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What part of my knee did i injure: Knee Injury (ACL, MCL, LCL) Symptoms, Signs, Treatment & Recovery Time

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Knee Pain & Injuries: Causes, Treatment, & Prevention

Being active is one of the best things you can do for your joints and the rest of your body. But injuries can happen, and they often involve the knees.

Some of the most common problems are sprained ligaments, meniscus tears, tendinitis, and runner’s knee. If you have an old knee injury that wasn’t properly treated, it may flare up now and then or hurt all the time.

What Else Can Cause Knee Pain?

 

  • Bursitis. A bursa is a sac that holds a small amount of fluid that’s under the skin above your joint. It helps prevent friction when the joint moves. Overuse, falls, or repeated bending and kneeling can irritate the bursa on top of your kneecap. That leads to pain and swelling. Doctors call this prepatellar bursitis. You may also hear it called ”preacher’s knee.”
  • Dislocated kneecap. This means that your kneecap slides out of position, causing knee pain and swelling. Your doctor may call this “patellar dislocation.”
  • IT (iliotibial) band syndrome. The iliotibial (IT) band is a piece of tough tissue that runs from your hip down to the outer part of your knee. When you overdo activity, it can become inflamed over time. That causes pain on the outer side of the knee. It’s common among runners when going downhill.
  • Meniscal tear. Sometimes, a knee injury can cause cartilage to rip. These rough edges can get stuck in the joint, which causes pain and swelling. Many times, people will have the sensation of “catching” in the joint when they are active.
  • Osgood-Schlatter disease. This condition happens when you’re young, when bones and other parts of the knee are still changing. It can cause a painful bump below the knee, where a tendon from the kneecap connects to the shin. Overdoing exercise, and irritation at a point on the bottom of your knee called the tibial tubercle, often make this area hurt. The ache may come and go over time. It’s especially common in teenage boys and girls.
  • Osteoarthritis. This is the “wear and tear” type of arthritis. It’s a top cause of knee pain after age 50. This condition causes the knee joint to ache or swell when you’re active. Joints affected by osteoarthritis can also be stiff early in the day.
  • Patellar tendinitis. This means you have inflammation in the tendon that connects the kneecap to the shinbone. Tendons are tough bands of tissue that connect muscles to your bones. When you overdo exercise, they can become inflamed and sore. You may also hear it called “jumper’s knee” because repetitive jumping is the most common cause.
  • Patellofemoral pain syndrome. Muscle imbalance, tightness, and alignment problems of the legs usually cause this condition. It causes knee pain and occasional “buckling,” meaning your knee suddenly can’t bear your weight. It’s not due to an injury. It’s more common for women than for men.

 If you or someone you’re with has a knee injury, call 911 if: 

  • The knee or leg bones look deformed.
  • The person can’t put weight on the leg.
  • The pain is extreme.
  • There is immediate swelling, tingling, or numbness below the knee.

 

What Does a Knee Injury Feel Like?

Obviously, it hurts! But the type of pain and where you feel it can vary, depending on what the problem is. You may have:

  • Pain, usually when you bend or straighten the knee (including when you go down stairs)
  • Swelling
  • Trouble putting weight on the knee
  • Problems moving your knee
  • Knee buckling or “locking”

If you have these symptoms, see your doctor. They will check your knee. You may also need X-rays or an MRI to see more detail of the joint.

What Can You Do for the Pain?

Your plan will depend on your specific injury. Mild to moderate issues will often get better on their own. To speed the healing, you can:

  • Rest your knee. Take a few days off from intense activity.
  • Ice it to curb pain and swelling. Do it for 15 to 20 minutes every 3 to 4 hours. Keep doing it for 2 to 3 days or until the pain is gone.
  • Compress your knee. Use an elastic bandage, straps, or sleeves to wrap the joint. It will keep down swelling or add support.
  • Elevate your knee with a pillow under your heel when you’re sitting or lying down to cut down on swelling.
  • Take anti-inflammatorymedications. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen will help with pain and swelling. Follow the instructions on the label. These drugs can have side effects, so you should only use them now and then unless your doctor says otherwise.
  • Practice stretching and strengthening exercises if your doctor recommends them. You may want to do physical therapy, too.

Make an appointment with a doctor if you still have pain after 2 weeks of home treatment, if the knee becomes warm, or if you have fever along with a painful, swollen knee.

Some people with knee pain need more help. For instance, if you have bursitis, your doctor may need to draw out extra fluid from the bursa in your knee. If you have arthritis, you may need an occasional corticosteroid shot to settle down inflammation. And if you have a torn ligament or certain knee injuries, you may need surgery.

When Will My Knee Feel Better?

The recovery time depends on your injury. Also, some people naturally heal faster than others.

While you get better, ask your doctor if you can do an activity that won’t aggravate your knee pain. For instance, runners could try swimming or other types of lower-impact cardio.

Whatever you do, don’t rush things. Don’t try to return to your regular level of physical activity until you notice these signs:

  • You feel no pain in your knee when you bend or straighten it.
  • You feel no pain in your knee when you walk, jog, sprint, or jump.
  • Your injured knee feels as strong as the other knee.

