Knee Pain

• For an appointment with a DMC orthopedic specialist, call with (888) 362-2500

The knee is the largest joint in the body. It has many moving parts, such as bones, cartilage, muscles, ligaments and tendons. Any one of these parts can suffer from disease or injury causing pain in the knee. Though the most common disease to cause knee pain is arthritis, a number of injuries can lead to knee pain and with the increasing number of aging adults, overuse injuries are becoming more common.

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Diseases that cause knee pain

Osteoarthritis is the number one disease that causes knee pain. Osteoarthritis wears away the cartilage in the knee and eventually affects the adjacent bones. Osteoarthritis most typically affects adults over age 50. Younger people can be prone to osteoarthritis if it runs in the family, or if they had a previous injury that triggers the onset of osteoarthritis. Osteoarthritis treatments include:

  • medicines to reduce pain, such as aspirin and acetaminophen
  • medicines to reduce swelling and inflammation, such as ibuprofen and non-steroidal anti-inflammatory drugs (NSAIDs)
  • exercises to improve movement and strength
  • weight loss
  • knee replacement surgery

Rheumatoid arthritis is another cause of pain in the knee, but it affects a much smaller portion of the population. This autoimmune disease causes the body to attack the membranes that line the joints. This results in inflammation and damage to the bone, tendons and ligaments of the knee. Rheumatoid arthritis treatments include:

Injury

Your knee plays an essential role in everyday life and supports the weight of your body, allowing you to walk, run, stoop, bend and jump. Pain in the knee can result from a direct blow, falling, twisting or over-extension. There are many parts of the knee, and each can contribute to knee pain.

Cartilage Injuries

Chondromalacia occurs when the cartilage of the knee cap softens. This can be caused by injury, overuse, or muscle weakness, or if parts of the knee are out of alignment. The meniscus is a C-shaped piece of cartilage that acts like a pad between the femur (thigh bone) and tibia (shin bone). It is easily injured if the knee is twisted while bearing weight.

Symptoms

Generally, when you injure a meniscus, you feel some pain, particularly when the knee is straightened. The knee pain may be mild to severe, and includes swelling. Although symptoms of meniscus injury may disappear on their own, if they persist or reoccur, treatment is recommended.

Treatment

  • exercises to strengthen muscles
  • electrical stimulation to strengthen muscles
  • surgery for severe injuries

Ligament Injuries

Ligament injuries are known as sprains. Two commonly injured ligaments in the knee are the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL). The ACL is most often stretched or torn by a sudden twisting motion. The PCL is usually injured by a direct impact, such as in an automobile accident or football tackle. If a ligament is the cause of your knee pain, you may hear a popping sound, and the leg may buckle when you try to stand on it.

Treatment

  • ice packs immediately after the injury to reduce swelling
  • exercises to strengthen muscles
  • a brace
  • surgery for more severe injuries

Tendon Injuries

The three main types of tendon injuries and disorders are:

  • itendinitis and ruptured tendons
  • Osgood-Schlatter disease
  • iliotibial band syndrome

People with tendinitis describe the knee pain as tenderness at the point where the patellar tendon meets the bone. A complete rupture of a tendon is not only painful, but also makes it difficult for a person to bend, extend, or lift the leg.

Treatment

  • rest
  • ice
  • elevation
  • medicines such as aspirin or ibuprofen to relieve pain and reduce swelling
  • limiting sports activity
  • exercise to stretch and strengthen
  • a cast, if there is a partial tear
  • surgery for complete tears or very severe injuries

Types of surgery for knee pain:

  • arthroscopic surgery
  • open surgery
  • knee resurfacing implants
  • total knee replacement

Is surgery right for my knee pain?

If you have a serious knee injury, surgery may be the preferred option to repair the damage and prevent your pain. You and your doctor will discuss your knee pain and evaluate your options. Often, total knee replacement is the answer for persistent pain, and when the limited range of motion in their knee joint severely affects your quality of life.

