Knee Pain Associated with Misalignment of the Knee Joint
Introduction & Background
I chose to write about knee pain and the misalignment of the knee joint, because it is something that I suffer from on a daily basis. In the last 11 years I have had three knee surgeries I have had part of my medial meniscus taken out and then followed it seven years later with the complete removal of the lateral meniscus. Due to my very valgus alignment, which is when you knee joint points towards the midline they then decided to do a distal femoral osteotomy. With this surgery they cut my right femur in half at the distal head and created a gap with donor bone. They then put a plate with seven screws in it to hold the femur in place. When the surgery is complete in my case I was unable to bear weight for two months due to the fact that the donor bone may be crushed or the Plate and screws could break during the first part of the healing process.
More common that the distal femoral osteotomy is the closing wedge or tibal osteotomy this is used for varus or bull legged people, whereas the distal femoral is used for valgus or “knock knee” which is how my doctor explained it to me. In the closing wedge osteotomy All the same procedure are the same as In the distal only this time the surgery is done on the medial side of the head of the tibia.
Although this is a major surgery this can be a very good surgery for a young person because there are not many other options. In the long run this can save a 33 year old person like my self up to 20 years before getting a knee replacement, which my doctor is certain I will need. So as drastic as this might sound it can be quite beneficial. Currently the rate of success on second time knee...
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Anterior knee pain plagues the athletic community, the most common being runner’s knee or patellofemoral pain syndrome (PFPS). One point or another in an athlete’s career they have experienced this kind of pain. When comparing between male and female athletes and who has the higher chance of knee pain, female athletes have a higher prevalence than male athletes (Dolak KL). There are several different mechanisms of patellofemoral pain a few being: pes planus,an increased Q angle, weak, tight or an imbalance in the quadriceps or hip muscles. Recently in my clinic site as the spring sports such as, baseball, soccer and track and field the athlete’s perform a lot of squatting, running, and kneeling which load the patellofemoral joint. We are now starting to see several and treat several athletes with patellofemoral knee pain. Each of them experiencing the pain from a different mechanism. As an athletic trainer we want to treat not only the symptoms, but the mechanism of injury to prevent further injuries down the road. If patellofemoral pain syndrome is not properly treated it can develop into chronic diseases such as chondromalacia or arthritis, maybe eventually leading to a total knee plan. (Lee SE) Treatment while the athletes are young and symptoms aren’t severe is key to preventing further injury.
In November of 2010, I was playing basketball in the fifth game of my senior season. It was just like any other game. However, I would soon find out otherwise. It was late in the game; I drove into the lane and got fouled hard. I was knocked so off-balance that I speared the floor with my knee. As soon as my knee hit the floor I heard a “snap” that I will never forget for the rest of my life. Little did I know at the time, that would be the last shot of my high school basketball career. Not long after my injury, I consulted a doctor. After getting an x-ray and an MRI, the doctor informed me that I had completely torn my ACL and would need to have surgery. An ACL tear can be a very devastating injury. The anterior cruciate ligament (ACL) is one of the four major ligaments within the knee. The ACL is one of the most commonly injured ligaments, injured by an estimated 200,000 patients each year. Of the 200,000 annual ACL injuries, surgery is performed in approximately 100,000 cases. There are many types of reconstructive surgery on the ACL. However, there is an alternative to surgery in the form of physical therapy.
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During the surgery for a total knee replacement, the patient is put under general anesthesia. Then an incision is made in the front of the knee. Through this incision access is gained into the joint capsule. The damaged portion of the joint is then
...cient knee during activities of daily living, as they have yet to be determined ⁷². In understanding the factors contributing to the mechanism of non-contact ACL injury, investigators should consider whether the kinematics, kinetics and muscle activation strategies observed are the cause of increased ACL strain or compensation for other kinetic chain insufficiencies ²⁹. Further knowledge on how movement patterns and other kinetic chain structures affect ACL loads prove critical in enhancing future prevention strategies ²⁹ ³⁴. As with reconstruction, rehabilitation should aim to aid the knee in attaining its near-normal function ⁵⁵. Through producing rehabilitation programmes built around existing knowledge on the biological and mechanical properties of the ACL, objectives such as reduced pain, greater ROM and improved muscle function can be achieved ⁵⁵.
Amanda was in her sophomore year of soccer season when she heard the pop of her knee that cut her season short. The next thing she knew she was at the doctor’s who told her she had an ACL tear, and wasn’t sure if she could play again. From there it was boiled down to two options. One to re-strengthen her knee through rehabilitation, physical therapy and bracing, or to undergo an ACL reconstruction surgery. Although it is costly and some may consider it frivolous, those who have encountered ACL tears should receive the reconstruction surgery instead of attending rehabilitation for the damage to their knee, because it dramatically lessens the chances of meniscal injuries and osteoarthritis occurring later and allows the patient to return back to their sport or physical activity with better knee mobility and less pain in a timely manner.
