but this means that 20-30% of patients with ACL tears can preserve their original ACL and avoid having to sacrifice their spare parts for an ACL reconstruction. 

ACL repair is technically more complex, and the repair may fail to heal in roughly 10% of cases. However, with successful healing, patients who have undergone ACL repairs rehabilitate much faster and potentially have better function than patients who have undergone the traditional ACL reconstruction surgery.

What Is an ACL Tear?

What Is a Meniscus Tear?
CAUSES  |  SYMPTOMS  |  TREATMENT OPTIONS

The meniscus is a shock absorber that cushions and provides stability in the knee. 

A meniscus tear refers to a tear of this shock-absorber. Any activity which causes a forceful strain on the joint to rotate or twist, especially adding the entire body weight onto the knee, can easily lead to a torn meniscus.

There are two types of meniscus tears:

  1. Acute tears – these are common to children and young adults who are active.
  2. Degenerative tears – These tears are due to cumulative stress and deterioration related to age.
    .

What Causes a Meniscus Tear?  

Meniscus tears are related to either trauma or age. These are the common causes:

  • Athletic activities in contact sports
  • A sudden stop or forceful twist of the knee 
  • Stress caused by heavy bodyweight or malaligned bones
  • Degeneration due to routine daily activities
  • Degeneration due to age
    .

What Are the Symptoms of a Meniscus Tear? 

It is common for the symptoms of a meniscus tear to be similar to those for Anterior Cruciate Ligament (ACL) injury. 

Here are the symptoms you may experience:

  • A popping sensation in the knee
  • Acute onset of pain in the knee
  • Swelling in the knee a few hours after the popping sensation
  • Difficulty in straightening the knee (locking)
    .

After the injury, you may experience the following symptoms:

  • Persistent pain in one side of the knee
  • Inability to fully straighten the knee
  • A sensation of the knee locking up (occasionally unable to fully straighten)
    .

Meniscus Tear Treatment

Pain from meniscal tears will often resolve with time. The tears usually do not heal and may give rise to recurrent symptoms or a progression of the tear’s severity.

Non-Surgical Treatment for a Meniscus Tear

  • Physiotherapy
    Exercises performed during a physiotherapy session can help to decrease pain and improve knee function.
    .
  • Painkillers
    Treatment for meniscus tears usually involves painkillers in the early painful phase to help patients manage the symptoms.
    .

Surgical Treatment for a Meniscus Tear

  • Arthroscopic / Key-Hole Surgery
    As meniscal tears do not commonly heal independently, surgery may sometimes be required to restore its shock-absorption function. Without the meniscus, the knee is prone to developing osteoarthritis.
    .

Surgery is usually in the form of a keyhole meniscus repair where the meniscus’s torn edges are stitched together. In some severe or complex tear cases, the meniscus may not be repairable. In these instances, the tear would then be trimmed until a stable rim is reached to reduce the chances of the damage progressing in the future.

What Is a Meniscus Tear?

WHAT IS A PATELLA (KNEECAP) DISLOCATION?
CAUSES  |  SYMPTOMS  |  TREATMENT OPTIONS

The kneecap, also known as the patella, is a tiny bone that sits in a groove in front of the knee located at the end of the thigh bone. When you bend or straighten your leg, the kneecap glides over the groove.

The kneecap is held in place by a group of ligaments and muscles. A dislocation occurs when these ligaments and muscles are overstretched or torn, allowing the kneecap to slide out of the groove. Typically, this movement happens suddenly. You are likely to experience sharp pain, and you might be unable to straighten your knee after that.
.

What Causes a Patella (Kneecap) Dislocation? 

Here are some scenarios where a kneecap dislocation may occur:

  • A sudden and abrupt direction change while the leg is anchored firmly on the ground will put pressure on the kneecap. Too much pressure will overstretch the support tissues causing dislocation. Likely scenarios for this situation is when playing sports like soccer or basketball.
  • A fall or a direct blow to the knee will tear or overstretch the support tissues, leading to dislocation.
  • In some people, dislocation could result from bony abnormalities in the hip, knee or shin bone.
  • Loose ligaments make joints too flexible hence predisposing the individual to patella dislocation.
    .

What Are the Symptoms of a Patella (Kneecap) Dislocation?

  • A visibly deformed knee
  • Difficulty in straightening a bent knee 
  • Tenderness and pain in the knee
  • Swelling of the knee
    .

Subsequent symptoms after the kneecap has been put back in place include:

  • Kneecap is sloppy and can move sideways excessively
  • A sensation of instability and of the kneecap wanting to dislocate again
  • Pain and locking in the knee if there are other accompanying injuries following the dislocation
    .

Patella (Kneecap) Dislocation Treatment

There is a range of options for treating kneecap dislocation based on the injury’s extent and severity. The typical treatment is non-surgical, where the kneecap is manipulated back into place, then followed by a period of splinting physiotherapy.

Non-Surgical Treatment of a Patella (Kneecap) Dislocation

  • Patella manipulation:
    Patella manipulation involves relocating the kneecap back into its normal position.
    .
  • Physiotherapy:
    Physiotherapy aims to strengthen the muscles that hold the kneecap in position to compensate for the torn ligaments that usually stabilise the kneecap. Physiotherapy can also help correct underlying functional abnormalities with knee and hip muscles, which may predispose one to dislocate their kneecap.
    .

Surgical Treatment of a Patella (Kneecap) Dislocation

  • Knee Reconstruction Surgery:
    In recurrent cases of knee dislocations, surgery may be required to stabilise the kneecap. This usually involves reconstructing the torn ligament known as the Medial Patellofemoral Ligament (MPFL). In cases where there is a severe underlying bony deformity, our surgeon may have to cut and realign the bone or deepen the groove in which the kneecap sits typically.

What is a Patella (Kneecap) Dislocation?

