Anterior Knee Pain - Frisco, TX
The knee joint is one of the largest in the body which is subjected to a lot of weight bearing. This joint is made up of the thigh bone (femur), lower leg bones (tibia and fibula) and the knee cap (patella). Anterior knee pain occurs when the coordination between or any one of these constituent parts is affected. This pain typically occurs in the front of the knee joint or at the center. The knee cap is placed in front of the joint and as we move the leg forward or backward this knee cap (patella) glides across the other two bones. This is enabled by the strong rope like tissue structures called tendons while the cartilage layer beneath the patella prevents friction between the bones as well as absorb external shocks. Anterior Knee Pain sets in when the knee cap fails to function normally and rubs against the other bones.

Causes

  • Weakening or loss of the soft cartilage tissue lying beneath the knee cap. It is referred to as the Chondromalacia of patella
  • Swelling or stretching of the tendons that connect the quadriceps muscle to the knee cap
  • Patellar tendinitis- damage to the tendon that connects the shin bone and the knee cap
  • An unstable knee cap which is poorly aligned in relation to the other bones can be a potential cause
  • Weak or tight quadriceps muscles that may exert additional pressure on the patella
  • Overuse injury- exercises or activities such as skiing, jumping, football that put a lot of stress on the knee joint may be responsible
  • Overpronation or presence of flat feet- the absence of a foot arch can cause a lot of stress to the knee joint
  • Overweight
  • Part knee joint injuries such as fractures and dislocations
  • Plica syndrome- the internal protective lining  (synovial) within the joint may get pinched and cause pain
  • Inflammation of the joint due to arthritis

Symptoms

  • A dull pain that is typically felt on the sides, beneath or under the patella
  • Movement of the leg or the knee can create a grinding sensation
  • Discomfort is typically felt while moving downhill, standing up after the patient has been seated for some time or bending the knee
  • Swelling and tenderness may also be seen

Diagnosis

  • A thorough clinical examination of the affected joint to find existing symptoms
  • Medical history and daily activities of the patient is considered before making a diagnosis
  • The alignment of the constituent bones is checked
  • X-ray imaging of the knee cap may be required to check for arthritis or mis alignment
  • The patient may be asked to perform some physical activities to check for the range of motion that is intact or the movements that aggravate the symptoms
  • MRI scans may be required in very few cases to analyze the soft tissue structures

Treatment

  • Anterior Knee Pain is generally observed to improve with conservative methods of treatment in most cases. Surgical intervention is required only if there is internal problem with the soft tissue structures
  • Prescription of non-steroidal anti inflammatory medicines and pain killers
  • The affected knee should be given adequate rest and weight bearing should be prevented
  • Specific exercises that strengthen the core, thigh muscles and the leg muscles need to be incorporated in the routine
  • Orthotic devices may be used to support flat feet
  • Knee taping may be an option in case the patella is misaligned
  • Use of correct exercising techniques and good sport shoes is highly recommended
  • Maintain an ideal weight to reduce the pressure on the joint
  • Surgical removal of the damaged cartilage beneath the patella
  • The tendons may be repaired or reconstructed to give better support to the joint