Please click to read more about the following conditions:
Anterior cruciate ligament (ACL) injuries are one of the more well-known sporting injuries sustained at the knee. Many of us may remember a famous sports star being cut down during a season or limping off the field unceremoniously. This particular knee injury can have a lasting effect on an individual and is something that we deal with on a daily basis at KneeCare.
Total knee and hip arthroscopy, otherwise known as a joint replacement has been increasing year on year in many developed countries, and insurance groups who pay for this surgery are now questioning the sustainability and value of these services. Over the last 5 years in New Zealand there has been a 16% increase in knee replacements. Statistical records for 2011 showed that just over 7000 knee replacement surgeries were performed. During 2011, within Australia, knee replacements increased to 44,500, reportedly an increase of 8% on the previous year, and hip replacements surpassed 36,000, a rise of almost 8%.
The menisci or cartilage of the knee joint are crescent-shaped wedges of fibrocartilage that sit on the top surface of the tibia or shinbone. They deepen the surface of the knee joint and play an important role in shock absorption. The menisci can be damaged with twisting at the knee or in combination with larger more traumatic knee ligament injuries. Irrespective of the injury mechanism, the menisci can be slow to heal as their blood supply is very limited. Meniscectomy surgery may be required to remove fragments or smooth down rough edges of the meniscus that are causing locking or catching of the knee. Regardless of the management of a meniscal injury, there is an increased risk of developing knee osteoarthritis down the track. Studies have shown that approximately half of those who have had a meniscectomy show x-ray evidence of osteoarthritis 10-15 years later (Lohmander et al., 2007).
Osteoarthritis is a common and debilitating condition affecting an increasing number of people in New Zealand and internationally. Although it is more common in older individuals, knee osteoarthritis is not an inevitable part of ageing – many older people are not affected and conversely, it can also affect younger people who have sustained a previous knee injury – the so-called ‘young people with old knees’!
Patellofemoral syndrome is a common cause of pain around the knee cap in both children and adults. It is particularly common in active females. Whenever we move, the knee cap (patella) tracks through a groove in the thigh bone (femur). In patellofemoral syndrome, there is generally maltracking of the patella which produces friction and irritation of tissues less able to cope with load and stress (Heintjes et al. 2009). This abnormal movement of the patella may be caused by several factors. These include an imbalance in the muscles around the knee with weaker muscles on the inside, damaged structures after patella dislocation, malaligned knees, pronated (flat) feet, decreased flexibility, hypermobility or laxity of the patella and weakness of the pelvis and hip musculature (Davis & Powers 2010; Fagen & Delahunt, 2008).
Achilles tendon pain is a debilitating and persistent condition affecting many in the community. Achilles tendon pain can occur for various reasons ranging from overtraining to limited ankle flexibility to faulty footwear. Like all musculoskeletal conditions, it is essential to gain an accurate diagnosis and appropriately tailored treatment plan. This ensures a timely recovery and reduces the likelihood of problems in the future.
Finding ways to reduce musculoskeletal injury rates could be considered the Holy Grail in preventative medicine. Not only does it morally and ethically feel good, insurance groups and providers enjoy reduced costs and long-term liability. From a personal perspective at KneeCare we see first hand how devastating it can be for people when they become injured. Strict cost analysis cannot fairly describe the impact an injury can have on an individual and their families and how an injury can affect someone’s quality of life.
Similar to knee osteoarthritis, hip osteoarthritis is a chronic joint condition characterised by a loss of the articular cartilage responsible for the smooth gliding of the ball and socket hip joint. As the capsule around the joint tightens, which it does in more than 40% of those with hip osteoarthritis, the space between the ball and socket is reduced, causing an increase in the compression of the hip joint. Bony outgrowths around the margins of the joint typically develop over time and become visible on x-ray.