WHAT IS KNEE OSTEOARTHRITIS?
CAUSES  |  SYMPTOMS  |  TREATMENT OPTIONS

Knee Osteoarthritis is a degenerative disease where the cartilage in the knee joint wears away. Eventually, bone spurs may begin to form, and the two bone ends start to rub directly against each other. As a result, patients experience pain in the knee.

.

What Causes Knee Osteoarthritis?

Causes of Knee Osteoarthritis:

  • Heavy body weight adds a lot of stress to the joint and predisposes one to osteoarthritis.
  • Malalignment of the knee can overload certain parts of the knee, resulting in rapid wear and tear of the joint.
  • Previous trauma such as fractures, meniscus tears or ligament tears to the knee can affect the bony alignment and stability of the knee, resulting in early wear and tear on the joint.
  • Knee infections can damage the internal structures in the knee, giving rise to premature osteoarthritis.
  • Inflammatory conditions of the knee, such as rheumatoid arthritis and gout, can cause damage to the cartilage and progress to osteoarthritis.
    .

What are the Symptoms of Knee Osteoarthritis?

The following are the symptoms of knee osteoarthritis:

  • Pain with an activity that improves at rest
  • The feeling of stiffness in the knee joint, especially in the morning or when trying to begin movement
  • Swelling in the knee
  • Loss of full flexibility in the knee.
    .

Knee Osteoarthritis Treatment

If you’re experiencing chronic knee pain, it’s best practice to consult a doctor to have it diagnosed and treated as early as possible. Treatment aims to reduce pain and to improve function in the knee.

Non-Surgical Treatment of Knee Osteoarthritis

  • Weight loss:
    Activities like exercise to produce weight loss are encouraged to relieve pressure on the knee.
    .
  • Physiotherapy:
    Physiotherapy can help to improve flexibility and pain in the knee.
    .
  • Intra-Articular Injections:
    Corticosteroids and gel injections of hyaluronic acid are commonly injected into the joint to improve osteoarthritis symptoms.
    .
  • Oral medication and supplements:
    Painkillers and oral anti-inflammatory medication can help with painful flares of osteoarthritis. Joint supplements can also help reduce the level of pain and inflammation in the joint. These include herbal anti-inflammatories or collagen supplementation.
    .

Surgical Treatment of Knee Osteoarthritis

In early cases of osteoarthritis, doctors usually try to preserve the joint. These procedures are largely termed ‘joint preserving surgery’. As doctors try to avoid replacing the knee with an artificial joint. Mild cases may be responsive to cartilage repair.

The most common procedure is microfracture, where small holes are drilled into the bone to stimulate the cartilage’s healing. This procedure is often augmented with the addition of collagen, hyaluronic acid or bone marrow aspirate concentrate (BMAC) over the repair site to improve the success rates. Where possible, a torn and non-functioning meniscus is repaired. Underlying bony malalignment may be necessary to protect the knee from further wear and tear.

  • Subchondroplasty:
    In some painful joints that aren’t repairable, subchondroplasty may reduce the bone pain of osteoarthritis and improve knee function. Subchondroplasty involves injecting a bone substitute into the painful, damaged parts of the bone around an arthritic joint. With improvements in pain, this procedure can help some patients avoid a total knee replacement.
    .
  • Partial (unicompartmental) knee replacement:
    A partial knee replacement may help if only one compartment of the knee is worn out. This is a more minor operation than a total knee replacement and has a shorter recovery period.
    .
  • Total knee replacement:
    In severe osteoarthritis, a total knee replacement will remove all the damaged bone and cartilage in the joint and replace it with an artificial joint made out of metal and plastic.

What Is Knee Osteoarthritis?

WHAT ARE FRACTURES AROUND THE KNEE?
CAUSES  |  SYMPTOMS  |  TREATMENT OPTIONS

The knee is a complex joint that supports the body weight while you perform daily activities. Fractures around the knee can eventually lead to loss of function, chronic pain, and post-traumatic osteoarthritis.
.

What Causes Fractures Around the Knee?

Knee fractures may be isolated to specific parts of the knee joint or the entire section. Regardless of the nature of the injury, here are some of the common causes:

  • Highly traumatic events like a car accident or a severe fall
  • Sports activities which involve a lot of contacts, e.g. Rugby, Basketball 
  • A direct blow to the knee, such as in a fall
    .

What are the Symptoms of Fractures Around the Knee

Here are common symptoms of a fractured knee:

  • The presence of severe pain within the knee section
  • Tenderness, warmth, and swelling in the knee joint
  • The knee appearing deformed
  • Difficulty doing a straight-leg raise or merely straightening your knee
  • Reduced range of motion
    .

Fractures Around the Knee Treatment

The treatment of fractures around the knee is dependent mainly on the location and severity of the injury.

Non-Surgical Treatment of Fractures Around the Knee

  • Pain & Anti-Inflammatory Medication:
    Treatment for knee fractures usually involves painkillers in the early painful phase to help patients manage the symptoms.
    .
  • Immobilisation in a Cast:
    Non-surgically treated fractures often require immobilisation in a cast.
    .
  • Physiotherapy:
    While the fracture is healing in a cast, physiotherapy can help maintain the muscles around the knee and in the rest of the limb. After the fracture has healed, physiotherapy can also speed up functional recovery and improve the flexibility and strength of the joint.
    .

Surgical Treatment of Fractures Around the Knee

  • Fracture Fixation:
    Displaced fractures often require surgery. This usually involves open incisions, realignment of the fractured fragments, and securing them in position with metal plates, screws or nails. In specific injuries, the fractures may be secured with keyhole surgery.

What Are Fractures Around the Knee?

ACL Tear

What Is an ACL Tear?

What Is an ACL Tear?
CAUSES  |  SYMPTOMS  |  TREATMENT OPTIONS

The Anterior Cruciate Ligament (ACL) is a ligament that provides stability to the knee joint. 