DMC Orthopaedic Surgeons are specialists in knee pain, and are experts in knee repair. Procedures at DMC include:

  • Femur Fracture Repair
  • I-Total Knee Replacement
  • I-Uni Partial Knee Replacement Surgery
  • Knee ACL Reconstruction
  • MAKOplasty Knee Resurfacing
  • O.A.T.S. Procedure for Knee Cartilage
  • Torn Meniscus Repair

For more information on range of treatment options for knee pain, or an appointment with a DMC orthopedic specialist, call with (313) 578-6735 .

Femur Fractures

A fracture is a partial or complete break in the bone. When a fracture occurs, it is classified as either open or closed:

  • open fracture (compound fracture.) - the bone exits and is visible through the skin, or a deep wound that exposes the bone through the skin
  • closed fracture (simple fracture.) - the bone is broken, but the skin is intact

Symptoms

  • pain in the injured area
  • swelling in the injured area
  • obvious deformity in the injured area
  • difficulty using or moving the injured area in a normal manner
  • warmth, bruising, or redness in the injured area

Treatment

  • splint/cast
  • medication
  • traction
  • surgery

I-Total® Knee Replacement

If chronic knee pain is a part of your daily life, the I-Total® Knee Replacement may be just what you need. A new procedure, this knee replacement process uses specialized software to create a patient-specific knee implant, based on a CT scan of the patient’s knee. Customized implants mean a better fit and more natural feel. More bone is conserved and there is less bleeding. In addition, patients typically manage without walkers or canes sooner and return to work more quickly than with traditional knee replacement surgery.

I-Uni Partial Knee Replacement

Partial knee replacement is an option when your knee is not injured throughout the joint but in specific areas. Your knee consists of three “compartments” or sections. Partial knee resurfacing, also called partial knee replacement, offers a bone-preserving option for those affected with osteo-arthritis in only one or two compartments. Rather than replace the entire joint, partial knee replacement procedures target only those compartments affected by the disease. Healthy cartilage and bone in the rest of the knee is left alone.

DMC orthopaedic surgeons are the first in Michigan to use the Conformis I-Uni™ partial knee replacement system, which allows them to implant custom-made parts, rather than replacing the entire knee joint. Each implant is custom made to fit your body, giving you the opportunity for a minimally invasive procedure that enables rapid recovery and shortened rehabilitation [insert link http://www.rimrehab.org >Our Locations ]time.

Features of i-Uni knee replacement:

  • manufactured for each patient, based on their individual anatomy
  • minimally invasive, minimally traumatic procedure
  • bone and cartilage preserving
  • appropriate for young and active patients
  • potential for less post-operative pain and shorter post-operative recovery
  • preserves the ability to move to other treatment options in the future

ACL Reconstruction

The anterior cruciate ligament (ACL) is located toward the front of the knee and is the ligament of the knee that controls rotation and forward movement of the tibia (shin bone). It is one of the most common ligaments to be injured. The ACL is often stretched and/or torn during a sudden twisting motion (when the feet stay planted one way, but the knees turn the other way). Skiing, basketball, and football are sports that have a higher risk of ACL injuries.

Symptoms

Often, a cruciate ligament injury does not cause pain. Instead, the person may hear a popping sound as the injury occurs, followed by the leg buckling when trying to stand on it, and swelling.

Treatments

  • medication such as ibuprofen
  • muscle-strengthening exercises
  • protective knee brace (for use during exercise)
  • ice pack application (to reduce swelling)
  • surgery

MAKOplasty® Partial Knee Resurfacing

MAKOplasty® is a Detroit Medical Center robotic arm assisted partial knee resurfacing procedure designed to relieve the pain caused by joint degeneration due to osteoarthritis (OA). By selectively targeting the part of your knee damaged by OA, your DMC Orthopaedic surgeon can resurface your knee while sparing the healthy bone and ligaments surrounding it.

MAKOplasty Partial Knee Resurfacing:

  • enables surgeons to precisely resurface only the arthritic portion of the knee
  • preserve healthy tissue and bone
  • facilitates optimal implant positioning to result in a more natural feeling knee following surgery
  • results in a more rapid recovery and shorter hospital stay than traditional total knee replacement surgery

Unlike more invasive procedures, MAKOplasty® can often be performed through a four to six inch incision over your knee with small incisions in both your femur (thigh bone) and tibia (shin). By preserving your own natural bone and tissue and using patient specific implant positioning, your surgery should result in a more natural feeling knee. And since healthy bone is preserved, Detroit Medical Center patients who undergo MAKOplasty® partial knee procedures may still be a candidate for a total knee replacement procedure later in life if necessary.