How Can I Prevent Knee Pain?

Although you can’t prevent all injuries, you can take these steps to make them less likely.

  • Stop exercising if you feel pain in your knee.
  • If you want to make your workout more intense, always do it gradually.
  • Stretch your legs before and after physical activity.
  • Use kneepads to prevent bursitis, especially if you have to kneel a lot.
  • Wear shoes that fit well and offer enough support.
  • Keep your thigh muscles strong with regular stretching and strengthening.
  • If you’re overweight, work to drop some pounds so there’s less stress on all of your joints, including your knees.

 

Anterior Cruciate Ligament (ACL) Injuries

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Overview

The anterior cruciate ligament is the smallest of the four main ligaments in the knee. Despite its size, it is the most important of the four in keeping your leg stable when you twist your body. It connects the thighbone (femur) to the largest shinbone (tibia) at the center of your knee.

Without the anterior cruciate ligament, your knee would wobble and move around when you twist your body. When the shinbone and thighbone rotate too far in opposite directions – or when the knee is bent in the wrong direction – the anterior cruciate ligament can be torn or sprained.

Often when the anterior cruciate ligament tears, you will have damage to other ligaments – most often the medial collateral ligament, or the cartilage of the knee.

Symptoms

If you tear your anterior cruciate ligament, you may have the sensation of your knee giving out or buckling. You may even hear a popping sound. Your knee joint will start to swell. This happens because the small blood vessels in the ligament also tear and leak blood into the joint.

The pain resulting from a torn anterior cruciate ligament varies widely. The anterior cruciate ligament itself has no pain receptors. But the movement that causes the ligament to tear often causes damage to other parts of the knee that do have pain receptors. Some people are unable to walk. Others may feel they can play through the injury. Your knee often feels as though it will give way or easily bend backward.

Causes and Risk Factors

Quick changes of direction while running cause most anterior cruciate ligament injuries. When a basketball player running down the court plants his foot hard to change direction, his knee buckles as the thighbone and shinbone move in opposite directions, tearing the anterior cruciate ligament.

Basketball, soccer and skiing often cause anterior cruciate ligament injuries. Football players have the greatest risk for multiple knee injuries like combined anterior cruciate ligament, medial cruciate ligament and cartilage damage.

Diagnosis

Your doctor will generally ask you how the injury occurred, whether you’ve had other knee injuries and how your knee has felt since the injury. You may also be asked about your physical and athletic goals. This will help your doctor decide what treatment might be best for you.

Because the anterior cruciate ligament is deep inside the knee, diagnosing the condition can be challenging. Two common physical tests are used to confirm an anterior cruciate ligament injury and its severity:

  • Lachman Test – The injured leg is held slightly bent and the doctor pulls on the lower leg (tibia). If the leg moves significantly more than the other, uninjured, knee, you may have a torn anterior cruciate ligament. A hand-held instrument called an arthrometer may also be used to measure the stability of the knee.
  • Anterior Drawer Test – With the knee bent 90 degrees, the doctor will pull the lower leg (tibia) forward. If the tibia moves excessively forward, that would strongly suggest a torn anterior cruciate ligament.

If more tests are needed to determine whether your anterior cruciate ligament is torn, a magnetic resonance imaging (MRI) scan will be ordered. An MRI is nearly 90% accurate in determining whether an anterior cruciate ligament has been torn and how badly.

MRIs are not good, however, at providing details about a partial tear. The best way to see a partial tear is arthroscopy. With a camera probe into the knee, a doctor can look at the anterior cruciate ligament to see how badly torn it is and whether reconstructive surgery is needed. Though less painful than some procedures, arthroscopy is not pain-free.

Treatment

If a torn anterior cruciate ligament is not treated, your knee joint will continued to give way, putting you at risk for more injuries to your knee. Additionally, there is usually cartilage damage that can lead to osteoarthritis.

A torn anterior cruciate ligament is usually treated by one or a combination of the following:

  • Arthroscopic reconstruction.
  • Physical therapy and strengthening. This program takes about four months to six months to complete.
  • Surgery to reconstruct the anterior cruciate ligament.

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

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Why Does My Knee Hurt? 5 Common Sources of Knee Pain

Most people experience knee pain at some point in their lives. While some may have only mild or sporadic symptoms, others may experience knee pain so severe that it interferes with daily activities or reduces quality of life. The degree of knee pain you’re experiencing usually depends on the complexity of the condition or injury. Here are five possible conditions that are common sources of knee pain.

Possible Sources of Knee Pain

1. Bursitis

Inflamed bursae may cause knee pain in some people. Bursae are small pockets of fluid that lubricate the tendons of the hips, shoulders and knees in order for them to move freely along joints. Pain from bursitis builds up gradually or can be sudden and severe, especially if calcium deposits are present.