An ACL tear commonly occurs when pivoting or landing badly from a jump. ACL injuries are common among people who engage in highly demanding physical activities, especially high-intensity sports.

ACL injuries can result in a loose knee that prevents them from participating in regular sports, even with an extended period of physiotherapy and rehabilitation.
.

What Causes an ACL Tear?

ACL tears are associated with sporting or fitness activities that put too much strain on the knee joint. In most cases, the ligament stretches instead of twists to firmly ground the foot. 

Some causes include:

  • A sudden change of direction while engaging in an intense physical activity
  • Trying to pivot while a foot is planted-firmly
  • Landing incorrectly while jumping or stopping abruptly while running
  • The knee is being hit or injured in a collision
    .

ACL tears can also result from non-movement-related causes such as:

  • Poor conditioning of the knee
  • Wearing footwear that does not fit properly 
  • Playing on artificial turf surfaces 
  • Using poorly maintained sports equipment, causing the knee to sprain
    .

What are the Symptoms of an ACL Tear?

After the time of injury, you may experience some of these common symptoms of a torn ACL:

  • A loud pop or popping sensation at the knee 
  • Severe, abrupt pain to the knee while engaging in physical activity 
  • Rapid swelling of the knee
  • Being unable to stand, walk or move the knee
    .

After an ACL tear, you may experience a sensation of the knee giving way when playing or pivoting.
.

ACL Tear Treatment

Non-surgical treatment is a preferred option for less severe cases. Patients who do not often participate in intense activities such as running, jumping, or pivoting can particularly benefit from non-surgical treatment.

Depending on the severity of the damage on the ACL, a patient can benefit from surgery to reconstruct or repair an injury. However, surgery remains beneficial for people who engage in intense physical activities often. 

Reconstruction involves using a tendon graft to replace the torn ACL. Most patients will receive nine months of physiotherapy after surgery before they can return to sports.

Non-Surgical Treatment of an ACL Tear

Physiotherapy:
Non-surgical treatment with physiotherapy is a preferred option for less active patients who do not participate in intense activities such as running, jumping, or pivoting.
.

Surgical 

Customised ACL Treatment:
Every ACL injury is different. The benefit of such a tailored approach is that the Orthopaedic Surgeon can utilise the remaining ACL to improve the knee’s final function after surgery.
.

All-Inside ACL Reconstruction:
In this procedure, the new ACL is secured into sockets that are drilled into the bones of the knee.
.

ACL Preservation Surgery:
This surgery allows a patient to avoid a full ACL Reconstruction. The Orthopaedic Surgeon will repair part of the ACL and augment the irreparable component with a tendon graft. 

This is done to avoid removing the entire ACL and replacing it with a new one. ACL repair changes the treatment of ACL injuries by employing surgical devices and techniques to repair the original, torn ligament. 

Only an estimated 20-30% of ACL tears are repairable, but this means that 20-30% of patients with ACL tears can preserve their original ACL and avoid having to sacrifice their spare parts for an ACL reconstruction. 

ACL repair is technically more complex, and the repair may fail to heal in roughly 10% of cases. However, with successful healing, patients who have undergone ACL repairs rehabilitate much faster and potentially have better function than patients who have undergone the traditional ACL reconstruction surgery.

Meniscus Tear

What Is a Meniscus Tear?

What Is a Meniscus Tear?
CAUSES  |  SYMPTOMS  |  TREATMENT OPTIONS

The meniscus is a shock absorber that cushions and provides stability in the knee. 

A meniscus tear refers to a tear of this shock-absorber. Any activity which causes a forceful strain on the joint to rotate or twist, especially adding the entire body weight onto the knee, can easily lead to a torn meniscus.

There are two types of meniscus tears:

  1. Acute tears – these are common to children and young adults who are active.
  2. Degenerative tears – These tears are due to cumulative stress and deterioration related to age.
    .

What Causes a Meniscus Tear?  

Meniscus tears are related to either trauma or age. These are the common causes:

  • Athletic activities in contact sports
  • A sudden stop or forceful twist of the knee 
  • Stress caused by heavy bodyweight or malaligned bones
  • Degeneration due to routine daily activities
  • Degeneration due to age
    .

What Are the Symptoms of a Meniscus Tear? 

It is common for the symptoms of a meniscus tear to be similar to those for Anterior Cruciate Ligament (ACL) injury. 

Here are the symptoms you may experience:

  • A popping sensation in the knee
  • Acute onset of pain in the knee
  • Swelling in the knee a few hours after the popping sensation
  • Difficulty in straightening the knee (locking)
    .

After the injury, you may experience the following symptoms:

  • Persistent pain in one side of the knee
  • Inability to fully straighten the knee
  • A sensation of the knee locking up (occasionally unable to fully straighten)
    .

Meniscus Tear Treatment

Pain from meniscal tears will often resolve with time. The tears usually do not heal and may give rise to recurrent symptoms or a progression of the tear’s severity.

Non-Surgical Treatment for a Meniscus Tear

Physiotherapy
Exercises performed during a physiotherapy session can help to decrease pain and improve knee function.

Painkillers
Treatment for meniscus tears usually involves painkillers in the early painful phase to help patients manage the symptoms.
.

Surgical Treatment for a Meniscus Tear

Arthroscopic / Key-Hole Surgery
As meniscal tears do not commonly heal independently, surgery may sometimes be required to restore its shock-absorption function. Without the meniscus, the knee is prone to developing osteoarthritis.

Surgery is usually in the form of a keyhole meniscus repair where the meniscus’s torn edges are stitched together. In some severe or complex tear cases, the meniscus may not be repairable. In these instances, the tear would then be trimmed until a stable rim is reached to reduce the chances of the damage progressing in the future.

What is a Patella (Kneecap) Dislocation?

What is a Patella (Kneecap) Dislocation?

