Dr. MJ Bazos MD,
Q & A
About Knee Problems
This fact sheet contains general information
about knee problems. It includes descriptions and a diagram of the different
parts of the knee, including bones, cartilage, muscles, ligaments, and tendons.
Individual sections of the fact sheet describe the symptoms, diagnosis, and
treatment of specific types of knee injuries and conditions. Information is also
provided on the prevention of knee problems.
How Common Are Knee Problems and
What Causes Them?
According to the
American Academy of Orthopaedic Surgeons, more than 4.1 million people seek
medical care each year for a knee problem.
Some knee problems result from wear of
parts of the knee, such as occurs in osteoarthritis. Other problems result from
injury, such as a blow to the knee or sudden movements that strain the knee
beyond its normal range of movement.
How Can People Prevent Knee
Some knee problems, such as
those resulting from an accident, cannot be foreseen or prevented. However, a
person can prevent many knee problems by following these suggestions:
•First warm up by walking or riding a
stationary bicycle, then do stretches before exercising or participating in
sports. Stretching the muscles in the front of the thigh (quadriceps) and back
of the thigh (hamstrings) reduces tension on the tendons and relieves pressure
on the knee during activity.
•Strengthen the leg muscles by doing
specific exercises (for example, by walking up stairs or hills, or by riding a
stationary bicycle). A supervised workout with weights is another pathway to
strengthening leg muscles that benefit the knee.
•Avoid sudden changes in the intensity of
exercise. Increase the force or duration of activity gradually. •Wear
shoes that both fit properly and are in good condition to help maintain balance
and leg alignment when walking or running. Knee problems may be caused by flat
feet or overpronated feet (feet that roll inward). People can often reduce some
these problems by wearing special shoe inserts (orthotics). Maintain appropriate
weight to reduce stress on the knee. Obesity increases the risk of degenerative
(wearing) conditions such as osteoarthritis of the knee.
What Kinds of Doctors Treat Knee
Extensive injuries and
diseases of the knees are usually treated by an orthopaedic surgeon, a doctor
who has been trained in the nonsurgical and surgical treatment of bones, joints,
and soft tissues (for example, ligaments, tendons, and muscles). Patients
seeking nonsurgical treatment of arthritis of the knee may also consult a
rheumatologist (a doctor specializing in the diagnosis and treatment of
arthritis and related disorders).
What Are the Major Structures of
the Knee and What Do They Do?
joint works like a hinge to bend and straighten the lower leg. It permits a
person to sit, stand, and pivot.
The knee joint is the
junction of three bones-the femur (thigh bone or upper leg bone), the tibia
(shin bone or larger bone of the lower leg), and the patella (kneecap). The
patella is about 2 to 3 inches wide and 3 to 4 inches long. It sits over the
other bones at the front of the knee joint and slides when the leg moves. It
protects the knee and gives leverage to muscles.
The ends of the three bones in the knee
joint are covered with articular cartilage, a tough, elastic material that helps
absorb shock and allows the knee joint to move smoothly. Separating the bones of
the knee are pads of connective tissue called menisci, which are divided into
two crescent-shaped discs positioned between the tibia and femur on the outer
and inner sides of each knee. The two menisci in each knee act as shock
absorbers, cushioning the lower part of the leg from the weight of the rest of
the body, as well as enhancing stability.
There are two groups of muscles at the
knee. The quadriceps muscle comprises four muscles on the front of the thigh
that work to straighten the leg from a bent position. The hamstring muscles,
which bend the leg at the knee, run along the back of the thigh from the hip to
just below the knee.
Ligaments are strong, elastic bands of
tissue that connect bone to bone. They provide strength and stability to the
joint. Four ligaments connect the femur and tibia:
•The medial collateral ligament (MCL)
provides stability to the inner (medial) aspect of the knee.
•The lateral collateral ligament (LCL)
provides stability to the outer (lateral) aspect of the knee.
•The anterior cruciate ligament (ACL), in
the center of the knee, limits rotation and the forward movement of the tibia.
•The posterior cruciate ligament (PCL),
also in the center of the knee, limits backward movement of the tibia.
Other ligaments are part of the knee
capsule, which is a protective, fiber-like structure that wraps around the knee
joint. Inside the capsule, the joint is lined with a thin, soft tissue, called
Tendons are tough cords of tissue that
connect muscle to bone. In the knee, the quadriceps tendon connects the
quadriceps muscle to the patella and provides power to extend the leg. The
patellar tendon connects the patella to the tibia. Technically, it is a
ligament, but it is commonly called a tendon.
