Knee

Services

Your knee is a complex joint with many components, making it vulnerable to a variety of injuries. Some of the most common knee injuries include fractures, dislocations, sprains, and ligament tears.

Many knee injuries can be successfully treated with simple measures, such as bracing and rehabilitation exercises. Other injuries may require surgery to correct.

Knee injuries often cause instability and can make normal day-to-day activities difficult. At Orthopedic Associates of Dutchess County, we have a team of many skilled board-certified orthopedic surgeons, doctors, and pain management specialists whose goal is to get you mobile again in the fastest and safest way possible. Our providers are specialty-trained to quickly diagnose your cause of pain and establish a course of treatment that meets your individual needs and goals.

When you are first injured, the RICE method -- Rest, Ice, gentle Compression and Elevation - can help speed your recovery.

Be sure to seek treatment as soon as possible, especially if you:

Conditions

Patellar (Kneecap) Fractures

A patellar fracture is a break in the patella, or kneecap, the small bone that sits at the front of your knee. Because the patella acts as a shield for your knee joint, it is vulnerable to fracture if you fall directly onto your knee or hit it against the dashboard in a vehicle collision. A patellar fracture is a serious injury that can make it difficult or even impossible to straighten your knee or walk.

Some simple patellar fractures can be treated by wearing a cast or splint until the bone heals. In most patellar fractures, however, the pieces of bone move out of place when the injury occurs. For these more complicated fractures, surgery is needed to restore and stabilize the kneecap and allow for the return of function.

Symptoms
The most common symptoms of a patellar fracture are pain and swelling in the front of the knee. Other symptoms may include:

Bruising
Inability to straighten the knee or keep it extended in a straight leg raise
Inability to walk

Distal Femur (Thighbone) Fractures Of The Knee

A fracture is a broken bone. Fractures of the thighbone that occur just above the knee joint are called distal femur fractures. The distal femur is where the bone flares out like an upside-down funnel.

The distal femur is the area of the leg just above the knee joint.
Distal femur fractures most often occur either in older people whose bones are weak, or in younger people who have high energy injuries, such as from a car crash. In both the elderly and the young, the breaks may extend into the knee joint and may shatter the bone into many pieces.

Symptoms
The most common symptoms of distal femur fracture include:

Pain with weightbearing
Swelling and bruising
Tenderness to touch
Deformity – the knee may look “out of place” and the leg may appear shorter and crooked

In most cases, these symptoms occur around the knee, but you may also have symptoms in the thigh area.

Fractures Of The Proximal Tibia (Shinbone)

A fracture, or break, in the shinbone just below the knee is called a proximal tibia fracture. The proximal tibia is the upper portion of the bone where it widens to help form the knee joint.

In addition to the broken bone, soft tissues (skin, muscle, nerves, blood vessels, and ligaments) may be injured at the time of the fracture. Both the broken bone and any soft-tissue injuries must be treated together. In many cases, surgery is required to restore strength, motion, and stability to the leg, and reduce the risk for arthritis.

Symptoms

Pain that is worse when weight is placed on the affected leg
Swelling around the knee and limited bending of the joint
Deformity – The knee may look “out of place”
Pale, cool foot – A pale appearance or cool feeling to the foot may suggest that the blood supply is in some way impaired.
Numbness around the foot – Numbness, or “pins and needles,” around the foot raises concern about nerve injury or excessive swelling within the leg.

If you have these symptoms after an injury, go to the nearest hospital emergency room for an evaluation.

Dislocation

A dislocation occurs when the bones of the knee are out of place, either completely or partially. For example, the femur and tibia can be forced out of alignment, and the patella can also slip out of place. Dislocations can be caused by an abnormality in the structure of a person’s knee. In people who have normal knee structure, dislocations are most often caused by high energy trauma, such as falls, motor vehicle crashes, and sports-related contact.

Unstable Kneecap

When things are “in the groove,” they’re going smoothly. That certainly is the case with your knee. As long as your kneecap (patella) stays in its groove in the knee, you can walk, run, sit, stand, and move easily. When the kneecap slips out of the groove, problems and pain often result.

Symptoms

Knee buckles and can no longer support your weight
Kneecap slips off to the side
Knee catches during movement
Pain in the front of the knee that increases with activity
Pain when sitting
Stiffness
Creaking or cracking sounds during movement
Swelling

Patellar Dislocation And Instability In Children (Unstable Kneecap)

Your child’s kneecap (patella) is usually right where it should be-resting in a groove at the end of the thighbone (femur). When the knee bends and straightens, the patella moves straight up and down within the groove. Sometimes, the patella slides too far to one side or the other. When this occurs – such as after a hard blow or fall – the patella can completely or partially dislocate.