What is a Patella (Kneecap) Dislocation?
CAUSES  |  SYMPTOMS  |  TREATMENT OPTIONS

The kneecap, also known as the patella, is a tiny bone that sits in a groove in front of the knee located at the end of the thigh bone. When you bend or straighten your leg, the kneecap glides over the groove.

The kneecap is held in place by a group of ligaments and muscles. A dislocation occurs when these ligaments and muscles are overstretched or torn, allowing the kneecap to slide out of the groove. Typically, this movement happens suddenly. You are likely to experience sharp pain, and you might be unable to straighten your knee after that.
.

What Causes a Patella (Kneecap) Dislocation? 

Here are some scenarios where a kneecap dislocation may occur:

  • A sudden and abrupt direction change while the leg is anchored firmly on the ground will put pressure on the kneecap. Too much pressure will overstretch the support tissues causing dislocation. Likely scenarios for this situation is when playing sports like soccer or basketball.
  • A fall or a direct blow to the knee will tear or overstretch the support tissues, leading to dislocation.
  • In some people, dislocation could result from bony abnormalities in the hip, knee or shin bone.
  • Loose ligaments make joints too flexible hence predisposing the individual to patella dislocation.
    .

What Are the Symptoms of a Patella (Kneecap) Dislocation?

  • A visibly deformed knee
  • Difficulty in straightening a bent knee 
  • Tenderness and pain in the knee
  • Swelling of the knee
    .

Subsequent symptoms after the kneecap has been put back in place include:

  • Kneecap is sloppy and can move sideways excessively
  • A sensation of instability and of the kneecap wanting to dislocate again
  • Pain and locking in the knee if there are other accompanying injuries following the dislocation
    .

Patella (Kneecap) Dislocation Treatment

There is a range of options for treating kneecap dislocation based on the injury’s extent and severity. The typical treatment is non-surgical, where the kneecap is manipulated back into place, then followed by a period of splinting physiotherapy.

Non-Surgical Treatment of a Patella (Kneecap) Dislocation

Patella manipulation:
Patella manipulation involves relocating the kneecap back into its normal position.
.

Physiotherapy:
Physiotherapy aims to strengthen the muscles that hold the kneecap in position to compensate for the torn ligaments that usually stabilise the kneecap. Physiotherapy can also help correct underlying functional abnormalities with knee and hip muscles, which may predispose one to dislocate their kneecap.
.

Surgical Treatment of a Patella (Kneecap) Dislocation

Knee Reconstruction Surgery:
In recurrent cases of knee dislocations, surgery may be required to stabilise the kneecap. This usually involves reconstructing the torn ligament known as the Medial Patellofemoral Ligament (MPFL). In cases where there is a severe underlying bony deformity, our surgeon may have to cut and realign the bone or deepen the groove in which the kneecap sits typically.

Knee Osteoarthritis

What Is Knee Osteoarthritis?

What Is Knee Osteoarthritis?
CAUSES  |  SYMPTOMS  |  TREATMENT OPTIONS

Knee Osteoarthritis is a degenerative disease where the cartilage in the knee joint wears away. Eventually, bone spurs may begin to form, and the two bone ends start to rub directly against each other. As a result, patients experience pain in the knee.

.

What Causes Knee Osteoarthritis?

Causes of Knee Osteoarthritis:

  • Heavy body weight adds a lot of stress to the joint and predisposes one to osteoarthritis.
  • Malalignment of the knee can overload certain parts of the knee, resulting in rapid wear and tear of the joint.
  • Previous trauma such as fractures, meniscus tears or ligament tears to the knee can affect the bony alignment and stability of the knee, resulting in early wear and tear on the joint.
  • Knee infections can damage the internal structures in the knee, giving rise to premature osteoarthritis.
  • Inflammatory conditions of the knee, such as rheumatoid arthritis and gout, can cause damage to the cartilage and progress to osteoarthritis.
    .

What are the Symptoms of Knee Osteoarthritis?

The following are the symptoms of knee osteoarthritis:

  • Pain with an activity that improves at rest
  • The feeling of stiffness in the knee joint, especially in the morning or when trying to begin movement
  • Swelling in the knee
  • Loss of full flexibility in the knee.
    .

Knee Osteoarthritis Treatment

If you’re experiencing chronic knee pain, it’s best practice to consult a doctor to have it diagnosed and treated as early as possible. Treatment aims to reduce pain and to improve function in the knee.

Non-Surgical Treatment of Knee Osteoarthritis

Weight loss:
Activities like exercise to produce weight loss are encouraged to relieve pressure on the knee.

Physiotherapy:
Physiotherapy can help to improve flexibility and pain in the knee.

Intra-Articular Injections:
Corticosteroids and gel injections of hyaluronic acid are commonly injected into the joint to improve osteoarthritis symptoms.

Oral medication and supplements:
Painkillers and oral anti-inflammatory medication can help with painful flares of osteoarthritis. Joint supplements can also help reduce the level of pain and inflammation in the joint. These include herbal anti-inflammatories or collagen supplementation.
.

Surgical Treatment of Knee Osteoarthritis

In early cases of osteoarthritis, doctors usually try to preserve the joint. These procedures are largely termed ‘joint preserving surgery’. As doctors try to avoid replacing the knee with an artificial joint. Mild cases may be responsive to cartilage repair.

The most common procedure is microfracture, where small holes are drilled into the bone to stimulate the cartilage’s healing. This procedure is often augmented with the addition of collagen, hyaluronic acid or bone marrow aspirate concentrate (BMAC) over the repair site to improve the success rates. Where possible, a torn and non-functioning meniscus is repaired. Underlying bony malalignment may be necessary to protect the knee from further wear and tear.

Subchondroplasty:
In some painful joints that aren’t repairable, subchondroplasty may reduce the bone pain of osteoarthritis and improve knee function. Subchondroplasty involves injecting a bone substitute into the painful, damaged parts of the bone around an arthritic joint. With improvements in pain, this procedure can help some patients avoid a total knee replacement.