How Are Knee Problems Diagnosed?
Doctors use several methods to
diagnose knee problems.
•Medical history—the patient tells
the doctor details about symptoms and about any injury, condition, or general
health problem that might be causing the pain.
•Physical examination—the doctor
bends, straightens, rotates (turns), or presses on the knee to feel for injury
and discover the limits of movement and location of pain.
•Diagnostic tests-the doctor uses one or
more tests to determine the nature of a knee problem.
•X ray (radiography)—an x-ray beam
is passed through the knee to produce a two-dimensional picture of the bones.
•Computerized axial tomography (CAT)
scan-x rays lasting a fraction of a second are passed through the knee at
different angles, detected by a scanner, and analyzed by a computer. This
produces a series of clear cross-sectional images ( slices") of the knee tissues
on a computer screen. CAT scan images show soft tissues more clearly than normal
x rays. Individual images can be combined by computer to give a
three-dimensional view of the knee.
•Bone scan (radionuclide scanning)—a
very small amount of radioactive material is injected into the patient's
bloodstream and detected by a scanner. This test detects blood flow to the bone
and cell activity within the bone, and can show abnormalities in these processes
that may aid diagnosis.
•Magnetic resonance imaging
(MRI)—energy from a powerful magnet (rather than x rays) stimulates
tissues of the knee to produce signals that are detected by a scanner and
analyzed by computer. This creates a series of cross-sectional images of a
specific part of the knee. An MRI is particularly sensitive for detecting damage
or disease of soft tissues, such as ligaments and muscles. As with a CAT scan, a
computer can be used to produce three-dimensional views of the knee during MRI.
•Arthroscopy—the doctor manipulates
a small, lighted optic tube (arthroscope) that has been inserted into the joint
through a small incision in the knee. Images of the inside of the knee joint are
projected onto a television screen.
Cartilage Injuries and Disorders
KON-DRO-MAH-LAY-SHE-AH), also called chondromalacia patellae, refers to
softening of the articular cartilage of the kneecap. The disorder occurs most
often in young adults and may be caused by trauma, overuse, parts out of
alignment, or muscle weakness. Instead of gliding smoothly across the lower end
of the thigh bone, the kneecap rubs against it, thereby roughening the cartilage
underneath the kneecap. The damage may range from a slight abnormality of the
surface of the cartilage to a surface that has been worn away completely to the
bone. Traumatic chondromalacia occurs when a blow to the knee cap tears off
either a small piece of articular cartilage or a large fragment containing a
piece of bone (osteochondral fracture).
What Are the Symptoms of
Chondromalacia? How Is It Diagnosed?
The most frequent symptom of
chondromalacia is a dull pain around or under the kneecap that worsens when
walking down stairs or hills. A person may also feel pain when climbing stairs
or during other activities when the knee bears weight as it is straightened. The
disorder is common in runners and is also seen in skiers, cyclists, and soccer
players. A patient's description of symptoms and a followup x ray usually help
the doctor make a diagnosis. Although arthroscopy can confirm the diagnosis of
chondromalacia, it is not performed unless the condition requires extensive
How Is Chondromalacia
Many doctors recommend that
patients with chondromalacia perform low-impact exercises that strengthen
muscles, particularly the inner part of the quadriceps, without injuring joints.
Swimming, riding a stationary bicycle, and using a cross-country ski machine are
acceptable as long as the knee is not bent more than 90 degrees. Electrical
stimulation may also be used to strengthen the muscles. If these treatments fail
to improve the condition, the physician may perform arthroscopic surgery to
smooth the surface of the articular cartilage and wash out" cartilage fragments
that cause the joint to catch during bending and straightening. In more severe
cases of chondromalacia, surgery may be necessary to correct the angle of the
kneecap and relieve friction involving the cartilage or to reposition parts that
are out of alignment.
to the Meniscus
What Is the Cause
of Injuries to the Meniscus?
menisci are easily injured by the force of rotating the knee while bearing
weight. A partial or total tear of a meniscus may occur when a person quickly
twists or rotates the upper leg while the foot stays still (for example, when
dribbling a basketball around an opponent or turning to hit a tennis ball). If
the tear is tiny, the meniscus stays connected to the front and back of the
knee; if the tear is large, the meniscus may be left hanging by a thread of
cartilage. The seriousness of a tear depends on its location and extent.