2. Knee Ligament Injuries

The ligaments are what connect your thigh bone to your lower leg bones; they hold your bones together and keep the knee stable. Knee ligament sprains and tears are very common sports injuries, and can occur to the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL) and medial collateral ligament (MCL). These injuries cause significant pain, and they require medical attention and oftentimes surgery.

3. Patellar Tendinitis

If you have this condition, you have inflammation in the tendon that connects the kneecap to the shinbone. Tendons are tough bands of tissue that connect muscles to your bones. When you overdo exercise, they can become inflamed and sore. You may also hear it called “jumper’s knee” because repetitive jumping is the most common cause.

4. Osteoarthritis

Osteoarthritis – commonly known as “wear and tear arthritis” – may affect men, women and children, with women over the age of 55 at the highest risk. The condition induces pain from the loss of cartilage, which causes the bones to rub together and produce intense discomfort. It may also form from joint malformations present at birth, injuries caused in active sports or work conditions that require repetitive movements. Those with osteoarthritis typically experience pain that increases when you’re active, but gets better with rest; stiffness in the knee, especially in the morning or after sitting for a while; and/or a creaking/crackly sound that is heard when the knee moves.

5. Damaged Meniscus

According to the Mayo Clinic, a torn meniscus is one of the most common knee injuries in adults. Any activity that causes you to twist or rotate your knee can lead to a torn meniscus. Menisci are thin layers of cartilage that act like a cushion between your shinbone and thigh bone. If too much stress is placed on the knees, the meniscus may tear, which can cause pain and interfere with the knees proper functioning. A torn meniscus causes pain, swelling and stiffness. You might also feel a block to knee motion and have trouble extending your knee fully. How your orthopedic surgeon treats your tear will depend on the type of tear you have, its size and its location.

Artificial Meniscus Implant

An artificial meniscus may soon be available. If you are suffering from knee pain following meniscus surgery or are without viable treatment options, the NUsurface® Meniscus Implant may provide an alternative option, once approved by the U.S. Food and Drug Administration. NUsurface is designed to mimic the function of the natural meniscus and redistribute loads transmitted across the knee joint. The implant is made from medical grade plastic and, as a result of its unique materials, composite structure and design, does not require fixation to bone or soft tissues. NUsurface has the potential to address the treatment gap of those suffering from meniscus deficiency and deterioration who are too old for meniscus repair and too young for total knee arthroplasty. U.S. clinical trials completed enrollment in June 2018, and the company is expecting to file for approval by the U.S. Food and Drug Administration within the next two years.

 

CAUTION – Investigational device. Limited by United States law to investigational use.

Common running knee injuries and how to treat them

Running is on the rise. According to Sport England’s Active People Survey results over 2 million people a week participate in running and, it’s the second most popular activity for people doing 30 minutes’ exercise at a moderate intensity at least once a week.

So why are we a nation that loves to run? There are many reasons. Running is inclusive, cheap and accessible without the need to arrange a court or organise a team. Some people run to lose weight, to get fit, to keep healthy, to beat their personal best time or to have time out to think and once we’ve been for a run we experience runners high with the release of feel good chemicals.

But no matter whether you are a beginner whose muscles are not used to running or a highly experienced runner training for the upcoming London Marathon on 23rd April when you’ll join up to 50,000 other runners as they pound the streets to finish the 26.2 mile run, anyone can be affected by a running injury.

Common knee injuries due to running

The knee is the most commonly injured joint among runners. Damage to the structures inside and outside your knee joint can result in fractures, dislocations, sprains, and tears. Knee components susceptible to running injuries include:

– Articular cartilage – covers the ends of your shin bone, thigh bone and the back of your kneecap (patella).

– Ligaments – there are four ligaments including your anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) in your knee that connect your bones together.

– Menisci – two cartilage discs that act as shock absorbers and help to stabilise your knee.

– Tendons – connect your muscles to your bone.

Runners Knee

Runners knee, also known as patellofemoral pain syndrome (PFPS), is knee pain associated with your patella or kneecap. It is the most common condition for runners. It’s thought to be caused by an imbalance in the muscles that support your knee, and mechanical errors that can cause poor knee tracking.

The main symptom is pain around your knee when you run. The pain can be dull or sharp and severe and usually worsens as the intensity of exercise increases.

Chondromalacia Patella (CMP)

Chondromalacia patella is damage to your articular cartilage. It is a chronic condition that causes your kneecap cartilage to soften and break down resulting in pain and inflammation. It is caused by overuse of the knee, alignment problems, injury or ageing.

Knee pain around the patella typically feels worse when going up or down stairs. It may be brought on by sitting (with the knees bent) for long periods.

Patellar Tendonitis (Tendinopathy)

Patellar tendonitis is generally an overuse and ageing injury that affects your knee. It is the result of your patella tendon being overstressed. A common name for it is jumper’s knee.

Patella tendinopathy usually causes pain, stiffness, and loss of strength in your knee.

IT Band Syndrome (ITBS)

Your iliotibial (IT) band is a tendon that connects your knee to your hip. It helps to stabilise your knee.