Partial (unicompartmental) knee replacement:
A partial knee replacement may help if only one compartment of the knee is worn out. This is a more minor operation than a total knee replacement and has a shorter recovery period.

Total knee replacement:
In severe osteoarthritis, a total knee replacement will remove all the damaged bone and cartilage in the joint and replace it with an artificial joint made out of metal and plastic.

Fractures Around the Knee

What Are Fractures Around the Knee?

What Are Fractures Around the Knee?
CAUSES  |  SYMPTOMS  |  TREATMENT OPTIONS

The knee is a complex joint that supports the body weight while you perform daily activities. Fractures around the knee can eventually lead to loss of function, chronic pain, and post-traumatic osteoarthritis.
.

What Causes Fractures Around the Knee?

Knee fractures may be isolated to specific parts of the knee joint or the entire section. Regardless of the nature of the injury, here are some of the common causes:

  • Highly traumatic events like a car accident or a severe fall
  • Sports activities which involve a lot of contacts, e.g. Rugby, Basketball 
  • A direct blow to the knee, such as in a fall
    .

What are the Symptoms of Fractures Around the Knee

Here are common symptoms of a fractured knee:

  • The presence of severe pain within the knee section
  • Tenderness, warmth, and swelling in the knee joint
  • The knee appearing deformed
  • Difficulty doing a straight-leg raise or merely straightening your knee
  • Reduced range of motion
    .

Fractures Around the Knee Treatment

The treatment of fractures around the knee is dependent mainly on the location and severity of the injury.

Non-Surgical Treatment of Fractures Around the Knee

Pain & Anti-Inflammatory Medication:
Treatment for knee fractures usually involves painkillers in the early painful phase to help patients manage the symptoms.

Immobilisation in a Cast:
Non-surgically treated fractures often require immobilisation in a cast.

Physiotherapy:
While the fracture is healing in a cast, physiotherapy can help maintain the muscles around the knee and in the rest of the limb. After the fracture has healed, physiotherapy can also speed up functional recovery and improve the flexibility and strength of the joint.
.

Surgical Treatment of Fractures Around the Knee

Fracture Fixation:
Displaced fractures often require surgery. This usually involves open incisions, realignment of the fractured fragments, and securing them in position with metal plates, screws or nails. In specific injuries, the fractures may be secured with keyhole surgery.

Pain Symptoms

Find out which condition matches your pain points the best. Do note that it might not be accurate, but we hope to give you a better idea of the condition that you might be experiencing

  • A loud pop or popping sensation at the knee 
  • Severe, abrupt pain to the knee while engaging in physical activity 
  • Rapid swelling of the knee
  • Unable to stand, walk or move the knee

You may have:
ACL Tear
A tear or sprain of the ACL occurs whenever there is a sudden change in the direction or pivot of a locked knee.

ACL injuries are a common phenomenon among people who engage in highly demanding physical activities more so sports.

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  • A popping sensation in the knee
  • Acute onset of pain in the knee
  • Swelling in the knee a few hours after the popping sensation
  • Difficulty in straightening the knee 
  • Difficulty in moving the knee, or feeling as though the knee is locked

You may have:
Meniscus Tear
A meniscus tear refers to damage to the cartilage which causes the knee to lose its function and is mostly related to either trauma or age.

Some common causes are degeneration, a sudden stop or forceful wist of the knee or even stress casued by heavy body weight.

It is common for the symptoms of a meniscus tear to present similar to those for Anterior Cruciate Ligament (ACL) injury.

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  • A visibly deformed knee
  • Difficulty in straightening a bent knee 
  • Tenderness and pain in the knee
  • A swelling knee
  • Kneecap is sloppy and can move sideways excessively

You may have:
Patella (kneecap) Dislocation
The kneecap is held in place by a group of ligaments and muscles. A dislocation occurs when these ligaments and muscles are overstretched or torn, and the kneecap slides out of the groove.

Typically, this movement happens suddenly. You are likely to experience sharp pain, and you might be unable to stretch your knee.

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  • Pain becomes unbearable with activity and lessens when you rest
  • Stiffness in the knee joint
  • Swelling which is worse when one is resting
  • Inability to move the knee freely, and a feeling of a locked-up knee
  • Buckling sensation in the knee
  • Warmth and tenderness in the knee joint
  • A crackly knee during movement

You may have:
Knee Osteoarthritis
Knee Osteoarthritis is a degenerative disease where the cartilage in the knee joint wears away. In some cases, bone spurs might begin to form. As a result, patients experience pain in the knee.

Almost everyone develops a form of arthritis as they age. It is also the most commonly reported cause of knee osteoarthritis.

However, people who have suffered rheumatic arthritis are predisposed to suffering knee osteoarthritis.

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  • Presence of severe pain within the knee section
  • Tenderness, warmth and swelling in the knee joint
  • The knee looking deformed
  • Difficulty doing a straight-leg raise or extending the knee
  • Reduced range of motion

You may have:
Fractures around Knee
Fractures around the knee implies a fracture in one or more of the components making up the knee. Fractures of the knee could be dangerous, especially when they lead to compartment syndrome, also known as neurovascular compromise.

Knee fractures could be isolated to specific parts of the knee joint or the whole section.

The symptoms could be an aggregation of injuries to the individual components of the knee joint.

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What is a Rotator Cuff Tear?What is a Shoulder Impingement?What is a Dislocated Shoulder?
What is SLAP Tear?What is a Frozen Shoulder?What is Shoulder Arthritis?

What is a Rotator Cuff Tear?

What is a Rotator Cuff Tear?
CAUSES  |  SYMPTOMS  |  TREATMENT OPTIONS

To get a better understanding of what a rotator cuff tear is, it would help to understand the anatomy of your shoulder. Your shoulder is made up of three bones. These are your humerus (the upper arm bone), your scapula (the shoulder blade), and your clavicle (the collarbone). The top of your humerus fits into the scapula to form your shoulder.