What Are the Symptoms of Injury?
Generally, when people injure a
meniscus, they feel some pain, particularly when the knee is straightened. The
pain may be mild, and the person may continue activity. Severe pain may occur if
a fragment of the meniscus catches between the femur and tibia. Swelling may
occur soon after injury if blood vessels are disrupted, or swelling may occur
several hours later if the joint fills with fluid produced by the joint lining
(synovium) as a result of inflammation. If the synovium is injured, it may
become inflamed and produce fluid to protect itself. This causes swelling of the
knee. Sometimes, an injury that occurred in the past but was not treated becomes
painful months or years later, particularly if the knee is injured a second
time. After any injury the knee may click, lock, or feel weak. Symptoms of
meniscal injury may disappear on their own but frequently, symptoms persist or
return and require treatment.
Is Meniscal Injury Diagnosed?
addition to listening to the patient's description of the onset of pain and
swelling, the physician may perform a physical examination and take x-rays of
the knee. The examination may include a test in which the doctor flexes (bends)
the leg then rotates the leg outward and inward while extending it. Pain or an
audible click suggests a meniscal tear. A MRI test may be recommended to confirm
the diagnosis. Occasionally, the doctor may use arthroscopy to help diagnose and
treat a meniscal tear.
How Is an
Injured Meniscus Treated?
If the tear
is minor and the pain and other symptoms go away, the doctor may recommend a
muscle-strengthening program. Exercises for meniscal problems are best performed
with initial guidance from a doctor and physical therapist or exercise
therapist. The therapist will make sure that the patient does the exercises
properly and without risk of new or repeat injury. The following exercises after
injury to the meniscus are designed to build up the quadriceps and hamstring
muscles and increase flexibility and strength.
•Warming up the joint by riding a
stationary bicycle, then straightening and raising the leg (but avoiding
straightening the leg too much).
•Extending the leg while sitting (a weight
may be worn on the ankle for this exercise).
•Raising the leg while lying on the
•Exercising in a pool, including walking
as fast as possible in chest-deep water, performing small flutter kicks while
holding onto the side of the pool, and raising each leg to 90 degrees in
chest-deep water while pressing the back against the side of the pool.
If the tear to a meniscus is more
extensive, the doctor may perform either arthroscopic surgery or open surgery"
to see the extent of injury and to repair the tear. The doctor can suture (sew)
the meniscus back in place if the patient is relatively young, the injury is in
an area with a good blood supply, and the ligaments are intact. Most young
athletes are able to return to vigorous sports with meniscus-preserving repair.
If the patient is elderly or the tear
is in an area with a poor blood supply, the doctor may cut off a small portion
of the meniscus to even the surface. In some cases, the doctor removes the
entire meniscus. However, degenerative changes, such as osteoarthritis, are more
likely to develop in the knee if the meniscus is removed. Medical researchers
are currently investigating a procedure called an allograft, in which the
surgeon replaces the meniscus with one from a cadaver. A grafted meniscus is
fragile and may shrink and tear easily. Researchers have also attempted to
replace a meniscus with an artificial one, but the procedure is even less
successful than an allograft. Recovery
after surgery to repair a meniscus takes several weeks longer and post-operative
activity is slightly more restricted than when the meniscus is removed.
Nevertheless, putting weight on the joint actually fosters recovery. Regardless
of the form of surgery, rehabilitation usually includes walking, bending the
legs, and doing exercises that stretch and build up the leg muscles. The best
results of treatment for meniscal injury are obtained in people who do not show
articular cartilage changes and who have an intact anterior cruciate ligament.
3. Arthritis of the Knee
What Is Arthritis of the Knee?
Arthritis of the knee is most often
osteoarthritis, a degenerative disease where cartilage in the joint gradually
wears away. In rheumatoid arthritis, which can also affect the knees, the joint
becomes inflamed and cartilage may be destroyed. Arthritis not only affects
joints, it may also affect supporting structures such as muscles, tendons, and
ligaments. Osteoarthritis may be caused by
excess stress on the joint, such as from repeated injury, deformity, or if a
person is overweight. It most often affects middle-aged and older people. A
young person who develops osteoarthritis may have an inherited form of the
disease or may have experienced continuous irritation from an unrepaired torn
meniscus or other injury. Rheumatoid arthritis usually affects people at an
earlier age than osteoarthritis.
