Knee pain

Knee pain

To understand what causes knee pain, it can be helpful to know the structures that make up the knee joint. Cartilage is a slippery substance found at the ends of the bones in the knee. It allows the bones to rub against each other or pass smoothly as the leg bends and straightens. Meniscus It acts as a cushion between the femur and the tibia . Ligaments around the knee hold the bones together and stabilize the knee . Damage to ligaments can result from overuse or a traumatic injury, such as in sports. Tendons are connective tissues that connect the muscles in the legs to the bones.

Causes of knee pain

Degenerative tissue disorders such as osteoarthritis are usually seen in advanced ages. Obesity puts a serious strain on the knees. Ligament injuries, meniscal injuries, rheumatoid Auto- inflammatory diseases such as arthritis , tendonitis , infections , bursitis , chondromalacia ( damage to the patella or the cartilage under the kneecap), gout, Baker's cyst, and tumors can cause knee pain.

Obesity : Obesity and overweight are the most important causes of chronic knee pain.

Gout: It is a metabolic disease. People with gout may experience knee pain because gout causes uric acid crystals to build up in the joints. The result can be painful inflammation, and this can also affect knee movement.

Degenerative tissue disorders: Osteoarthritis (OA) is a common, chronic degenerative disease that results from the "wearing out" of joints over time. Common symptoms are pain and stiffness after prolonged rest. Knees can also swell after prolonged activity.

Bacterial infection : Bacterial infections such as cellulitis can cause sudden knee pain. Cellulite occurs when bacteria that are normally found on the skin surface get under the skin's protective surface. If left untreated, cellulitis around the knee can cause infection in the joint , causing redness, swelling, pain and stiffness. Chronic knee pain can develop over time.

Autoinflammatory causes: rheumatoid Arthritis (RA) is the most common connective tissue disease that causes knee pain. It is an autoinflammatory disease in which the body's immune system attacks its own tissues . When RA attacks the tissues of the knee, knee pain can occur. Symptoms include pain, arthritis, fatigue, fever, and loss of appetite.

Treatment

After diagnosis, treatment is planned according to the cause. A team consisting of orthopedics, physical therapy, algology , rheumatology , dietitian and psychologist takes part in the treatment planning. They plan drug therapy, a low-stress exercise plan and physical therapy, rest, knee support and, if necessary, surgical treatment .

Prevention

Here are tips for reducing the risk of knee pain and improving the appearance of existing knee problems. Reducing alcohol intake, quitting smoking and maintaining a healthy weight are the first steps. Obesity is, first, a risk factor for many conditions that cause knee pain. Another effect is to put a chronic strain on the knee. Therefore, keeping body weight under control can greatly reduce chronic knee strain and the risk of knee pain.

To exercise

directly reduces the risk of many diseases, including heart disease, cancer, diabetes, high blood pressure, depression, obesity and osteoporosis . If osteoarthritis develops, activities that strengthen the knees can help reduce symptoms of knee pain . Low-stress exercises that can help improve or prevent knee pain are swimming, cycling, and walking.

Physiotheraphy

A separate physical therapy plan should be made for each pathology that develops in the knee. Here are some examples of these treatments.

During the painful period of the patient , tens (electric currents to help reduce pain), ice, magnetic field, laser , JOBS (compression device), ultrasound , CPM (passive motion-enhancing machine) and massage are applied. As the pain decreases, a stretching and strengthening program is applied. By using exercise bands and weights, the angles that protect the cartilage are strengthened. postural stabilization exercises, balance exercises, isotonic weighted exercises and cycling exercises are added to the treatment program.

Manual manual kneecap mobilizations as therapy , lateral retinaculum release, proprioceptive neuromuscular facilitation (PNF) techniques can be applied. cybex isokinetic forward strengthening, special knee tapings ( kinesiotape and lakotape ) are performed. If the patient has an imbalance problem in the hip, ankle and waist region, it is tried to be eliminated. core stabilization exercises, proprioception exercises, and plyometric exercises should be added to the treatment program in the return to sports phases .

Algological treatment

the Algology department offers intra-knee joint injections for pain relief , genicular radiofrequency blockade, prolotherapy , neural therapy and platelet rich can perform plasma therapy (PRP) applications.

orthopedic treatment

can have many different causes, such as injury-related meniscus tear, anterior cruciate ligament tear, or degeneration- related calcification. These diseases are treated orthopedically with different methods.

Knee calcification ( gonarthrosis )

It occurs as a result of the deterioration and reduction of the fluid that feeds the cartilage in the knee joint and reduces friction. The movements we normally do without feeling it become painful. As the disease progresses, the cartilage forming the joint is damaged.

In the treatment: physical therapy in the initial stage, cartilage nourishing drugs, platelet rich Plasma therapy (PRP) is very beneficial. Likewise, it is very important for patients to lose weight under the control of a dietitian. However, surgical treatment is a good option for patients whose walking distance is very short, who have pain at rest and who have advanced. The joint surface is changed by open surgery. This is called knee arthroplasty ( prosthesis ). Patients start walking immediately the next day after the surgery.

Meniscus tear

The cartilage structure that provides the harmony of the joint in the form of a half moon in the knee is called the meniscus. Generally, tears occur in this cartilage as a result of rotation of the knee while the foot is stationary. When a tear occurs, complaints such as swelling, pain, locking , and limitation of movement occur in the knee. Examination is important in diagnosis. The location and type of the tear can be seen with X-ray and magnetic resonance (MR).

Treatment: Meniscus tear is the most common disease of the knee that requires surgery. Closed surgery is performed. A small camera called an arthroscope is entered into the knee through two small holes and the torn part of the meniscus stuck between the joint is seen and removed. Post-operative cramping and pain complaints are completely gone. The recovery process is very fast, patients can stand up on the same day and return to their daily lives in a very short time by being discharged the next day.

anterior cruciate ligament rupture

The anterior cruciate ligament is one of the structures that connects the tibia and femur bones in the knee joint. It is the most important structure that prevents the tibia bone from moving forward abnormally. It enables the knee joint to withstand difficult movements in those who do active sports. In case of rupture of the ligament, patients experience a feeling of emptiness and insecurity during running or descending stairs. Serious swelling and limitation of movement occur in the knee. A ruptured ligament is diagnosed with magnetic resonance (MR) images.

In the treatment: when the diagnosis is made in active sports and young people, surgery is decided. However, in those who do not do active sports, it is beneficial to use the medical treatment and physical therapy opportunities to the fullest before the surgery. Likewise, a comprehensive rehabilitation program should be started the next day after surgery.