The Knee Joint

The Knee Joint

The knee is a hinge joint formed by two bones (femur and tibia) and is held together by four ligaments (medial collateral ligament, lateral collateral ligament, anterior cruciate ligament, posterior cruciate ligament).The patella, or knee cap, also is part of the normal knee anatomy. The ends of the femur and tibia and underside of the patella are covered by articular cartilage, a slippery surface which allows friction-free, pain free movement.

The normal knee joint is surrounded by a membrane (the synovium) which produces a small amount of thick fluid (synovial fluid). The synovial fluid helps to nourish the cartilage and keep it slippery. The synovium also has a tough outer layer (the joint capsule) which protects and supports the joint.
The normal knee joint is surrounded by a membrane (the synovium) which produces a small amount of thick fluid (synovial fluid). The synovial fluid helps to nourish the cartilage and keep it slippery. The synovium also has a tough outer layer (the joint capsule) which protects and supports the joint.

The surface layer of cartilage breaks down and wears away in osteoarthritis (sometimes called wear-and-tear arthritis). The breakdown of cartilage causes the bones under the cartilage to rub together (bone-on-bone).

Pain, swelling, and loss of motion result. The joint may lose its normal shape over time and become deformed. Bone spurs can develop along the edges of the joint. Bits of bone or cartilage can break off and float inside the joint space, causing even more pain and damage.

The location of the knee pain can be useful information when trying to obtain an accurate diagnosis. Pain on the front of the knee can be caused by bursitis, arthritis, or softening of the patella cartilage as in chrodomalacia of patella.

Pain on the sides of the knee is usually related to injuries to the collateral ligaments, arthritis, or tears to the meniscuses. Pain in the back of the knee can be caused by arthritis or an accumulation of synovial fluid behind the knee. Infection can be another possible cause of knee pain.

Knee Pain:

Understanding what is causing your knee pain may be a simple task, but sometimes could be complicated. A physician can use clues to determine the cause of your knee pain. Some of these clues have to do with you; how old are you? What types of activities do you do? But others with your symptoms (has your knee pain been ongoing? Was there a recent injury?).

Common knee joint symptoms include:

Location of Pain:

·         Inside of Knee: Pain on the inside, or medial side, of the knee is commonly caused by meniscus tears, MCL injuries , and arthritis.

·       Outside of Knee: Pain on the outside of the knee, or lateral side, is commonly caused by lateral meniscus tears, LCL injuries, band tendonitis, and arthritis.

·         Back of Knee: Pain in the back of the knee can be due to the collection of fluid.

·         Front of Knee: Pain over the front of the knee is most commonly related to the knee cap whose causes could be by several different problems.

Timing of Pain:

·         Morning pain: Pain after first waking in the morning that quickly resolves with gentle activity is typical of early arthritis

·         While going down stairs: Pain while walking down steps is very commonly associated with kneecap problems.

Swelling:

Swelling of the knee is common with several different knee problems. When there is an effusion immediately after a knee injury, a possible cause is severe injury to an internal joint structure, like the anterior cruciate ligament or a fracture of the top of the shin bone.

When swelling develops gradually over hours to days after an injury, it is likely to be something less severe, like a tear of the meniscus or a ligament sprain.

Swelling that occurs without the presence of a known injury can be due to osteoarthritis (common), gout (less common), inflammatory arthritis, or a joint infection (uncommon).

Mobility:

Mobility of the knee can be affected by a number of common conditions. If mobility is chronically limited, often the cause is arthritis. When the surface of the joint becomes irregular as a result of the arthritis, the mobility of the joint may become limited.

If the mobility is limited after an acute injury, there is likely swelling limiting the motion, or a torn structure that is limiting the mobility.

Instability/Giving Way:

The stability of the kneeis provided by the ligaments that connect the shin bone to the thigh bone. When the ligaments are stretched or torn, the knee may feel as though it is giving way beneath the patient. A sensation that the knee may give out from beneath you is a common symptom of ligament injury.

Popping/Clicking/Crunching/Grinding:

Popping and snapping within the knee is common, and often not a symptom of any particular problem. When the pops are painless, there is usually no problems but painful pops and snaps should be evaluated by your doctor. A pop is often heard or felt during an injury when a ligament, such as the ACL, is torn.

Grinding or crunching is a common symptom of cartilage problems. If the cartilage is damaged -- a condition called chondromalacia -- a crunching sensation is often felt by placing the hand over the kneecap and bending the knee. A similar grinding sensation may be felt with knee arthritis.

Locking:

Locking is a symptom that occurs when a patient cannot bend or straighten their knee. The locking can either be due to something physically blocking motion of the knee, or by pain preventing normal knee motion.

One way to determine if there is something physically blocking knee motion is to inject the knee with a numbing medication. After the medication has taken effect, you can attempt to bend the knee to determine if pain was blocking the motion or if there is a structure, such as a torn meniscus, that is blocking normal motion.

Treatment:

The most effective nutritional supplement for joint health and treatment of arthritic symptoms in the world can be found at http://www.tripleclicks.com/detail.php?item=6016/9580169.


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