IT band syndrome (ITBS) can occur due to overuse, overstrain and biomechanical factors. Your IT band tightens and becomes irritated and inflamed. The main symptom is pain on the side of your knee.

ACL and PCL injuries

An ACL or PCL tear is caused by overstretching the knee’s ligament. It can occur when a runner stops suddenly, changes direction rapidly, whilst slowing down, landing incorrectly or has a direct collision.

You will feel pain and swelling around your knee. You might hear a popping noise and you may feel your knee give way from under you.

Kneecap Bursitis

Prepatellar bursitis is an inflammation of your bursa (cushioning sacs between bones and soft tissues to reduce friction) in the front of your kneecap. Your bursa can become irritated and swell and then put pressure on your adjacent knee parts.

It can be caused by either repetitive friction on the area, muscle tightness, or from a sudden injury to the knee. 

Kneecap Subluxation

Your kneecap can be pulled to the side of (subluxation), or fully dislocate from, the groove it normally glides over in your knee joint. The supporting tissues can be stretched or torn when this happens. It can be caused by a blow or a sudden change in direction when you put your foot on the ground.

Your kneecap will look out of place and will be accompanied by knee pain, swelling and a popping sensation.

Medial Meniscus Tear

A meniscus tear is a tear to the cartilage in your knee joint causing pain on the inside of your knee.

The most common cause of a meniscus tear is twisting of your knee when your foot is on the ground. It can also occur through direct impact in contact sports and in older athletes through gradual degeneration.

Plica Syndrome

A plica is a fold of the soft inner lining of your knee joint that can be more prominent in some people. Plica syndrome occurs when this lining of your knee joint is irritated and inflamed and causes knee pain.

Activities that repeatedly bend and straighten your knee, such as running can irritate the plica and cause plica syndrome.

Knee Stress Fracture

A stress fracture in the knee can be the result of increasing the amount or intensity of an activity, such as running, too quickly. Unfamiliar surface (path rather than grass), improper equipment (worn or less flexible running shoes) and increased physical stress (a runner increasing their running time) can also cause a knee stress fracture.

A stress fracture will cause you pain in your knee.

When to seek treatment for your knee pain caused by running

Most knee injuries in runners can be resolved by conservative methods such as rest, ice and stretching. If your pain is not severe but lasts for a week or more you should seek medical advice to have your knee checked over. Your GP or a physiotherapist will offer advice about exercises and stretched that will help your recovery.

However, if your pain is severe or your knee is swollen you should see a doctor straight away. They will ask about your symptoms and perform a physical examination of your knee. You may be referred to an orthopaedic surgeon for further investigations or treatment.

Diagnosing your knee condition

Your GP or orthopaedic surgeon may request the following tests to investigate further your knee pain:

– An X-ray or CT scan – to check for a fracture or arthritis.

– An MRI scan – to determine cartilage or soft tissue damage.

– Knee aspiration – to drain off fluid and help in the diagnosis of knee joint disease.

– Knee arthroscopy – your doctor looks inside your knee using a telescope and a tiny camera to see if there is meniscus, cartilage or ligament damage. Knee arthroscopy is minimally invasive surgery and can be used to treat your knee problem at the same time.

Treatment options for knee problems caused by running

Treatment will depend on your specific knee problem and your doctor will be able to advise you on the best course of treatment. Options include:

– Rest

– Ice

– Non-steroidal anti-inflammatory medication

– Exercise to strengthen and stretch your muscles

– Knee tape or brace

– Advice for footwear

– Surgery – some knee pain conditions will need surgery. This may include fractures, ligament tears such as ACL tear, removal of the plica, malalignment of the patella or, damage to the cartilage under your kneecap.A knee arthroscopy can be performed to wash out loose fragments in your joint caused by wear or to trim or repair torn cartilage and ligaments.

Treatment for knee problems caused by running at Berkshire Independent Hospital in Reading

We hope that you enjoy running without injury or knee problems. However, if you do suffer from a knee condition, you can rest assured that Berkshire Independent Hospital offers a local and comprehensive range of service for the diagnosis, treatment and management of knee conditions caused by running.

We also offer first class physiotherapy delivered by senior chartered physiotherapists for knee problems due to running.

For more information or to make an appointment call 0118 902 8114 or contact us.

Knee Care| Knee Surgery | UC San Diego Health

Knee pain and problems can have many causes, and can greatly impact daily life.

Look to UC San Diego Health orthopedists to find the source of you knee problem and to personalize your treatment plan to your knee condition and lifestyle preferences. We are repeatedly ranked among the nation’s best in orthopedic care by U.S. News & World Report. 

UC San Diego Health is the Official Health Care Provider of the San Diego Padres. We are also a designated Center of Excellence for orthopedic care by Optum, which means you’ll receive expert, safe and cost-effective care.

When to See a Doctor

If you have knee pain that lasts more than a week, you should see a doctor. An early diagnosis and the right treatment can prevent more serious or permanent damage to the knee joint and surrounding soft-tissue. 

Do I Need a Referral for Orthopedic Care?