Made up of four muscles that come together as tendons, the rotator cuff is what holds your scapula and humerus together. The rotator cuff is responsible for your ability to lift and rotate your arm.

If any of these tendons are damaged or torn, they are no longer fully attached to the top of your humerus. A torn tendon typically begins to fray before completely tearing. You may experience either a partial or full-thickness tear. 

A partial tear refers to a damaged tendon that has not yet completely severed. Alternatively, a full-thickness tear refers to a complete tear that leaves a hole in the tendon. 

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What Causes a Rotator Cuff Tear? 

A rotator cuff tear is typically caused by one of two things – these are either degeneration or injury. 

A degenerative tear refers to general wear and tear of the muscles that make up your rotator cuff over time. A degenerative tear in one arm often leads to a tear in the unaffected arm. Factors such as repetitive stress, a reduced blood supply (which occurs with age), and bone overgrowth (bone spurs) may all contribute to a degenerative rotator cuff tear. 

Alternatively, one may suffer from an acute tear which is the result of an injury. This can occur if you fall with an outstretched arm or try to lift a heavy object incorrectly. An acute tear can also happen together with other shoulder-related conditions such as a dislocated shoulder.
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What are the Symptoms of Rotator Cuff Tear?

The symptoms of a rotator cuff tear tend to occur both when the arm is moved in a specific direction and when the arm is at rest. Patients often describe this as a weakness and ache in the arm, which can lead to issues trying to sleep at night. 

You may experience some of these symptoms if you are suffering from a rotator cuff tear: 

      • A dull ache from ‘deep’ in the shoulder 
      • Difficulty reaching back or overhead
      • Issues sleeping on the affected shoulder
      • A crackling sensation when the shoulder is moved in a particular direction
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Rotator Cuff Tear Treatment

If you find yourself experiencing chronic shoulder pain, make an appointment to see a doctor. Treatment of rotator cuff tears varies based on several factors. Our doctors will first examine the type of tear you are suffering from, your age, activity level, and general health before deciding on the best course of treatment. 

Non-Surgical
Typically, a non-surgical treatment plan will be explored first. You may be asked to allow your shoulder plenty of rest by steering clear of overhead activity and keeping the affected arm in a sling. You may also be prescribed anti-inflammatory drugs to reduce the swelling. There are also some strengthening exercises that you may be asked to practice that can help relieve pain and prevent further injury. Lastly, our doctors may prescribe a steroid injection. 

Non-surgical treatment of rotator cuff tears is usually recommended as there are no risks of infection or lengthy recovery times.

Surgical 
However, if the condition persists, a surgical treatment plan may need to be put in place as you may be at risk of the tear increasing in size over time. 

If you lead a reasonably active lifestyle and use your arms for overhead work or sports, a surgical plan may be the recommended option for you. Additionally, should your rotator cuff tear be on the larger side (more than 3cm) with healthy surrounding tissue, our doctor may also advise that you explore the surgical treatment option.

Typically, surgery to fix a rotator cuff tear will involve reattaching the tendon to the humerus. However, our doctors will discuss which method best suits you and your needs.


What is Shoulder Impingement?

What is Shoulder Impingement?
CAUSES  |  SYMPTOMS  |  TREATMENT OPTIONS

Shoulder impingement is usually caused by pinching of the rotator cuff tendons and their overlying bursa between the bones in one’s shoulder, which can occur when reaching overhead. Shoulder impingement can also be associated with other rotator cuff injuries. 

Typically, an impinging shoulder will resolve itself in a matter of weeks to months. This is especially so with the right strengthening exercises. However, there are cases where it can become an ongoing problem.

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What Causes Shoulder Impingement?  

The movement of lifting your arm causes the tendon to pass through the subacromial space, which exists at the top of your shoulder. This space can be narrowed with poor shoulder posture or poor muscle balance. 

Alternatively, the bursa overlying the tendons may become inflamed and irritated from either overuse of the shoulder or a shoulder injury. 

Other causes of shoulder impingement include the development of bony spurs on the acromion as one ages or a curved acromion.

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What are the Symptoms of Shoulder Impingement? 

The symptoms of shoulder impingement are similar to that experienced if one is suffering from a rotator cuff tear. Your arm may hurt both at rest and when in motion. Patients often describe pain from a shoulder impingement as being a dull ache or weakness in the arm. 

You may experience these symptoms if you are suffering from a shoulder impingement:

      • Pain from the side of the arm to the front of the shoulder
      • Stiffness 
      • Sudden pain when reaching upwards
      • Pain when resting

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Shoulder Impingement Treatment

When dealing with shoulder impingement, our doctors may recommend that you first try to manage the condition with a non-surgical treatment plan. If the issue persists, you may then be asked to go for surgery to alleviate the condition.

Non-Surgical
Non-surgical treatment of shoulder impingement includes a series of exercises that both improve posture and alleviate the impingement. Alternatively, our doctors may recommend steroid injections to help relieve the pain and swelling of shoulder impingement. However, you will still be required to perform the strengthening exercises.

Surgical 

In the case that neither the exercises nor the steroid injections are helping, and if the symptoms are causing problems with your daily activities such as dressing, washing and/or sleeping, it may be recommended that you have surgery. Surgery for shoulder impingement is called subacromial decompression.

This is a keyhole surgery that involves widening the space surrounding the rotator cuff tendon to prevent it from becoming impinged. 


What is Shoulder Impingement?

What is a Dislocated Shoulder?
CAUSES  |  SYMPTOMS  |  TREATMENT OPTIONS

A dislocated shoulder refers to an injury where your humerus (upper arm bone) pops out of the cup-shaped socket, which is a part of your shoulder blade, where it sits. Should this happen, your joint may become unstable.