What Are the Signs of Knee
Arthritis and How Is It Diagnosed? A
person who has arthritis of the knee may experience pain, swelling, and a
decrease in knee motion. A common symptom is morning stiffness that lessens
after moving around. Sometimes the knee joint locks or clicks when the knee is
bent and straightened, but these signs may also occur in other knee disorders.
The doctor may confirm the diagnosis by performing a physical examination and
taking x rays, which typically show a loss of joint space. Blood tests may be
helpful for diagnosing rheumatoid arthritis, but other tests may be needed as
well. Analysis of fluid from the knee joint may be helpful in diagnosing some
kinds of arthritis. The doctor may use arthroscopy to directly visualize damage
to cartilage, tendons, and ligaments and to confirm a diagnosis, but arthroscopy
is usually done only if a repair procedure is to be performed.
How Is Arthritis of the Knee
Treated? Most often osteoarthritis of
the knee is treated with analgesics (pain-reducing medicines), such as aspirin
or acetaminophen (Tylenol):* nonsteroidal anti-inflammatory drugs (NSAIDs), such
as ibuprofen (Motrin, Nuprin, Advil); and exercises to restore joint movement
and strengthen the knee. Losing excess weight can also help people with
osteoarthritis. Rheumatoid arthritis of the knee may require a treatment plan
that includes physical therapy and use of more powerful medications. In people
with arthritis of the knee, a seriously damaged joint may need to be surgically
replaced with an artificial one. (Note: A new procedure designed to stimulate
the growth of cartilage using a patient's own cartilage cells is being used
experimentally to repair cartilage injuries at the end of the femur at the knee.
It is not a treatment for arthritis.)
1. Anterior and Posterior Cruciate
Ligament Injury What
Are the Causes of Injury to the Cruciate Ligaments?
Injury to the cruciate ligaments of
the knee is sometimes referred to as a "sprain." The anterior cruciate ligament
is most often stretched, torn, or both by a sudden twisting motion (for example,
when the feet are planted one way and the knees are turned another way). The
posterior cruciate ligament is most often injured by a direct impact, such as in
an automobile accident or football tackle.
What Are the Symptoms of Cruciate
Ligament Injury? How Is Injury Diagnosed?
Injury to a cruciate ligament may not
cause pain. Rather, the person may hear a popping sound, and the leg may buckle
when he or she tries to stand on it. To diagnose an injury, the doctor may
perform several tests to see if the parts of the knee stay in proper position
when pressure is applied in different directions. A thorough examination is
essential to the diagnosis. An MRI is very accurate in detecting a complete
tear, but arthroscopy may be the only reliable means of detecting a partial
tear. How Are Cruciate Ligament
Tears Treated? For an incomplete tear,
the doctor may recommend that the patient begin an exercise program to
strengthen surrounding muscles. The doctor may also prescribe a protective knee
brace for the patient to wear during activity. For a completely torn anterior
cruciate ligament in an active athlete and motivated patient, the doctor is
likely to recommend surgery. The surgeon may reattach the torn ends of the
ligament or reconstruct the torn ligament by using a piece (graft) of healthy
ligament from the patient (autograft) or from a cadaver (allograft). Although
repair using synthetic ligaments has been tried experimentally, the procedure
has not yielded as good results as use of human tissue. One of the most
important elements in a patient's successful recovery after cruciate ligament
surgery is following an exercise and rehabilitation program for 4 to 6 months
that may involve the use of special exercise equipment at a rehabilitation or
sports center. Successful surgery and rehabilitation will allow the patient to
return to a normal full lifestyle.
2. Medial and Lateral Collateral
Ligament Injury What Is the
Most Common Cause of Injury to the Medial Collateral Ligament?
The medial collateral ligament is more
easily injured than the lateral collateral ligament. It is most often caused by
a blow to the outer side of the knee, which often happens in contact sports like
football or hockey, that stretches and tears the ligament on the inner side of
the knee. What Are the Symptoms of
Collateral Ligament Injury? How Is Injury Diagnosed?
When injury to the medial collateral
ligament occurs, a person may feel a pop and the knee may buckle sideways. Pain
and swelling are common. A thorough examination is essential to determine the
nature and extent of injury. To diagnose a collateral ligament injury, the
doctor exerts pressure on the side of the knee to determine the degree of pain
and looseness of the joint. An MRI is helpful in diagnosing injuries to these
ligaments. How Are Collateral
Ligament Injuries Treated? Most
sprains of the collateral ligaments will heal if the patient follows a
prescribed exercise program. In addition to exercise, the doctor may recommend
that the patient apply ice packs to reduce pain and swelling and wear a small
sleeve-type brace to protect and stabilize the knee. A sprain may take 2 to 4
weeks to heal. A severely sprained or torn collateral ligament may be
accompanied by a torn anterior cruciate ligament, which usually requires
surgical repair. Tendon Injuries
and Disorders 1. Tendinitis and
Ruptured Tendons What Are the
Causes of Tendinitis and Ruptured Tendons?
