The knee is a complex hinge joint made up of 2 bones, the thighbone (femur) and the shinbone (tibia). Another smaller bone that runs along the side of the tibia, called the fibula, and the kneecap (patella) are also bones of the knee joint. All are surrounded by connective tissue that stabilize the joint and contribute to the function of the knee, tendons, ligaments, and muscles.
Articulating surfaces between the bones are covered with a white, slippery layer called articular cartilage. The cartilage provides a smooth surface that facilitates easy movement. This is the tissue that degenerates in osteoarthritis. To further reduce friction between the articulating surfaces of the bones, the knee joint cavity is lined by a synovial membrane, which produces a thick, clear fluid called synovial fluid. This fluid lubricates and nourishes the cartilage and bones inside the joint capsule.
Ligaments are tough bands of tissue that connect one bone to another bone. The ligaments of the knee stabilize the knee joint. Two primary groups of ligaments hold the bones of the knee joint together: collateral ligaments and cruciate ligaments.
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Common conditions of the knee include:
Osteoarthritis. Osteoarthritis, also called degenerative joint disease, is the most common form of arthritis. It occurs most often in older people. This disease affects the tissue covering the ends of bones in a joint (articular cartilage). In a person with osteoarthritis, the cartilage becomes damaged and worn out causing pain, swelling, stiffness, and restricted movement in the affected joint. This condition most commonly affects the joints in hips, knees, hands, and spine. Rarely, the disease may affect the shoulders, wrists and feet.
Common causes include: overweight, excessive strain over prolonged periods of time, previous fracture, growth abnormalities, joint diseases, and injury. Some people have congenital abnormalities of the joints that cause early degeneration leading to osteoarthritis.
Meniscus & cartilage wear and tears. The 2 wedge-shape cartilage pieces between the thighbone and the shinbone are called menisci. Menisci stabilize the knee joint and act as "shock absorbers."
Meniscus tear is the most common knee injury in athletes, especially those involved in contact sports. A sudden bend or twist in the knee causes the meniscus to tear. Elderly people are more prone to degenerative meniscal tears as the cartilage wears out and weakens with age.
A torn meniscus causes pain, swelling, stiffness, and catching or locking in your knee that makes you unable to move your knee through its complete range of motion.
Ligament injury. These connective tissues are prone to injury during high impact and often just normal activity.
Collateral ligaments are present on either side of the knee, stabilizing the knee in side-to-side motion. The collateral ligament on the inside knee is called the medial collateral ligament (MCL) and the collateral ligament on the outside is called the lateral collateral ligament (LCL). Cruciate ligaments, located inside the knee joint, control the back and forth motion of the knee. The cruciate ligament in the front of the knee is called anterior cruciate ligament (ACL) and the cruciate ligament in the back of the knee is called posterior cruciate ligament (PCL).
Damaged ligaments release substances that cause pain and shortening of the tissue around the joint. The scar tissue that forms is less elastic than normal tissue and gets worse the longer the knee is immobile. Restoring movement as soon as possible encourages blood flow to the area and keeps the joint fluid from becoming thick and sticky.
Other common knee conditions include:
- Osgood-Schlatter disease
- Patellofemoral pain syndrome ("Runner's Knee")
- Patellar tracking Disorder
- Chondromalacia patella
- Jumper's knee
- Iliotibial (IT) band syndrome