Every disease is known for having their own cycle or process; well as for Osteoarthritis its process is pretty complex. In osteoarthritis (OA), at the end of the bone where they meet to form a joint, allowing movement, the cartilage covering the bone begins something called breakdown. Cartilage is a tissue that cushions the joint when it moves. As the cartilage wears away, the bones are now exposed and they begin to rub against one another. The bone is no longer functioning smoothly, for the joints shape and makeup is affected due to cartilage deterioration. Due to the fact that your bones are being rubbed against one another it is highly possible that other problems can occur inside the joint.
"Chapter 37." Operative Techniques in Orthopaedic Surgery. Ed. Sam Wiesel. 4th ed. Vol. 2. Lippincott Williams & Wilkins, 2011. eBook.
The primary outcome measurement of this study will be the overall Knee injury and Osteoarthritis Outcome Score (KOOS), including all 5 subscales: pain, symptoms, activities of daily living, sport and recreation function, and knee-related quality of life (Appendix B). The KOOS is a 42-question, self-assessed Likert Scale questionnaire. Each subscale of the KOOS is scored on a scale from 0 to 100, indicating extreme symptoms to no symptoms, respectively. All 5 subscales of the KOOS test have been validated for knee OA and knee injuries that can lead to posttraumatic OA, including meniscal injuries, for both short-term and long-term outcomes.31,32 However, the KOOS test as a total score has not been validated, and thus the KOOS User Guide recommends averaging subscale scores to use as a primary outcome measure for RCTs. As such, the overall KOOS score will be calculated in this manner. All KOOS subscales will also be used individually as primary outcomes.
When an athlete catches the sound of their knee crack and pop, they better prepare themselves for a long journey. The Center for Injury and Policy (CIRP), from Science Daily, reports that, “Knees are the most accident prone part of the body in high school athletes.” Knee injuries are very common; in fact, they are responsible for 45% of the injuries that occur in high school athletics across America. Knee injuries are well known to not just those in the medical field, but also to athletes. Injuries to the knee are caused by many factors, and what happens after the injury has taken place is what’s most concerning (Science Daily).
Total Knee Replacement (TKR): Total knee replacement, on the other hand, consists of replacing both the sides of a knee joint. TKR surgeries are more common in people, as compared to that of PKR.
“Doc, I fell and twisted my knee. I heard a pop. It hurt briefly. When I stood up, the knee felt as if it was not underneath me, and the knee gave way. It swelled up by the next day and ever since feels as though it would pop out when I twist or even cross the street quickly.” In almost all cases the above complaints occur due to an injury to the ACL (Anterior Crucial Ligament) of the knee. The ACL is a very important ligament in the knee that controls the pivoting motion of the knee. This joint guides the femur and tibia through a regular range of motion. It is the most common and serious of injury sustained to the knee (Duffy, f9). How this injury happens, who is most susceptible, and how it is treated are a few questions athletes are becoming heavily concerned with.
Orthopedic surgeons are responsible for mending and operating on the musculoskeletal system. “Orthopedics is a medical specialty that focuses on the diagnosis, care, and treatment of patients with disorders of the bones, joints, muscles, ligaments, tendons, nerves, and skin” (Career in Orthopaedics). Depending on the damage the patient has sustained determines how the orthopedic surgeon is able to correct the patient’s injury. In many cases there are multiple ways of correcting the patient’s injury such as; using medical, physical, and rehabilitative techniques to using complex surgical methods. “Typically, as much as 50 percent of the orthopedic surgeon’s practice is devoted to no surgical or medical management of injuries or disease and 50 percent to surgical management” (Career in Orthopaedics). The majority of surgeons, including orthopedic surgeons, prefer to choose the least invasive procedures such as; arthroscopy which is a technological advancement allowing orthopedic surgeons to use special cameras in order to diagnose and treat a joint with minimal cutting and trauma to...
Ruby, A., & Davis, P. (2011). Studies in osteo-arthritis using intra-articular temperature response to injection of hydrocortisone acetate and prednisone. Annals Of The Rheumatic Diseases,
An estimated 50 million Americans have suffered or are suffering knee pain or injuries. Most of these pains, sprains, and strains could probably have been avoided with proper conditioning (Fox, 147). I have had knee pain since my freshmen year of high school and have finally taken the initiative to find some exercises that will help ease this pain, and build muscle strength in the surrounding areas to avoid another possible injury.