You can make an appointment with one of our orthopedic specialists directly without a referral. If you have an HMO, however, your insurance plan may require a referral from your primary care physician.

Knee Conditions Treated

UC San Diego Health treats all types of knee conditions, including:

Evaluation and Diagnosis

At UC San Diego Health, you receive a complete work up of your knee condition. This includes a careful review of your health history and current symptoms, a physical exam of your knee and X-rays. Your doctor may also recommend an injection or MRI (or both) if there are inconsistencies in your diagnosis, symptoms or response to treatment. In some cases, your doctor may recommend knee arthroscopy to look inside your joint. Once you have a diagnosis, you and your doctor will discuss your treatment options and goals.

Nonsurgical Care

Your UC San Diego Health care team may be able to treat your knee condition without surgery. 

Lifestyle Modifications

Because the knee is a weight-bearing joint, you may find relief with low-impact exercise such as swimming or biking, instead of running, as well as weight loss when appropriate.

See
Weight Management Program for expert weight loss help.

Physical Therapy and Injections

Targeted exercises to strengthen the muscles that support your knee can also help. If physical therapy doesn’t resolve your condition, your doctor may recommend a corticosteroid injection to reduce painful joint inflammation.

See
Physical Medicine and Rehabilitation for more information on our comprehensive non-surgical care for orthopedic injuries and conditions.

Knee Surgery

UC San Diego Health orthopedic surgeons offer advanced surgical techniques for treating knee conditions that have not responded to conservative treatment.

Knee Arthroscopy

Knee arthroscopy, also known as a “knee scope,” is a minimally invasive approach for treating a range of knee problems, including meniscus, ligament and cartilage injuries. Minimally invasive knee surgery involves smaller incisions and leads to a faster recovery and better outcomes. You can usually go home the same day as your surgery. In many cases, you can return to sports at the same level of intensity or higher safely after completing your rehab.

Knee Replacement

If you have severe joint damage or degeneration, you may be a candidate for a total or partial knee replacement. UC San Diego Health surgeons offer a range of surgical approaches and are sought out for their expertise in complex revision surgeries as well.

See
Hip and Knee Replacement for more information on our surgical expertise in total and partial joint replacement.

More About Knee Conditions and Care

For more general information about knee conditions and treatments, visit our Health Library:

Knee Injuries | Knee pain symptoms and causes

Types of knee injury

Knee ligament injuries

You have two sets of ligaments in your knee. The collateral ligaments run down either side of your knee, while the cruciate ligaments lie inside your knee.

Collateral ligament injuries

Your medial collateral ligament (MCL) is on the inner side of your knee and the lateral collateral ligament (LCL) is on the outer side. They limit how much your knee can move from side to side.

  • You can sprain or tear your MCL if you get a direct blow to the outside of your knee, which stretches the inner side of your knee. This may happen when you’re skiing, for example.
  • You’re less likely to injure your LCL but it can happen if your lower leg gets forced inwards. This stretches the outer side of your knee.

Cruciate ligament injuries

Cruciate means cross-shaped. Your anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) form a cross inside your knee. They help to keep your knee stable by controlling how much it moves backwards and forwards.

  • ACL injuries are one of the most serious types of knee injury. They often happen when you twist your knee, such as when you land on your leg then quickly turn. This might happen when you’re playing football or basketball, for example.
  • Your PCL may get damaged if you fall on your knee while it’s bent. Another way of damaging your PCL is when your knees hit the dashboard during a car accident.

If one of your ligaments is damaged, a doctor may grade your knee ligament injury to show how bad it is. This will help to work out what treatment you need and how long your knee injury will take to heal.

  • Grade 1 is a stretch of the ligament without tearing it.
  • Grade 2 is a partial tear of the ligament.
  • Grade 3 is a complete tear through the ligament.

Other soft tissue injuries

You can damage other soft tissues around your knee, such as your cartilage and tendons. Soft tissue means any tissue in your body that isn’t bone.

Cartilage injuries

One of the most common knee injuries is to tear a meniscus (one of the wedge-shaped pieces of cartilage that lie inside your knee). This can happen if you play a sport that involves twisting, such as football or basketball. But it can also happen when you run, play tennis and ski. As you get older, your menisci may become worn, which makes them more likely to tear during normal daily activities. Your knee also has a different type of cartilage that covers the ends of your bones that lie inside the joint. This articular cartilage can get damaged too.

Tendon injuries

If you run regularly or play sports where you jump a lot, you may damage the tendons that attach muscles to your knee. You can irritate or tear the tendon that connects your kneecap (patella) to your thigh muscle. This tendon is called the quadriceps tendon. Or you may irritate soft tissue around your kneecap, including the patellar tendon just below your kneecap (jumper’s knee).

Prepatellar bursitis

Housemaid’s knee is the common name for prepatellar bursitis. It’s often caused by the pressure of kneeling forwards for long periods. The bursa (a small fluid-filled sac that acts as a cushion or lubrication in front of your kneecap) will swell up with fluid. Prepatellar bursitis can also be caused by a direct blow to your knee or a fall, or a bacterial infection.