The MAKOplasty procedure at DMC is indicated for patients suffering from unicompartmental or bicompartmental knee disease. A total replacement is sometimes necessary if your surgeon discovers during surgery that your knee has more damage than originally seen in the pre-operative X-rays and CT scan.

Your physician should discuss the specific risks associated with MAKOplasty and other treatment options with you. In addition, you should be informed of any pre-operative and post-operative instructions by your surgeon or his or her staff.

As a knee arthroplasty procedure, MAKOplasty is typically covered by Medicare insurers- check with your private health insurers. In some cases it may be performed on an outpatient basis depending on what your surgeon determines is the right course of treatment for you.

MAKOplasty™ Robotic Total Knee Replacement

The DMC is the only health system in the state of Michigan to offer the MAKOplasty™ Total Knee Replacement technology. The MAKOplasty™ Total Knee Replacement surgery is completed using a robotic arm-assisted technology which ensures accurate alignment and placement of the knee implant for nearly perfect results. 

The MAKOplasty™ robotic technology allows the surgeon to place and align the components with extreme precision, assuring a better outcome for the patient. When a single degree in any direction can make a difference on the performance of the new joint, being able to make alignments to within a millimeter is critical. The DMC can do that in real time in the operating room. This is the new standard for partial and total knee procedures. 

The DMC has used MAKOplasty™ technology since 2013 to perform other minimally invasive partial knee replacements and total hip replacements. Now we have the technology to perform MAKOplasty™ Total Knee Replacements. For an appointment with an orthopedic specialist trained to perform MAKOplasty™ Total Knee Replacements, call 888-DMC-2500.

Get More Information

Download a MAKOplasty Education Brochure

Download a MAKOplasty Pre-operative Guide

O.A.T.S.

OATS or osteoarticular transfer system, is a surgical procedure used to treat cartilage defects in the knee, where the cartilage has worn away or is missing. Cartilage defects can be due to trauma, and are commonly found with other injuries, including ACL and MCL tears.

Symptoms

  • pain
  • swelling
  • stiffness in the knee

Treatment

In an OATS procedure, holes left where cartilage is missing are “plugged” with cartilage from a non-weight bearing area of the knee (autograft) or by using cadaver bone (allograft).

This treatment is only used for small areas of cartilage damage, usually limited to 10-20 mm in size. This type of damage is usually seen in younger patients (less than 50 years old) who experience a trauma to their joint.

Torn Meniscus

The ends of the three bones in the knee are covered with cartilage that acts as a shock absorber. Between the bones of the knees are two crescent-shaped discs of connective tissue, called menisci, which also act as shock absorbers to cushion the lower part of the leg from the weight of the rest of the body.

Meniscus tears can occur during a rotating movement while bearing weight, such as when twisting the upper leg while the foot stays in one place during sports and other activities. Tears can be minor, with the meniscus staying connected to the knee, or major, with the meniscus barely attached to the knee by a cartilage thread.

Symptoms

  • pain, especially when holding the knee straight
  • swelling
  • knee may click or lock
  • knee may feel weak

Treatment

  • icing
  • medication such as ibuprofen
  • muscle-strengthening exercises
  • arthroscopic surgery

Knee Replacement Surgery

When a knee is so severely damaged by disease or injury, an artificial knee replacement may be the only option. The most common condition that results in the need for knee replacement surgery is osteoarthritis, a degenerative, joint disease that affects mostly middle-aged and older adults. Osteoarthritis is characterized by the breakdown of joint cartilage and adjacent bone in the knees.

Although each procedure varies, surgery to replace a knee usually lasts about two hours. After the damaged bone and cartilage of the knee is removed, your orthopedic surgeon will place your new, artificial knee in its place.

Treatment

The prosthesis (artificial knee) is comprised of the following three components:
  • tibial component (to replace the top of the tibia, or shin bone)
  • femoral component (to replace the two femoral [thighbone] condyles and the patella groove)
  • patellar component (to replace the bottom surface of the kneecap that rubs against the thighbone)