Knee

Normal Anatomy of the Knee Joint

The knee is made up of four bones. The femur or thighbone is the bone connecting the hip to the knee. The tibia or shinbone connects the knee to the ankle. The patella (kneecap) is the small bone in front of the knee and rides on the knee joint as the knee bends. The fibula is a shorter and thinner bone running parallel to the tibia on its outside. The joint acts like a hinge but with some rotation.

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Posterolateral Corner Knee Injuries

Posterolateral corner (PLC) knee injuries commonly result from a force directed at the anteromedial aspect of the knee with the foot planted firmly on the ground. Injuries are notoriously difficult to diagnose, treat and understand due to the complex anatomy comprising the posterior lateral corner. PLC injuries comprise approximately 16 % of ligamentous knee injuries and nearly 75% of PLC injuries are identified with concurrent damage to either the anterior (ACL) or posterior cruciate ligament (PCL).

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Trochlear Dysplasia and Trochleoplasty

Individuals who have recurrent patellar dislocations and do not have patellofemoral arthritis or signs of trochlear cartilage wear are potential candidates for a trochleoplasty. During this procedure, the lateral capsule is opened and the patella is retracted medially to access the trochlea. The periosteum and trochlear cartilage are detached from the subchondral bone as a flap and a new trochlear groove is modeled into the exposed subchondral bone. The chondral flap is then replaced over the newly formed groove and sutured into place. MPFL reconstruction or tibial tuberosity osteotomy may also be performed during the procedure, if indicated.

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Meniscus Tear

Meniscus tear is the commonest knee injury in athletes, especially those involved in contact sports. A sudden bend or twist in your knee can cause the meniscus to tear. This is a traumatic meniscus tear.

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Anterior Cruciate Ligament Tear

The anterior cruciate ligament, or ACL, is one of the major ligaments of the knee.It is located in the middle of the knee and runs from the femur (thigh bone) to the tibia (shin bone). It prevents the tibia from sliding out in front of the femur. Together with posterior cruciate ligament (PCL) it provides rotational stability to the knee.

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Patellofemoral Instability

The knee can be divided into three compartments: the patellofemoral, and the medial and lateral compartments. The patellofemoral compartment is the compartment in the front of the knee between the knee cap and thigh bone.

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Arthroscopy of the Knee Joint

Knee Arthroscopy is a common surgical procedure performed using an arthroscope, a viewing instrument, to look into the knee joint to diagnose or treat a knee problem. It is a relatively safe outpatient procedure, and is one of the most common surgical procedures performed throughout the United States.

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Total Knee Replacement (TKR)

Total knee replacement, also called total knee arthroplasty, is a surgical procedure in which the worn out or damaged surfaces of the knee joint are removed and replaced with artificial parts.

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Uni condylar Knee Replacement

Unicompartmental knee replacement is a minimally invasive surgery in which only the damaged compartment of the knee is replaced with an implant.

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Revision Knee Replacement

Revision knee replacement surgery involves replacing part or all of your previous knee prosthesis with a new prosthesis. Although total knee replacement surgery is successful, sometimes the procedure can fail due to various reasons and require a second revision surgery.

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Minimally Invasive Knee Joint Replacement

Total knee replacement is a very successful surgical treatment for knee arthritis. Over the years, minimally invasive knee replacement surgical techniques have been developed to lessen tissue trauma and improve patient outcomes.

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ACL Repair

ACL repair is performed by using the same two incisions used in standard knee arthroscopy. Often, a third incision or portal is used. A suture passing device is inserted and using high strength suture both bundles of the ACL are separately sewn from the bottom (tibial end) towards the top (femur end). The sutures are then loaded into two anchors which are placed at the anatomic center of each bundle and tensioned into place. Only two small holes, or sockets, are created in the femur bone for placement of the anchors. Because no graft is taken and because the amount of bone drilling is minimal the amount of pain and swelling after surgery may be much less than after traditional ACL reconstruction.

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ACL Reconstruction

ACL reconstruction and is one of the most commonly performed knee surgeries in the United States today. The new tissue required for reconstruction is called a graft and it can come from your own tissue (autograft) or from a cadaver (allograft). There are various advantages and disadvantages to the different types of graft and the decision making process is individualized based on your sporting activity, age, other injuries to the knee and your own preferences. Click on the patient info tab for graft choices and we describe our rationale for our preferred method for autograft ACL reconstruction – the quadriceps tendon.

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Click on the topics below to find out more from the orthopedic connection website of American Academy of Orthopaedic Surgeons.