Signs your knee injury could be serious: Jeffrey Halbrecht, MD: Orthopedic Surgeon

Is your knee bothering you?

As our world is getting back to some semblance of “normal”, people are resuming activities and sports that they had stopped during the pandemic. After long periods of inactivity, we are more prone to injury. 

When it comes to sporting and exercising activities, knee injuries tend to be quite a common occurrence. The good thing is that most of them do not require surgery. However, it is still important that you be on the lookout for any signs that may indicate your knee injury is serious and see a Bay Area knee injury specialist.  Some symptoms to watch for are:

 

Swelling

In most cases, it is normal for your knee to contain a bit of fluid around the injured area. However, if the swelling becomes too much just a couple of hours after injury, then you may have a fracture or a torn ACL. This injury will require a visit to a Bay Area knee doctor.

Pop sound

In case you hear some sort of loud popping sound after a fall or awkward land coming from your knee followed by a sharp pain, then you should consider visiting a knee injury specialist in the Bay Area to determine if you have a torn ligament.

Impossible to bear weight

Most serious knee injuries can result in pain whenever one tries to put pressure on the injured leg. If you find yourself in such a situation, it would be best that you seek medical attention.

Your knee giving out or buckling under pressure

If your knee happened to give out by twisting during a sporting event, or buckled under the pressure of a jump, then you should probably seek medical attention. This is because both scenarios could be a sign of a torn ligament.

A locked knee

It is common for young athletes to injure their meniscus in such a way that the inner torn fragment is flipped into the center, thereby preventing motion. Also, a bucket-handle meniscus tear will more than likely require surgery so that the surgeon can push it back in place and fix it with anchors or sutures.

Inability to fully extend the knee

Things such as inflammation, swelling, aches, or pains can restrict the knees’ range of motion. However, there are certain situations where such symptoms could be a sign of a larger problem like a torn ACL, patellar dislocation, meniscus, or other knee problems.

Inability to fully extend the knee is serious and requires medical attention. Visit a knee doctor in the Bay Area to get the treatment you need.

Still worried about your knee? Consult a Skilled Bay Area Knee Doctor.

If you are unsure how serious your knee injury is and would like a specialist’s opinion. Please contact our office for a consultation at 415-923-0944. We offer telehealth options over the phone for your initial consultation if you prefer. 

90,000 Cruciate ligament rupture: surgery, rehabilitation, costs

A clear, centered view of the anterior and posterior cruciate ligaments at the knee. The cartilaginous surfaces and menisci on the tibial side are indicated in purple. A cruciate ligament sprain or injury may result from a dislocation or impact. Complete destruction of this component of the knee is called a cruciate ligament rupture. © Istockphoto.com/MedicalArtInc

In the center of the knee joint, two ligaments intersect, which connect the femur (Femur) and the tibia (Tibia) and hold their position.Due to the rupture of one or two cruciate ligaments, the knee joint becomes unstable. Anterior cruciate ligament rupture is the most common occurrence in patients. Injuries are caused by injuries sustained after sports training, such as dislocation of the knee joint during skiing or collision during sports ball games.

When the cruciate ligament is torn, the knee swells greatly, and the victim feels severe pain. In most cases, the disease is accompanied by a clicking or crackling sound, during which you feel a jerk in the knee joint.After this, the patient’s knee is limited. In order to stabilize the knee again and prevent arthrosis of the knee joint, the orthopedist can either suture the cruciate ligament or replace it with a tendon graft.

Causes and course of the disease

Anterior cruciate ligament rupture is usually obtained after sports. Often, the outward deflection of the lower leg puts a load on the anterior cruciate ligament, as a result of which it breaks more easily. The following situations are specific to this injury:

  • Severe side impact with an opponent while playing football
  • hyperextension of the knee joint
  • sudden braking at full speed
  • Sudden change of direction at full speed
  • unsuccessful landing after jumping or spinning

A typical circumstance of an accident is hitting the knee of an opponent while playing football.In addition, a cruciate ligament rupture occurs during skiing, after a fall, followed by dislocation and overstretching of the lower leg.

As a rule, the patient feels a rupture already during the fall. Trauma is often accompanied by a characteristic click of a stretched and damaged cruciate ligament. The gap occurs only under significant force. The cruciate ligament can usually support 2400 kg. load. However, its strength can change: in women, the diameter of the cruciate ligament is much smaller.Therefore, they suffer from this disease much more often. In children, Segond’s fracture is more common – an avulsion fracture of a portion of the tibial condyle.

A rupture of the posterior cruciate ligament requires a stronger force than a rupture of the anterior cruciate ligament. Injuries of this magnitude are usually observed during road traffic accidents, for example, when the knee joint hits the passenger compartment. Therefore, injuries to the posterior cruciate ligament are much less common, namely only in 7-10% of all cases.

When is cruciate ligament rupture necessary?

