The knee joint is involved in almost every movement of the legs. It is therefore hardly surprising that overloading is one of the most common causes of knee pain. This applies regardless of age, as even children occasionally suffer from pain in the knee area, which can be attributed to excessive strain, among other things. Athletes can develop a so-called "jumper's knee", which orthopaedists also refer to as patellar tendinopathy. Active people in particular sometimes suffer a torn meniscus or cruciate ligament during sport.
Watch the following video for a brief overview of the anatomy of the knee joint:
In old age, knee pain is often the result of wear and tear(osteoarthritis). As the knee joint is used intensively, it is particularly affected by wear and tear. As a rule, signs of wear only become apparent from midlife onwards. However, this is not necessarily the case. Depending on the individual's physical condition and lifestyle, wear and tear in the knee joint can also become noticeable much earlier, for example after an accident or a serious injury to the knee joint at a young age.
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Sometimes knee joint pain can also be a symptom of an inflammatory disease, e.g. rheumatism. Patients usually also suffer from pain in other joints (e.g. the fingers) and often report morning stiffness in the hands. A feeling of fatigue and fever are also sometimes accompanying symptoms; the knee joints often swell with an inflammatory disease.
Sometimes, however, it is also possible that the knee is "reacting" to another illness that has nothing to do with the joints. This can occur, for example, a few weeks after an infection (gastrointestinal, flu, viral or similar). According to current medical knowledge, this is referred to as reactive arthritis.
In addition, metabolic diseases or blood disorders such as gout or iron storage disease can also affect the function of the knee joint.
Selected causes of knee pain at a glance:
Doctors divide pain into acute and chronic categories. While acute pain subsides within a few days or hours, chronic pain lasts for six weeks or longer. Pain in the knee joint can occur both during movement and at rest. In the case of chronic knee pain, conservative therapy can provide temporary relief from pain. However, relapses are not uncommon. Rheumatic diseases in particular lead to a recurrence of the pain.
Knee pain can be stabbing, shooting and only occur during exertion. Other injuries are characterized by throbbing, dull, constant pain, even at rest or at night. Depending on the cause, the knee hurts when bending, stretching or turning. Your doctor can deduce the possible cause of the painful knee from this.
As knee pain can have various causes, a careful diagnosis is extremely important. This begins with taking the patient's medical history (anamnesis). To do this, the patient reports in detail on current and past complaints. The pain is also localized and its intensity determined. It is already possible for an experienced orthopaedic surgeon to form initial suspicions and rule out potential causes.
The medical history is followed by a comprehensive physical examination. The knee joint is naturally the focus here. Most doctors start by palpating the knee. In this way, pain points and swelling can be identified. They also check whether the kneecap can be moved.
In addition, various movement tests can be helpful for diagnosis. These are used by orthopaedists and sports physicians to differentiate between various clinical pictures. It is also common to measure the circumference and length of the leg axes and the position of the foot.
In addition to a consultation and a detailed examination, the use of imaging techniques is also useful depending on the symptoms. Ultrasound examinations (sonography), X-rays, computer and magnetic resonance imaging (CT or MRI) provide important information about the condition of the knee. In individual cases, it is necessary to carry out a nuclear medicine examination (scintigraphy). Only in rare cases do doctors order a joint puncture orarthroscopy. The video shows how a knee arthroscopy is performed:
A basic distinction can be made between conservative treatment methods and surgical procedures:
- Conservative therapy relies on temporary protection of the knee joint. The aim is for the joint to recover on its own by reducing the load. Patients can follow the P-E-C-H scheme. The first aid for knee pain is therefore rest, ice pack cooling, compression - i.e. gentle pressure against swelling and bruising, and elevation of the affected leg. A mild painkiller, which also reduces the inflammatory stimulus, is usually prescribed for a short phase.
- Physiotherapy is also used. This contributes to strengthening and thus promotes healing. If physical therapy has been prescribed, aids such as knee supports, crutches, sticks or insoles are used.
- Knee surgery is the treatment of choice when conservative treatments no longer help. Thanks to advances in modern medicine, many joint-preserving procedures (e.g. meniscus surgery, cartilage transplants, cruciate ligament surgery) can now be performed minimally invasively as arthroscopic knee endoscopy(arthroscopy), so that only millimeter-sized incisions are made. If the cartilage damage is very extensive and the joint surface needs to be replaced, the classic joint opening (arthrotomy) is used. Here too, surgical techniques have been refined and a skilled surgeon can use particularly muscle-sparing surgical procedures. The most important knee operations are the use of a knee prosthesis, cartilage therapies and reconstructions of the ligaments. The use of an artificial knee joint should only be considered after conservative therapy has been exhausted. You should also use the option of a second opinion at a center that specializes in such procedures ("maximum care endoprosthesis center", database at: endoMap - database for certified endoprosthetics centers according to EndoCert). The procedure is particularly precise when computer-assisted surgery (navigation, robotics) is used.