Additionally, you might find that once you’ve had a shoulder dislocation, you may be prone to dislocating it again.

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What Causes a Dislocated Shoulder?  

A number of factors can cause a dislocated shoulder. Typically, it would require a strong blow to the shoulder to shift the bones out of their rightful place. Alternatively, should you rotate your shoulder to the extreme, you may also push the ball of your humerus out of its socket, resulting in a dislocated shoulder. 

Due to the nature of the shoulder joint and its ability to move in various directions, you can dislocate your shoulder either backwards or forwards, downwards, and completely or partially. A partial dislocation refers to a dislocation where the humerus is part in and part out of its socket. 

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What are the Symptoms of a Dislocated Shoulder?

The symptoms related to a dislocated shoulder often include a visibly displaced shoulder and an intense feeling of pain. 

You may experience these symptoms if you are suffering from a dislocated shoulder: 

      • Intense pain
      • Arm feels weak
      • Numbness/tingling reaches down the arm or up the neck
      • Shoulder Spasms
      • Shoulder looks out of place

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Dislocated Shoulder Treatment

There are several available treatment plans available should you dislocate your shoulder. There are both surgical and non-surgical options that our doctors will recommend based on your specific case.

Non-Surgical

Most often, doctors will attempt a closed reduction. This is where the shoulder is manoeuvred gently back into place. You may be prescribed some muscle relaxants or a sedative depending on your level of pain. 

Alternatively, our doctors may recommend that your arm be placed in a sling or a splint to immobilise the shoulder and allow it to rest. Once you can remove the sling or splint, you typically will need some rehabilitation to regain strength in the shoulder and to reduce the chance of re-dislocating it.

 

Surgical 

In the case that your shoulder labrum (shoulder joint’s socket lip) is torn and your joint is weakened, your sport or working demands may put you at a high risk of dislocating your shoulder again. You may also re-dislocate your shoulder if you have broken part of the shoulder socket.

In these cases, surgery may be recommended to treat a dislocated shoulder. During surgery, our doctors can repair the torn labrum. 

This is commonly done via arthroscopic (keyhole surgery) shoulder stabilisation, where the torn labrum can be repaired.


What is a SLAP Tear?

What is a SLAP Tear?
CAUSES  |  SYMPTOMS  |  TREATMENT OPTIONS

A Superior Labrum Anterior Posterior Tear (a SLAP Tear) refers to the damage of the top part of the labrum in your shoulder. Your labrum is a cup-shaped rim of fibrous tissue that helps to cushion the shoulder joint’s socket. It is responsible for stabilising the shoulder. The superior labrum is the part that is attached to your biceps’ tendon.

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What Causes a SLAP Tear?

SLAP tears are often the result of repetitive use of the shoulder. Through repetitive overhead use, the labrum may fray or detach. This is why athletes are more likely to suffer from SLAP tears.

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What are the Symptoms of a SLAP Tear?

If you are suffering from a SLAP tear, it is common to feel a deep pain within the shoulder. Additionally, patients often complain of weakness in the arm.

If you are suffering from a SLAP tear, you may experience these symptoms:

      • Deep, aching pain
      • Painful Clicking, Grinding, popping or locking sensation during rotational movement
      • Decreased shoulder strength
      • Limited range of motion

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SLAP Tear Treatment

Similar to the other shoulder conditions mentioned above, there are both surgical and non-surgical treatment plans available for a SLAP Tear.

Non-Surgical

Non-surgical treatment of a SLAP tear includes anti-inflammatory drugs that will help with the pain and swelling of the injury. Additionally, you will be given a range of strengthening exercises to perform that should both restore your range of motion and strengthen the shoulder.  

 

Surgical 

A surgical treatment plan for a SLAP tear repair is done arthroscopically, this is also referred to as keyhole surgery. During surgery, the torn part of the labrum is either removed entirely or reattached with stitches. Our doctors will determine which course of surgery is best for you.


What is a Frozen Shoulder?

What is a Frozen Shoulder?
CAUSES  |  SYMPTOMS  |  TREATMENT OPTIONS

Frozen shoulder, also known as adhesive capsulitis, is a common cause of shoulder pain and stiffness that commonly affects patients above the age of 40. A thin capsule usually covers the shoulder joint. When this capsule gets inflamed, it causes pain, and the shoulder becomes stiff. This usually resolves with time.

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What Causes a Frozen Shoulder?

As mentioned above, the shoulder joint is covered by a thin capsule of connective tissue. When this connective tissue tightens and thickens, it restricts the movement of your shoulder. This is what causes a frozen shoulder.

Most commonly, frozen shoulder is a secondary result of underlying shoulder injuries such as shoulder impingement, rotator cuff injury, shoulder dislocation, or SLAP tear.

Frozen shoulder also tends to occur in people who have recently suffered a shoulder fracture or in cases where the arm has had to be immobilised.

Additionally, frozen shoulder is also seen in patients with hormonal problems like diabetes and thyroid issues, heart problems like heart attack and neurological problems like stroke.

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What are the Symptoms of a Frozen Shoulder

Frozen shoulder tends to develop in stages – freezing, frozen, and thawing. It starts with a pain that is felt when you move your arm, develops into stiffness, and then slowly, your range of movement should improve.

If you are suffering from a frozen shoulder, you may experience these symptoms:

  • Stiffness or a dull ache and pain
  • Pain has lasted months
  • Pain reaching the upper arm

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Frozen Shoulder Treatment

Typically, treatment plans for a frozen shoulder are non-surgical. Doctors will usually recommend a non-surgical treatment plan to alleviate a frozen shoulder. However, in a small percentage of cases, you may require surgery.

Non-Surgical

Non-surgical treatment of a frozen shoulder may involve the injection of corticosteroids that help reduce the inflammation. You may also be prescribed numbing medications to ease the pain of a frozen shoulder. A range of exercises that help with your range of movement may also be recommended.  