The path of a healthy posterior cruciate ligament from the face of the thigh to the posterior articular surface of the tibia. © Radiopedia.org

Same patient: The anterior cruciate ligament is not visible due to rupture. © Radiopedia.org

If conservative treatment is unsuccessful or does not bring the desired result, as well as if the patient is young and leads an active lifestyle, surgical reconstruction is the best solution in order to preserve the patient’s quality of life and sports activity.In addition, surgery should be performed in the event of a rupture of more than 75% of the cruciate ligament or when a ligament with a bone fragment is torn off.

Cruciate ligament rupture must be treated promptly. Otherwise, within a few years you will develop other injuries in the knee joint. An excessive load will be exerted on the articular surfaces and menisci, which can lead to premature wear, damage to the articular cartilage, and in 10-15 years to arthrosis of the knee joint. Often, due to the existing instability of the cruciate ligament, the meniscus also breaks.

In 80% of cases, rupture of the cruciate ligament causes damage to other structures of the knee joint:

  • Internal meniscus rupture (69% probability)
  • Rupture of the outer meniscus (49% probability)
  • Articular cartilage injuries (20-50% probability)
  • Secondary arthrosis of the knee joint due to limited functionality of the meniscus
  • Internal ligament injuries (common)
  • Damage to the external ligaments (less often)
  • Rupture of the articular capsule of the knee joint

What happens before the surgery?

Before the operation, the doctor conducts a comprehensive clinical examination.First, all the circumstances of the injury and the degree of knee instability are clarified. Thus, the specialist receives information about the degree of rupture. Unfortunately, the diagnosis is often made several years after the injury, since patients do not attach much importance to this and consider this injury to be a simple sprain.

In the presence of strong thigh muscles, the diagnosis is usually not made within the framework of a clinical examination and the option of performing an operation is not considered. However, over time, the patient feels discomfort in the knee joint.The cause of arthrosis can be trauma, as a result of which the cartilage is damaged. Very often, problems of the knee joint appear only after several years, and only then does the patient notice some instability while climbing stairs or during rotational movements, after which he feels severe pain in the knee.

In addition to diagnosing the degree of knee instability, cruciate ligament rupture is determined using special techniques such as the anterior drawer test (PVT), the Lachman test, or the lateral slip test (Macintosh test).

The Lachman test helps to establish the stability of the cruciate ligaments. The test is conducted on the principle of an anterior drawer (PVC), but also involves a 30 ° knee flexion. © joint-surgeon

In addition, the condition of the cruciate ligaments is determined by MRI. X-rays are required to exclude associated bone injuries of the knee joint. Also, joint puncture – aspiration of synovial fluid from the joint capsule – helps to diagnose. The cruciate ligaments have good blood supply.Therefore, their rupture becomes the cause of joint hemorrhage. The presence of blood in the joint fluid indicates a cruciate ligament rupture.

A After diagnosing and checking the patient’s health, the attending physician conducts an explanatory conversation with the patient, during which he talks in detail about the course of the surgical intervention, as well as about possible complications. After that, you will be referred for an appointment with an anesthesiologist, who will check again whether your health condition allows you to administer anesthetics.Typically, cruciate ligament rupture is performed the day after talking with the surgeon and anesthesiologist.

How is the operation going at Gelenk-Klinik?

The lateral or medial ligaments of the knee joint can suddenly heal. This self-healing process does not apply to the anterior and posterior cruciate ligaments. © ttsz, iStock

As a result of acute injuries, it is possible to operate only after the concomitant diseases have been cured and the wound has completely healed.For this reason, cruciate ligament reconstruction is performed approximately 2-3 months after the injury itself. During this period, the mobility of the knee joint is severely limited. Physiotherapy helps prepare the knee for surgery.

Cruciate ligaments differ in structure from other ligaments of the knee joint: in case of ruptures of the external and internal collateral ligaments, immobilization of the joint using a special orthosis can contribute to the sudden fusion of the injury.Cruciate ligaments do not have this self-healing effect. As a rule, cruciate ligament operations are performed to restore their functionality.

Surgical intervention usually lasts 1.5 – 2 hours. During the operation, surgeons perform tendon transplantation or suture. Which method is right for you, you need to discuss with your doctor.

Cruciate ligament replacement and tendon transplant

Cruciate ligament replacement surgery is the most common surgical technique.During this procedure, the surgeon first completely removes the damaged ligament in order to prepare the patient for transplantation. To receive a transplant, the doctor takes parts of the autogenous tendons from other parts of the knee joint. As a rule, the operating doctor uses the patellar ligament located between the patella and the tibia for this.

The advantage of autologous tendon transplantation is undoubtedly the absence of rejection of the body, since the graft is obtained from the patient’s body, namely from the patella tendon and the Achilles tendon.After the completion of the transplantation process in the femur and lower leg bones with the help of special bone screws, after a while the tendon graft is well absorbed by the body and begins to be supplied with blood vessels.

The only drawback of this intervention is the sensation of pain in the leg, namely at the site of the graft collection. The patient may feel discomfort for several months. Removing the tendon also slows down the development of physical strength.However, this fact is only important for athletes. After the operation, the patient will have long physical therapy sessions and specialized training.

