4. Meniscal Tears
Symptoms – what patients notice
Swelling
Catching and locking
Pain with pivoting and squatting
Exam Findings – what doctors find
Swelling (fluid on the knee)
Tenderness at the site of the tear
Pain with flexion/twisting
5. Meniscal Tears
Arthroscopic surgery to
remove torn tissue
Source: www.stoneclinic.com
Degenerative tears:
associated with
minimal or no trauma
Degenerative tears
often associated with
arthritis & not always
treated with surgery
Source: www.opsmart.com
6. Types of Ligament Injuries
ACL very common
MCL most common with ski injuries
Usually treated with bracing for 6 weeks
Combination injuries (ACL w/ MCL most common,
but any combo possible)
PCL involved frequently in multi-ligament injuries
12. Multi-ligament Knee Injuries
Higher energy mechanism than ACL
tears
Can be due to a complete knee
dislocation
Nerve and/or blood vessel injuries
possible
19. Patello-femoral Pain
Frequent cause for ANTERIOR knee pain
Pain worsened by running, squatting,
stair-climbing, and lunges
Often associated with grinding/popping at the
kneecap
MRI’s often “normal”
Treatment consists of formal P.T., NSAID’s,
weight loss, and occasional steroid injections
20. Knee Arthritis
Pain worse with standing
and better with rest
Physical Exam:
Stiffness & swelling
Deformity (bow-legged
versus knock-kneed)
21. Knee Arthritis – Treatment Options
Standard treatments:
1. Medicines
2. Injections
3. Surgery
(replacement usually)
22. Knee Arthritis Treatment – Tibial Osteotomy
Intermediate solution that
improves pain and function
usually for < 10 years
Allows for continued impact
activities
Associated with a longer
recovery time (to allow for
healing of the osteotomy)
23. Total Knee Replacement
Reliable solution that improves pain
and function usually for >15 years
Physical therapy and home exercises
important after surgery
New interest in better pain
management, smaller incisions, and
accelerated rehab
Not designed for impact activities
24. Thank You
Fred Huang, MD
www.valleyorthopedicassociates.com