Knee

Best Knee Surgeons: Bergen, Passaic, Morris County

The Knee Surgeons at Advanced Orthopaedic Associates treat surgical and non-surgical problems of the knee including:

Knee Sprains

Ligaments are the strong tissues which connect bones to each other to support and stabilize joints. A sprain occurs when the ligaments are stretched or torn and can result from a fall or twisting injury, or direct contact such as being tackled when your foot is planted on the ground. Knee sprains can involve either the medial or lateral collateral ligaments (MCL or LCL) that help stabilize the side to side motion of the knee or the anterior or posterior cruciate ligaments (ACL or PCL) which cross to form an “X” inside the knee and help stabilize the front to back motion of the knee joint.

Symptoms of Knee Sprains

A sprain of the knee ligaments can cause pain over the injured ligament, swelling, discoloration, instability and an inability to walk. Sprains are classified according to their severity ranging from stretching (Grade 1 or mild) to partial tearing which can cause laxity of the knee (Grade 2 or moderate) to complete tearing of the ligaments which causes instability (Grade 3 or severe). Multiple ligaments can simultaneously be torn in the knee. Knee sprains can occur in association with other injuries such as meniscal tears, effusions (fluid in the knee) osteochondral fractures, or fractures of the proximal part of the tibia (tibial plateau).

Diagnosis of a knee sprain is made by taking a careful history of the injury and performing a thorough physical examination. Radiographs or X-rays of the knee may be necessary to determine if any fractures or broken bones are present. An MRI may be needed to determine the full extent of the injury.

Treating Knee Sprains

Treatment of knee sprains depends on the severity and age of the injury. Initial treatment is often called RICE which stands for Rest, Ice, Compression and Elevation.

Rest: You need to rest your ankle and avoid activities which could cause further damage. Crutches may be needed to prevent weight bearing and help you walk

Ice: Use an ice pack (or a bag of frozen peas or corn if one is not available) for 20 minutes at a time every couple of hours to help decrease swelling and relieve pain. Wrap the ice in a towel and never apply it directly to your skin.

Compression: A compression bandage can help reduce or prevent additional swelling.

Elevation: Elevating your leg higher than the level of your heart can help decrease swelling and pain. Rest your leg on a pillows and remember to allow your heel to hang off the pillow to prevent pressure to the area.

Bracing may be used to immobilize the knee or provide support once you are evaluated. Medications such as anti-inflammatories may be used to help control your pain and reduce inflammation. Physical therapy may be needed to help recovery. Severe sprains with complete ligament tears may require surgery to stabilize the joints.

Collateral Ligament Injuries of the Knee (MCL or LCL Tears)

Ligaments are the strong tissues which connect bones to each other to support and stabilize joints. A sprain occurs when the ligaments are stretched or torn and can result from direct contact such as being tackled or clipped when your foot is planted on the ground. Collateral ligament injuries can involve either the medial or lateral collateral ligaments (MCL or LCL) that help stabilize the side to side motion of the. Injury of the MCL is more common.

A sprain or tear of the MCL is more common can cause pain over the injured ligament, swelling, discoloration, instability and an inability to walk. Sprains are classified according to their severity ranging from stretching (Grade 1 or mild) to partial tearing which can cause laxity of the knee (Grade 2 or moderate) to complete tearing of the ligaments which causes instability (Grade 3 or severe). Multiple ligaments can simultaneously be torn in the knee. MCL injuries can occur in association with other injuries such as meniscal tears, effusions (fluid in the knee), ACL or PCL injuries, osteochondral fractures, or fractures of the proximal part of the tibia (tibial plateau).

Diagnosing and Treating MCL Injuries

Diagnosis of an MCL injury is made by taking a careful history of the injury and performing a thorough physical examination. Radiographs or X-rays of the knee may be necessary to determine if any fractures or broken bones are present. An MRI may be needed to determine the full extent of the injury.

Treatment of an MCL injury depends on the severity and age of the injury. Initial treatment is often called RICE which stands for Rest, Ice, Compression and Elevation.

A hinged knee brace may be used to immobilize the knee or provide support once you are evaluated. Medications such as anti-inflammatories may be used to help control your pain and reduce inflammation. Physical therapy may be needed to help recovery. Severe sprains with complete ligament tears associated with tearing of other supportive structures of the knee may require surgery to stabilize the joints.