 

Surgical 

Surgery to treat a frozen shoulder is done arthroscopically. During surgery, the inflamed and thickened joint capsule is cut to allow you to move your shoulder freely. Often, other shoulder problems like impingement or rotator cuff tears that have resulted in the frozen shoulder will be addressed during the surgery.


What is Shoulder Arthritis?

What is Shoulder Arthritis?
CAUSES  |  SYMPTOMS  |  TREATMENT OPTIONS

Shoulder arthritis refers to damage to the cartilage in the shoulder joints. It occurs when the cartilage starts wearing down on the ball and socket of the shoulder joint, causing pain.

There are various treatment options for arthritis in the shoulder, such as medication, lifestyle changes (such as daily activities or exercise) or physiotherapy. However, if your condition worsens, surgery might be recommended.

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What Causes Shoulder Arthritis?

Shoulder arthritis is the result of the general wear and tear of the cartilage present in your shoulder joint. The cartilage covers the surface of the bones in your joints and allows the bones to glide smoothly over each other when the joints move. As the cartilage begins to break down, the exposed bone may rub against each other and cause you to feel pain.

The cartilage tends to break down when faced with stress. Therefore, more painful and stressful activities are likely to break down the cartilage more.

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What are the Symptoms of Shoulder Arthritis

Since the breakdown and loss of cartilage differs in patients, the symptoms also vary. However, patients who suffer from shoulder arthritis generally complain of longstanding pain and stiffness in the joint, and weakness in the arm.

If you suffer from shoulder arthritis, you may experience these symptoms:

  • Pain in the shoulder joint
  • A weakness of the shoulder
  • Swelling or tenderness at the joint
  • A feeling of grinding within the joint
  • Pain that has lasted months/years

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Shoulder Arthritis Treatment

Our doctors will typically recommend non-surgical treatment options if you suffer from shoulder arthritis. However, if non-surgical options show little to no signs of improvement, surgery may be required to improve your condition.

Non-Surgical

As with many of the other shoulder conditions, non-surgical treatment often involves range-of-motion exercises to strengthen the shoulder, steroid injections to reduce inflammation, and medication to ease the pain.

However, with the treatment of shoulder arthritis, you may also be told to use ice or heat to alleviate the pain. Speak to our doctors for more information about using cold or hot packs to ease shoulder arthritis pain.

 

Surgical 

In the case that non-surgical treatment options are unable to treat shoulder arthritis effectively, surgery may be recommended. Depending on how far along your shoulder arthritis is, our doctors may either recommend shoulder debridement surgery or a shoulder replacement surgery.

Shoulder debridement surgery is usually recommended for less advanced stages of shoulder arthritis, while a shoulder replacement may be needed in more severe cases.

Pain Symptoms

Find out which condition matches your pain points the best. Do note that it might not be accurate, but we hope to give you a better idea of the condition that you might be experiencing

  • A loud pop or popping sensation at the knee 
  • Severe, abrupt pain to the knee while engaging in physical activity 
  • Rapid swelling of the knee
  • Unable to stand, walk or move the knee
  • A popping sensation in the knee
  • Acute onset of pain in the knee
  • Swelling in the knee a few hours after the popping sensation
  • Difficulty in straightening the knee 
  • Difficulty in moving the knee, or feeling as though the knee is locked
  • A visibly deformed knee
  • Difficulty in straightening a bent knee 
  • Tenderness and pain in the knee
  • A swelling knee
  • Kneecap is sloppy and can move sideways excessively

You may have:
ACL Tear
A tear or sprain of the ACL occurs whenever there is a sudden change in the direction or pivot of a locked knee.

ACL injuries are a common phenomenon among people who engage in highly demanding physical activities more so sports.

Find Out More

Find Out

You may have:
Meniscus Tear
A meniscus tear refers to damage to the cartilage which causes the knee to lose its function and is mostly related to either trauma or age.

Some common causes are degeneration, a sudden stop or forceful wist of the knee or even stress casued by heavy body weight.

It is common for the symptoms of a meniscus tear to present similar to those for Anterior Cruciate Ligament (ACL) injury.

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You may have:
Patella (kneecap) Dislocation
The kneecap is held in place by a group of ligaments and muscles. A dislocation occurs when these ligaments and muscles are overstretched or torn, and the kneecap slides out of the groove.

Typically, this movement happens suddenly. You are likely to experience sharp pain, and you might be unable to stretch your knee.

Find Out More

Find Out

  • Pain becomes unbearable with activity and lessens when you rest
  • Stiffness in the knee joint
  • Swelling which is worse when one is resting
  • Inability to move the knee freely, and a feeling of a locked-up knee
  • Buckling sensation in the knee
  • Warmth and tenderness in the knee joint
  • A crackly knee during movement
  • Presence of severe pain within the knee section
  • Tenderness, warmth and swelling in the knee joint
  • The knee looking deformed
  • Difficulty doing a straight-leg raise or extending the knee
  • Reduced range of motion

You may have:
Knee Osteoarthritis
Knee Osteoarthritis is a degenerative disease where the cartilage in the knee joint wears away. In some cases, bone spurs might begin to form. As a result, patients experience pain in the knee.

Almost everyone develops a form of arthritis as they age. It is also the most commonly reported cause of knee osteoarthritis.

However, people who have suffered rheumatic arthritis are predisposed to suffering knee osteoarthritis.

Find Out More

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You may have:
Fractures around Knee
Fractures around the knee implies a fracture in one or more of the components making up the knee. Fractures of the knee could be dangerous, especially when they lead to compartment syndrome, also known as neurovascular compromise.

Knee fractures could be isolated to specific parts of the knee joint or the whole section.

The symptoms could be an aggregation of injuries to the individual components of the knee joint.

Find Out More

Find Out

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