Causes and treatment of knee pain in youngsters
Hello everybody I am Dr. Biren Nadkarni, consulting orthopedic and joint replacment surgeon attached to Holy Family and Sitaram Bhartia Hospitals in New Delhi. Today I am going to talk about knee pain in young people.
Knee pain is always discussed in context of old people where it is more seen in lines of arthritis, osteoarthritis, or rheumatoid arthritis. But we get a lot of patients who have the problem of knee pain especially in younger age group. I thought I should devote this session to this knee pain in younger age group.
First and foremost problem we see in patients of younger age groups with knee pain is anterior knee pain or patellofemoral knee pain.
What exactly are the causes ? If this is your knee joint (displaying with a model of knee joint) and this is how your knee cap behaves every time on bending, there is a problem when the kneecap tends to rub on one side and you can see a friction happening here. This is a common problem occurring in young ladies and it's called anterior knee pain and more technically chondromalacia patellae.
We normally tell our patients that this is not a precursor of arthritis, it is mainly an inflammatory problem where the under surface of the knee cap gets inflamed and leads to constant pain specially on sitting for long durations. It is in fact called a movie theatre sign because people who sit for 2/3 hours and suddenly want to get up , they feel knee pain and they are not able to straighten their knee.
The problem is normally addressed by physiotherapy. Of course we need to get x-rays and investigations , but what they respond to is good physiotherapy and anti inflammatory medications.
And if the problem we face in younger people are ligament injuries especially anterior cruciate ligament injuries. All adolescent people who have had injuries while playing soccer or any other games or while running and in your country specially bike injuries are a major problem which leads to this problem. These people normally come to us with instability, pain when walking for long distances, swellings in the knee and this causes lot of pain.
Anterior cruciate ligament injuries is normally treated by anterior cruciate ligament reconstruction which is an arthroscopic procedure, and it’s a day care procedure or normally a one day admission procedure and the patient is discharged the next day.
Similar to anterior cruciate ligament injuries, we also have Meniscus injuries. Meniscus are two cushions in the knee joint and they tend to reduce the loads on the joint as the patient puts weight on the joint.
So the blue tissue (displaying from the model) you can see is basically a meniscus, there is one on the inside and one on the outside. This is the medial meniscus and this is the lateral meniscus, and if you have a tear here, it will also cause a lot of pain. Medial and lateral meniscus tear can occur independently or they can occur with other injuries like Anterior cruciate ligament injuries. These injuries are normally treated by arthroscopic evaluation, repairs or meniscectomy and sometimes we require repair also for them,
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