Anterior Cruciate Ligament Injuries of the Knee (ACL Injuries)

Ligaments are the strong tissues which connect bones to each other to support and stabilize joints. An ACL injury occurs when the ligaments are stretched or torn and typically result from a twisting injury, direct contact or sudden change of direction. Cruciate ligament injuries can involve either the anterior or posterior cruciate ligaments (ACL or PCL) that help stabilize the back to front motion of the. Injury of the ACL is more common.

Symptoms of ACL Injuries

A sprain or tear of the ACL is more common can cause pain, effusion or fluid in the knee which often occurs rapidly after injury, painful limited range of motion, discoloration, instability and an inability to walk. Sprains are classified according to their severity ranging from stretching (Grade 1 or mild) to partial tearing which can cause laxity of the knee (Grade 2 or moderate) to complete tearing of the ligament which causes instability (Grade 3 or severe). ACL injuries often occur in association with other injuries such as meniscal tears, effusions (fluid in the knee), Medial collateral ligament injuries, osteochondral fractures, or fractures of the proximal part of the tibia (tibial plateau).

Diagnosing and Treating ACL Injuries

Diagnosis of an ACL injury is made by taking a careful history of the injury and performing a thorough physical examination. Radiographs or X-rays of the knee may be necessary to determine if any fractures or broken bones are present. An MRI may be needed to determine the full extent of the injury.

Treatment of an ACL injury depends on the severity of the injury, your age, associated injuries and your activity level. Initial treatment is often called RICE which stands for Rest, Ice, Compression and Elevation.

A knee immobilizer may be used to immobilize the knee or provide support once you are evaluated. Medications such as anti-inflammatories may be used to help control your pain and reduce inflammation. Aspiration of the knee to remove the fluid or blood may be appropriate. Physical therapy may be needed to help recovery. Complete ligament tears and injuries associated with tears of other supportive structures of the knee may require long term bracing or surgery to stabilize the joints.

Meniscus tears

The medial and lateral menisci are “C” shaped fibrocartilaginous structures that it on top of the tibial plateau. They serve as shock absorbers and help distribute forces evenly in the knee and cushion between the femur and tibia. Meniscal tears can occur as the result of either as a distinct twisting injury or from degeneration that occurs over time and are very common. Medial meniscal tears (on the inside of the knee) are more common than lateral meniscal tears (on the outside of the knee). The meniscal tissue can tear in different ways and tears can be described as complex, degenerative, bucket handle, radial or flap tears.

Symptoms of Meniscus Tears

Meniscal tears can cause pain, “popping”, locking, swelling, buckling or “giving way”, painful clicking, stiffness or limited range of motion. Symptoms can be intermittent or “come and go”. Most people can walk but it may be painful. effusion or fluid in the knee which often occurs rapidly after injury, painful limited range of motion, discoloration, instability and an inability to walk. Meniscal tears can occur in association with other injuries such as anterior cruciate ligament injuries, osteochondral fractures, or fractures of the proximal part of the tibia (tibial plateau).

Diagnosis and Treatment of a Torn Meniscus

Diagnosis of meniscal tear is made by taking a careful history of the injury and performing a thorough physical examination. Radiographs or X-rays of the knee may be necessary to determine if any fractures or broken bones are present. An MRI may be needed to determine the full extent a meniscal tear and associated injuries.

Treatment of a meniscal tear depends on the location and size of your tear, associated injuries and conditions, your age and activity level. The location of the tear is important because only the outer one-third of the meniscus has a blood supply (red zone). Tears in this region may be able to heal or be repaired. The inner two-thirds (or white zone) is avascular. Tears that involve the inner 2/3 (which are the most common tears) cannot heal due to the lack of a blood supply. Tears in this region are usually treated by trimming the torn edges.

Initial treatment of asymptomatic (no pain, locking or instability) small tears may be with anti-inflammatories and RICE which stands for Rest, Ice, Compression and Elevation.

Torn Meniscus Repair Surgery with Arthroscopy

Arthroscopy is used for surgical treatment of meniscal tears. Arthroscopy is a type of minimally invasive surgery in which 2 or 3 very small incisions called portals are made around your knee. An arthroscope or camera (often smaller than a pen) is used to look inside your knee while miniature instruments are placed through the other portal to trim the torn edge (partial menisectomy) or repair the meniscus. You can often walk right away after a partial menisectomy and your activities are often determined by how you feel. If the meniscus is repaired recovery is much longer. After partial menisectomy physical therapy may be recommended if needed. You are often able to return to your normal activities within a few weeks