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Understanding the Knee

  • Common Conditions affecting the Knee

    knee-joint

    The knee, one of the largest joints in the body, consists of 3 bones – the thigh bone (femur), the shin bone (tibia), and the kneecap (patella) – joined together by an extensive network of ligaments, cartilage, tendons and muscles. As the knee is an important structure responsible for movement and weight bearing, it is vital to understand the conditions that may affect its function, the treatment options available, and how to best care for the knees to help prevent future complications and long-term disability.

    Common Knee Injuries

    knee-injury

    Knee injuries can be a result of sports or recreational activities, accidental falls, or even everyday wear and tear. Most minor injuries like cuts and bruises heal on their own, but certain injuries may lead to serious conditions that can affect knee function in the long run. Common knee injuries include:

    Fracture

    The kneecap is the most common bone fracture in the knee. Many fractures around the knee are caused by high energy trauma, such as falls from heights or motor vehicle collisions. Should the force of impact cause the bone to break and displace from its original position, surgery may be required.

    Symptoms of bone fracture in the knee include pain, tenderness, swelling, deformity at the area of the fracture, and limitation in movement. For minor cases, treatment usually requires immobilisation with cast support until the bone fragments heal, which can take about 6 weeks. Surgery may be required to align and stabilise the bones. Consult with your doctor to understand the treatment options available.

    Arthritis

    Arthritis is a condition where inflammation occurs in and around the joint. Osteoarthritis is common in the knee, where the protective cushion between the joints (cartilage) can wear out due to ageing or wear and tear. Genetic factors, joint instability and injury may also contribute to osteoarthritis. Symptoms of osteoarthritis include pain, stiffness, limited movement, swelling, and at times a grinding sensation when moving.

  • Anterior Cruciate Ligament (ACL) Injury

    acl-injury

    Anterior cruciate ligament (ACL) sprain or tear is one of the most common knee injuries. The bones in the knee are connected by ligaments, which function to hold the bones together and keep the knee stable. Collateral ligaments are the side ligaments of the knee that function to control sideways motion and to brace against unusual movement. Cruciate ligaments are found inside the knee joint, and the anterior cruciate ligament at the front cross with the posterior cruciate ligament at the back to control twisting and back-forth motion of the knee. An ACL injury can be caused by a sudden change in the direction of movement, a sudden stop in movement, poor landing from a jump, or in a direct collision.

    Signs & Symptoms

    In most cases where the anterior cruciate ligament is injured, a popping sound may be heard and the knee can be felt to give way shortly after. Other common signs include:

    - Loss of full range of motion
    - Discomfort
    - Tenderness
    - Pain with swelling, usually within 24 hours

    If ignored, the knee may lose stability and further rigorous activities may damage the cushioning cartilage (meniscus) of the knee, leading to serious long-term problems.

    Diagnosis

    Your doctor may check your medical history and perform a physical examination. The following diagnostic tests may be used to further assess the injury.

    - X-ray
    - Magnetic resonance imaging (MRI)

    Treatment

    Treatment methods vary depending on the individual. For those with low activity levels, non-surgical methods such as the application of a brace to help protect the knee from instability. Physical therapy may also help to strengthen the leg muscles and aid in restoring function to the knees. Surgery may be recommended depending on individual needs, for example to aid a young athlete’s safe return to sporting activities. The goal of surgery is to reconstruct the ligament, restore knee stability and prevent irreparable damage to the meniscus. Consult with your doctor to understand the treatment options best suited for your lifestyle needs.

  • Meniscus Tear

    meniscus-tear

    A torn meniscus is one of the most common knee injuries. People at any age are prone to this condition, especially those who engage in contact sports. In the knee, 2 wedge-shaped pieces of cartilage known as the meniscus function to absorb shock, cushion the joint and maintain stability of the knee.

    Signs & Symptoms

    Meniscus tears encountered during sporting activities usually occur along with other knee injuries. Common symptoms include:

    - Pain
    - Swelling and stiffness
    - ‘Locking’ of the knee joint area
    - Limited range of motion

    Without immediate treatment, a piece of meniscus may loosen and dislodge into the joint, which may lead to knee instability or lockage.

    Diagnosis

    Your doctor may check your medical history and perform a physical examination. The following diagnostic tests may be used to further assess the injury.

    - X-ray
    - Magnetic resonance imaging (MRI)

    Treatment

    Your doctor may prescribe non-steroidal anti-inflammatory medication (NSAIDS) to help alleviate the pain. If symptoms persist, your doctor may advise minor surgery such as knee arthroscopy. In this procedure, an arthroscope – a long, flexible tube with a camera, together with miniature surgical instruments, are inserted into the knee area via a small incision to repair the tear. Speak to your doctor to understand the treatment options available.

  • Patellar Tendon Rupture

    patellar-tendon-rupture

    The patellar tendon connects the shin bone (tibia) to the kneecap (patella), working with the muscles in front of the thigh area to straighten the leg. Injury to the patellar tendon is usually due to jumping or a sudden huge load on the tendon. Age-related wear and tear can also weaken the patellar tendon, making it more susceptible to injury.

    Signs & Symptoms

    You may experience a tearing or popping sensation when a patellar tendon tear occurs. Other common signs include:

    - Pain and swelling
    - Inability to straighten the knee
    - Tenderness
    - Indentation at the bottom of the kneecap
    - Kneecap shifting up to the thigh
    - Cramping
    - Difficulty walking

    Diagnosis

    Your doctor may check your medical history and perform a physical examination. The following diagnostic tests may be used to further assess the injury:

    - X-ray
    - Magnetic resonance imaging (MRI)

    Treatment

    Non-surgical methods, such as using a brace and crutches to help keep the knee in position may help with healing. Physiotherapy may also help to strengthen the leg muscles. In most cases, surgery may be required to restore knee function. The goal of surgery is to reattach the torn tendon to the kneecap. Consult with your doctor to understand the treatment options available.

  • Managing Treatment Costs

    Private Hospitals Made Affordable

    If you are covered by an Integrated Shield Plan (ISP), you may not incur out-of-pocket expenses should you require hospitalisation in a private hospital such as Gleneagles Hospital. Here are some examples.

    Knee Anterior Cruciate Ligament (ACL) Reconstruction

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    knee-ACL-reconstruction-4-bedded-room

    Total Knee Replacement

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    total-knee-replacement-4-bedded-room
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