Knee tendon injuries range from
tendinitis (inflammation of a tendon) to a ruptured (torn) tendon. If a person
overuses a tendon during certain activities such as dancing, cycling, or
running, the tendon stretches like a worn-out rubber band and becomes inflamed.
Movements such as trying to break a fall may cause excessive contraction of the
quadriceps muscles and tear the quadriceps tendon above the patella or the
patellar tendon below the patella. This type of injury is most likely to happen
in older people whose tendons tend to be weaker. Tendinitis of the patellar
tendon is sometimes called jumper's knee. This is because in sports requiring
jumping, such as basketball, the muscle contraction and force of hitting the
ground after a jump strain the tendon. The tendon may become inflamed or tear
after repeated stress. What Are the
Symptoms of Tendon Injuries? How Are Injuries Diagnosed?
People with tendinitis often have
tenderness at the point where the patellar tendon meets the bone. They also may
feel pain during faster movements, such as running, hurried walking, or jumping.
A complete rupture of the quadriceps or patellar tendon is not only painful but
also makes it difficult for a person to bend, extend, or lift the leg against
gravity. If there is not much swelling, the doctor will be able to feel a defect
in the tendon near the tear during a physical examination. An x ray will show
that the patella is lower in position than normal in a quadriceps tendon tear
and higher than normal in a patellar tendon tear. The doctor may use an MRI to
confirm a partial or total tear.
How Are Knee Tendon Injuries
Treated? Initially, the doctor may ask
a patient with tendinitis to rest, elevate, and apply ice to the knee and to
take medicines such as aspirin or ibuprofen to relieve pain and decrease
inflammation and swelling. If the quadriceps or patellar tendon is completely
ruptured, a surgeon will reattach the ends. After surgery, the patient will wear
a cast for 3 to 6 weeks and use crutches. If the tear is only partial, the
doctor might apply a cast without performing surgery.
A partial or complete tear of a tendon
requires an exercise program as part of rehabilitation that is similar to but
less vigorous than that prescribed for ligament injuries. The goals of exercise
are to restore the ability to bend and straighten the knee and to strengthen the
leg to prevent a repeat knee injury. A rehabilitation program may last 6 months,
although the patient can return to many activities before then.
2. Osgood-Schlatter Disease
What Are the Causes of
Osgood-Schlatter disease is caused by
repetitive stress or tension on a part of the growth area of the upper tibia
(the apophysis). It is characterized by inflammation of the patellar tendon and
surrounding soft tissues at the point where the tendon attaches to the tibia.
The disease may also be associated with an avulsion injury, in which the tendon
is stretched so much that it tears away from the tibia and takes a fragment of
bone with it. The disease most commonly affects active young people,
particularly boys between the ages of 10 and 15, who play games or sports that
include frequent running and jumping.
What Are the Symptoms of
Osgood-Schlatter Disease? How Is It Diagnosed?
People with this disease experience
pain just below the knee joint that usually worsens with activity and is
relieved by rest. A bony bump that is particularly painful when pressed may
appear on the upper edge of the tibia (below the knee cap). Usually, motion of
the knee is not affected. Pain may last a few months and may recur until a
child's growth is completed.
Osgood-Schlatter disease is most often
diagnosed by the symptoms. An x ray may be normal, or show an avulsion injury,
or, more typically, show that the apophysis is in fragments.
How Is Osgood-Schlatter Disease
Treated? Usually, the disease
disappears without treatment. Applying ice to the knee when pain first begins
helps relieve inflammation and is sometimes used along with stretching and
strengthening exercises. The doctor may advise the patient to limit
participation in vigorous sports. Children who wish to continue participating in
moderate or less stressful sports may need to wear knee-pads for protection and
apply ice to the knee after activity. If a great deal of pain is felt during
sports activities, participation may be limited until any remaining discomfort
is tolerable. 3. Iliotibial Band
Syndrome What Causes Iliotibial
Band Syndrome? This is an overuse
inflammatory condition due to friction (rubbing) of a band of a tendon over the
outer bone (lateral condyle) of the knee. Although iliotibial band syndrome may
be caused by direct injury to the knee, it is most often caused by the stress of
long-term overuse, such as sometimes occurs in sports training.
