Knee Joint Problems
Pain in the knee can have various reasons. A clinical examination of the knee joints as well as images produced by x-ray and/or computer tomography, if need be, usually enable us to find the exact cause, or respectively, to make a corresponding diagnosis. When the cause is detected in time, specific therapeutic measures can often result in alleviating the problem
Modifications in the knee joint, which initially do not cause any difficulties are more problematic, such as small tears at the lateral and medial menisci or the onset of cartilage damage, which, in the course of time, may lead to an arthrosis of the knee joint.
Cartilage is a solid, smooth and flexible tissue. It covers opposite bone ends, which form the joint areas and, together with the synovial fluid, it enables smooth motion.
A damaged piece of cartilage does not usually heal by itself. This is due to the fact that cartilage - as opposed to bone - has no blood supply of its own but is nourished through the bone that it covers as well as via the synovial fluid.
Causes for cartilage damage can be, for example, the results of injuries, signs of ageing and overexertion, often resulting in "run-in" pain, pain under exertion, and a tendency toward swelling, over-heating and effusions.
Depending on the severity of damage to the cartilage, therapy ranges from injections into the knee joint via arthroscopy of the joint with therapeutic measures for the cartilage up to the replacement of the knee joint (endoprosthesis) in cases of complete destruction of the cartilage, i.e. arthrosis.
Damage to the Meniscus
The lateral meniscus and the medial meniscus are two crescent-shaped disks, which function as a kind of shock absorbers in the knee, between the thigh and the lower leg.
We distinguish between "fresh" ruptures of the meniscus, such, as for instance, as the result of a sports injury, which lead to acute problems, and degenerative lesions, which at first do not cause much pain but in the course of time create problems through recurrent swelling of the knee joint, especially under exertion.
It often makes sense to remove the damaged part of the meniscus within the framework of arthroscopic surgery, in order to prevent consequential damages. A rupture of the meniscus at its base, which is supplied with blood, can be mended by stitching.
Anterior Cruciate Ligament Rupture
A rupture of the anterior cruciate ligament is a frequent sports injury, which happens especially following a traumatic torsion of the knee joint.
Together with the posterior cruciate ligament, this ligament contributes considerably to the knee joint's stability. An immediate and painful restriction of mobility in connection with swelling, an effusion or hematoma, limitation of movement and a lack of stability in the knee indicate a rupture of the anterior cruciate ligament.
In addition to the clinical picture, diagnostics also depend on magnetic resonance tomography. In general, a torn anterior cruciate ligament should be treated surgically (including arthroscopic assistance) by anterior cruciate ligament plasty.
Arthrosis of the Knee Joint
Arthrosis is characterized by advanced signs of wear including the erosion of the articular cartilage. Typical signs are "run-in" pain, pain under exertion as well as swelling and overheating.
During the acute stage, relief can be obtained by administering anti-inflammatory, detumescent medication. In addition, conservative treatment includes repeated injections of hyaluronic acid into the knee joint as well as physiotherapeutic and physical measures.
Only in the final stage of arthrosis, or respectively, when the strain becomes unbearable, should the joint be surgically replaced (endoprosthesis).