Orthopedic Knee Surgeons and Doctors

Knee pain is a common condition that can affect people of any age. Luckily, most knee pain can be addressed through conservative measures such as nonsteroidal anti-inflammatories (NSAIDs), therapeutic exercises and activity modification.

For example, patellofemoral stress syndrome (PFSS) or anterior knee pain and patellar tendinitis are common overuse injuries to the knee that can generally be treated non-operatively. Anterior knee pain is an overuse problem often caused by an imbalance in the four muscles that make up the quadriceps muscle. This imbalance alters the patella's pathas it rides up and down in the groove of the femur or thigh bone as one bends and extends his or her knee joint. By avoiding activities that put a high stress load across the patella (such as squats, lunges, and stairs) and by targeting an exercise program to help increase the strength of the inside muscle of the quadriceps (vastus medialis obliquus muscle), a patient can often return to pain-free activities. Patella tendinitis is another overuse injury to the knee often caused by repetitive stress to this tendon. Patella tendinitis is frequently seen in athletes who participate in jumping sports. Repetitive stress to the tendon may lead to inflammation within the tendon and even to micro tears. Discontinuing activities that stress this area when pain is acute is important to try to reduce the risk of tearing the tendon. At the same time, one needs to participate in the exercise program to strengthen and enhance flexibility of the quadriceps-patellar tendon unit.

The knee joint is a complex joint.It has two compartments, the medial and lateral compartments, formed from the bottom of the thigh bone (femur) which sits on top of major lower leg bone (tibia). In the front of the joint, forming the third compartment is the kneecap (patella) which lies in the quadriceps tendon and rides in a groove in the end of the thighbone (femur). The knee joint has limited stability from a bony perspective. Therefore, the knee must rely on its ligaments and muscles to provide stability. The knee has four main ligaments: the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the medial collateral ligament (MCL), and the lateral collateral ligament (LCL). The hamstring muscles in the back of the thigh and the quadriceps muscles in the front of the thigh are the two main groups of muscles that help to stabilize this joint. The knee has two types of cartilage, meniscal cartilage and articular cartilage. Articular cartilage lines the ends of the bones that form the joint. It is white, shiny and resilient to impact loads. Meniscal cartilage is more rubbery than articular cartilage. The knee has two meniscal cartilages, one within each oftwo main compartments of the knee joint. These are called the medial and lateral meniscal cartilages. The meniscal cartilages add to the stability of the knee. They also help transmit forces from the thigh bone more evenly to that of the leg bone below. Meniscal cartilages can tear as can the ligaments about the knee, and injuries to these structures typically require advanced imaging such as an MRI to further evaluate them. If an injury to one of these structures is diagnosed, arthroscopic surgery may be needed to repair the torn ligament or cartilage.

Our doctors and surgeons understand that despite advanced surgical techniques to treat knee injuries, post traumatic arthritis of the knee may be the long-term outcome from such traumatic episodes. With aging, one can lose cartilage; this is termed degenerative or osteoarthritis. Conservative measures are typically the first line treatment approach. Such measures include NSAIDs, therapeutic exercise, brace supports, cortisone injections, viscosupplement injections, as well as alternative medicine options such as turmeric, Emu oil, copper bracelets or braces, chondroitin sulfate, glucosamine, and tart cherry juice. Regenerative medicineoptions such as platelet rich plasma (PRP) and stem cells injections are other treatment options. If conservative measures fail, however, surgery to replace the damaged lining of the joint, that is, a total knee arthroplasty, may be needed.

The good news is most injuries to the knee can be resolved conservatively, and majority of the others can be treated effectively surgically.

Click on any physician image below to learn more below about Atlanta's top orthopedic knee doctors and specialists.