Knee Pain

Knee Anatomy    

The knee (shown in video) is hinge joint formed by the femur (thigh bone) and the tibia (shin bone).  The patella (knee cap) slides in groove on the front of the knee.  (The human femur has two “knobs” on the knee joint end very similar to the end of a chicken’s drumstick bone.)  The knee joint is described as having three compartments.  The lateral (outer) part of the femur (called the lateral femoral condyle) makes contact with the lateral part of the tibia and is referred to as the lateral knee joint compartment.  The medial (inner) part of the femur (called the medial femoral condyle) makes contact with the medial part of the tibia and is referred to as the medial knee joint compartment.  The third compartment is where the patella slides in groove at the end of the femur in the front of the knee and is called the patellofemoral joint.  During weight bearing activities such as standing, walking and running there is much demand placed on the medial and lateral knee joint compartments.  Kneeling, jumping and climbing activities place more demand on the patellofemoral knee joint compartment.  Each joint surface is covered by a layer of cartilage called articular cartilage and there is an additional cartilage structure in the knee called the meniscus.  The meniscus is attached to the top of the tibia and is comprised of two loops that give the appearance of a “figure 8”.  The meniscus cartilage is thickest on the outside (lateral) part and thinnest on the inner (medial) part (Imagine a race track with very high banked curves).  The tibia’s double looped shaped meniscus combined with the thick outer and thin inner configuration perfectly accommodates the rounded shape of the medial and lateral condyles of the femur.  Ligaments connect bone to bone and there are four major knee ligaments.  A pair of ligaments cross inside the knee – the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL) and a pair of ligaments travel on the outside left and right side of each knee – the medial collateral ligament (MCL) and the lateral collateral ligament (LCL).  Tendons connect muscles to bone and there are several tendons that cross the knee.  The patella tendon is the single tendon that crosses the front of the knee and connects the quadriceps muscles in the front of the thigh to the patella.  There are several tendons that cross the back of the knee from the hamstring muscles and the calf muscles.  A “sack” called a bursa is strategically positioned in various locations to provide lubrication to all of these tendons. 

Knee Injuries    

As a result of the knee joint’s weight bearing responsibilities, degenerative osteoarthritis (shown in video) changes are common in all three compartments of this joint as a person ages.  Meniscus injuries can occur from either degeneration from repetitive overuse or from a specific injury.  The same is true for the knee ligaments.  Tendinitis is commonly caused by repetitive overuse and bursitis often follows as the body attempts to lubricate the injured tendons.  The patella bursa can become inflamed in isolation after direct impact to the front of the knee. 

Knee Injury Treatment  

Commonly Treated Knee Pain Diagnoses:  Knee Joint Arthritis, Knee Cartilage (meniscus) Tears, Knee Ligament (ACL, PCL, MCL, LCL) Injuries, Patella Tendinitis, Patella Bursitis.

Depending on the magnitude of degenerative change, the extent of meniscus tear or ligament compromise and of course the degree to which a person prioritizes avoiding a surgical intervention, Regenerative Medicine treatments can be considered for any of the knee injuries listed above. Call the Regenerative Spine & Joint Center today to find out if you are a candidate for Regenerative Medicine interventions for your knee pain. After discussing your knee history with you, performing a detailed physical examination and reviewing available imaging studies (x-ray, MRI, etc.) Dr. Terebuh will be able to give you his specific recommendations regarding whether or not Bone Marrow Cell Therapy or Platelet Rich Plasma (PRP) Therapy will help you accomplish the goals you have for your knee.