What Are the Symptoms of Iliotibial
Band Syndrome and How Is It Diagnosed?
A person with this syndrome feels an
ache or burning sensation at the side of the knee during activity. Pain may be
localized at the side of the knee or radiate up the side of the thigh. A person
may also feel a snap when the knee is bent and then straightened. Swelling is
usually absent and knee motion is normal. The diagnosis of this disorder is
usually based on the patient's symptoms, such as pain at the lateral condyle,
and exclusion of other conditions with similar symptoms.
How Is Iliotibial Band Syndrome
Treated? Usually, iliotibial band
syndrome disappears if the person reduces activity and performs stretching
exercises followed by muscle-strengthening exercises. In rare cases when the
syndrome doesn't disappear, surgery may be necessary to split the tendon so it
is not stretched too tightly over the bone.
Other Knee Injuries
1. Osteochondritis Dissecans
What Is Osteochondritis
Dissecans? Osteochondritis dissecans
results from a loss of the blood supply to an area of bone underneath a joint
surface and usually involves the knee. The affected bone and its covering of
cartilage gradually loosen and cause pain. A person with this disruption of the
joint may eventually develop osteoarthritis. This disorder usually arises
spontaneously in an active adolescent or a young adult. It may be due to a
slight blockage of a small artery or to an unrecognized injury or tiny fracture
that damages the overlying cartilage.
The bone undergoes avascular necrosis
(degeneration from lack of a blood supply). The involvement of several joints or
the appearance of osteochondritis dissecans in several family members may
indicate that the disorder is inherited.
What Are the Symptoms of
Osteochondritis Dissecans? How Is It Diagnosed?
If spontaneous healing doesn't occur,
cartilage eventually separates from the diseased bone and a fragment breaks
loose into the knee joint, causing locking of the joint, weakness, and sharp
pain. An x ray, MRI, or arthroscopy can determine the condition of the cartilage
and be used to diagnose osteochondritis dissecans.
How Is Osteochondritis Dissecans
Treated? If cartilage fragments have
not broken loose, a surgeon may fix them in place with pins or screws that are
sunk into the cartilage to stimulate a new blood supply. If fragments are loose,
the surgeon may scrape down the cavity to reach fresh bone and add a bone graft
and fix the fragments in position. Fragments that cannot be mended are removed,
and the cavity is drilled or scraped to stimulate new growth of cartilage.
Research is currently being done to assess the use of cartilage cell transplants
and other tissues to treat this disorder.
2. Plica Syndrome
What Is Plica Syndrome?
Plica (pronounced PLI-KAH) syndrome
occurs when plicae (bands of remnant synovial tissue) are irritated by overuse
or injury. Synovial plicae are remnants of tissue pouches found in the early
stages of fetal development. As the fetus develops, these pouches normally
combine to form one large synovial cavity. If this process is incomplete, plicae
remain as four folds or bands of synovial tissue within the knee. Injury,
chronic overuse, or inflammatory conditions are associated with development of
this syndrome. What Are the
Symptoms of Plica Syndrome? How Is It Diagnosed?
People with this syndrome are likely
to experience pain and swelling, a clicking sensation, and locking and weakness
of the knee. Because the symptoms are similar to symptoms of some other knee
problems, plica syndrome is often misdiagnosed. Diagnosis usually depends on the
exclusion of other conditions that cause similar symptoms.
How Is Plica Syndrome
Treated? The goal of treatment is to
reduce inflammation of the synovium and thickening of the plicae. The doctor
usually prescribes medicine such as ibuprofen to reduce inflammation. The
patient is also advised to reduce activity, apply ice and compression wraps
(elastic bandage) to the knee, and do strengthening exercises. If this treatment
program fails to relieve symptoms within 3 months, the doctor may recommend
arthroscopic or open surgery to remove the plicae. A cortisone injection into
the region of the plica folds helps about half of the patients treated. The
doctor can also use arthroscopy to confirm the diagnosis and treat the problem.
Academy of Orthopaedic Surgeons: http://www.aaos.orgAmerican
Physical Therapy Association: http://www.apta.orgArthritis
American College of Rheumatology:
Institutes of Health: http://www.nih.gov/niams