When the patella slips out of place – whether a partial or complete dislocation – it typically causes pain and loss of function. Even if the patella slips back into place by itself, it will still require treatment to relieve painful symptoms. Be sure to take your child to the doctor for a full examination to identify any damage to the knee joint and surrounding soft tissues.

Symptoms
The symptoms associated with a patellar dislocation depend on how far out of place the patella has moved and how much damage occurred when it happened.

Some general symptoms your child may experience include:

Pain
Feeling the kneecap shift or slide out of the groove
Feeling the knee buckle or give way
Hearing a popping sound when the patella dislocates
Swelling
A change in the knee’s appearance – the knee may appear misshapen or deformed
Apprehension or fear when running or changing direction.

Conditions

Anterior Cruciate Ligament (ACL) Injuries

The anterior cruciate ligament is often injured during sports activities. Athletes who participate in high demand sports like soccer, football, and basketball are more likely to injure their anterior cruciate ligaments. Changing direction rapidly or landing from a jump incorrectly can tear the ACL. About half of all injuries to the anterior cruciate ligament occur along with damage to other structures in the knee, such as articular cartilage, meniscus, or other ligaments.

Posterior Cruciate Ligament Injuries

The posterior cruciate ligament is located in the back of the knee. It is one of several ligaments that connect the femur (thighbone) to the tibia (shinbone). The posterior cruciate ligament keeps the tibia from moving backwards too far.

An injury to the posterior cruciate ligament requires a powerful force. A common cause of injury is a bent knee hitting a dashboard in a car accident or a football player falling on a knee that is bent.

Symptoms
The typical symptoms of a posterior cruciate ligament injury are:

Pain with swelling that occurs steadily and quickly after the injury
Swelling that makes the knee stiff and may cause a limp
Difficulty walking
The knee feels unstable, like it may “give out”

Collateral Ligament Injuries

Knee ligament sprains or tears are a common sports injury.
Your knee ligaments connect your thighbone to your lower leg bones. The medial collateral ligament (MCL) and lateral collateral ligament (LCL) are found on the sides of your knee.

Athletes who participate in direct contact sports like football or soccer are more likely to injure their collateral ligaments.

Symptoms
The typical symptoms of a posterior cruciate ligament injury are:

Pain at the sides of your knee. If there is an MCL injury, the pain is on the inside of the knee; an LCL injury may cause pain on the outside of the knee.
Swelling over the site of the injury.
Instability – the feeling that your knee is giving way.

Meniscus Tears

Meniscus tears are among the most common knee injuries. Athletes, particularly those who play contact sports, are at risk for meniscus tears. However, anyone at any age can tear a meniscus. When people talk about torn cartilage in the knee, they are usually referring to a torn meniscus.

Symptoms
You might feel a “pop” when you tear a meniscus. Most people can still walk on their injured knee. Many athletes keep playing with a tear. Over 2 to 3 days, your knee will gradually become more stiff and swollen.
The most common symptoms of meniscus tear are:

Pain
Stiffness and swelling
Catching or locking of your knee
The sensation of your knee “giving way”
You are not able to move your knee through its full range of motion

Without treatment, a piece of meniscus may come loose and drift into the joint. This can cause your knee to slip, pop, or lock.

Patellar Tendon Tear

Tendons are strong cords of fibrous tissue that attach muscles to bones. The patellar tendon works with the muscles in the front of your thigh to straighten your leg.

Small tears of the tendon can make it difficult to walk and participate in other daily activities. A large tear of the patellar tendon is a disabling injury. It usually requires surgery and physical therapy to regain full knee function.

Symptoms
When a patellar tendon tears there is often a tearing or popping sensation. Pain and swelling typically follow, and you may not be able to straighten your knee. Additional symptoms include:

An indentation at the bottom of your kneecap where the patellar tendon tore
Bruising
Tenderness
Cramping
Your kneecap may move up into the thigh because it is no longer anchored to your shinbone
Difficulty walking due to the knee buckling or giving way

Quadriceps Tendon Tear

Tendons are strong cords of fibrous tissue that attach muscles to bones. The quadriceps tendon works with the muscles in the front of your thigh to straighten your leg.

Small tears of the tendon can make it difficult to walk and participate in other daily activities. A large tear of the quadriceps tendon is a disabling injury. It usually requires surgery and physical therapy to regain full knee function.

Quadriceps tendon tears are not common. They most often occur among middle-aged people who play running or jumping sports.

Symptoms
When a quadriceps tendon tears, there is often a tearing or popping sensation. Pain and swelling typically follow, and you may not be able to straighten your knee. Additional symptoms include:

An indentation at the top of your kneecap where the tendon tore
Bruising
Tenderness
Cramping
Your kneecap may sag or droop because the tendon is torn
Difficulty walking due to the knee buckling or giving way

Meet our

Knee Team

William W. Colman, M.D.

ORTHOPEDIC KNEE & SHOULDER REPLACEMENT SURGEON / SPORTS MEDICINE