In addition, the operation does not contribute to the restoration of the innervation process, which is of great importance for the coordination of movements. In big sports, this is considered a disadvantage, but for most patients this fact does not matter much.

Suturing cruciate ligaments by refixing damaged structures

Modern procedures allow the endogenous cruciate ligaments to be preserved even after they have ruptured.The aim of the Ligamis plasty, offered by our clinic since the beginning of 2014, is to restore the stability of the knee joint – in accordance with natural functions. Using this system, the surgeon replaces the torn ligament with an artificial implant, which during the recovery period is responsible for mechanical stabilization of the damaged cruciate ligament in the very center of the knee joint. In this case, the torn parts grow together again and heal under the influence of the implant.If this technique is successful, the patient will not need an endogenous tendon grafting of the cruciate ligament.

The result after Ligamis surgery is much better than after autologous tendon transplantation, since after refixation all nerves are preserved and, thus, the process of controlling the knee joint movements remains normal. Athletes should pay attention to the choice of the operation method.

Since donor material is not required for the tendon graft re-fixation, there is no need for material sampling, accompanied by pain and muscle weakness in the area of ​​graft extraction.Already a few days after re-fixation, the patient can fully load the knee.

Before the patient is referred for surgical refixation of the cruciate ligament, it is necessary to undergo a volumetric MRI examination. After that, the decision should be made as soon as possible, since more than 3 weeks after the injury, the ability of the cruciate ligament to heal itself decreases. Thus, this surgical intervention is recommended to be carried out during the exacerbation of the rupture, namely within three weeks after the injury.Otherwise, only transplantation can help the patient.

Our highly qualified specialists remove the Ligamis implant usually 6-9 months after the successful healing of the cruciate ligament. During the removal of the implant, the healing process is also checked.

Which physician performs the surgical treatment of a cruciate ligament rupture?

At the orthopedic medical center Gelenk-Klinik in Germany, a trusting relationship between the patient and the medical staff is highly valued.Your orthopedic surgeon will accompany you from the first meeting with him to the postoperative period. He also provides follow-up care for the patient. Thus, you will have a responsible person to whom you can contact at any time. Specialists in the treatment of knee diseases and cruciate ligament ruptures at Gelenk-Klinik are Dr. Baum, prof. Dr. Ostemaer Privat-Assistant Professor Dr. med. Dr. Markvas.

Probability of success after cruciate ligament rupture

Cruciate ligament surgery is very successful and in 90% of all cases leads to a complete restoration of the functions of the knee joint.Almost all patients return to their usual activities, and professional athletes can resume training. This intervention is carried out in our clinic quite often. Therefore, our highly qualified surgeons have many years of experience in the surgical treatment of this injury.

What type of anesthesia is used during the operation?

Cruciate ligament surgery is usually performed under general anesthesia. However, sometimes doctors consider administering spinal anesthesia to avoid the risk of general anesthesia.To do this, the anesthesiologist injects an anesthetic into the spinal canal of the lumbar spine. In this case, the patient is fully conscious. The anesthesiologists of Gelenk-Clinic have many years of experience in performing such operations. Which of the above methods corresponds to your indicators is decided during an explanatory conversation.

Postoperative observation, rehabilitation and aids after cruciate ligament rupture

In the first days after cruciate ligament rupture, the knee is immobilized using the Mecron knee brace, which stabilizes the limb in the 0 ° position.For further healing, we use a rigid 4-point sports-functional low-profile orthosis of increased strength, which allows you to regulate the process of flexion and extension of the knee. In order to avoid unnecessary stress on the knee, you are given special crutches with support on the elbow. During this process, prevention of thrombosis with heparin and enoxaparin is mandatory. In addition, you need to wear compression stockings until complete recovery. We will be happy to make sure that you receive all the necessary funds on time….

Will I feel pain after the operation?

Every surgical procedure can cause pain. An operation to treat a rupture of the cruciate ligament of the knee is no exception. Thanks to the high professionalism and long-term experience of our surgeons, we manage to reduce patient pain to a minimum. Before the operation, the anesthesiologist will give a special injection that will numb the knee joint for approx. for 30 hours. After that, the pain decreases and the patient’s treatment continues with conventional medications.The goal of the medical staff of Gelenk-Clinic is to provide a painless postoperative period for the patient

Conditions of stay in Gelenk-Clinic

Solitary ward at Gelenk-Klinik in Gundelfingen, Germany. © joint-surgeon

During your inpatient stay at the clinic, you are in a solitary ward with a shower and toilet. Towels, a bathrobe and slippers are provided in each room. In addition, you can use the safe, minibar and watch TV.You must bring your own medicines, comfortable clothing and nightwear with you. After surgery, your condition is monitored around the clock by nursing staff and professional physiotherapists. As a rule, you stay in the clinic for no more than three days. Your relatives can stay at a hotel that is located near the medical center. We will be happy to take care of your hotel room reservation.

What to look for after surgical treatment for a cruciate ligament rupture?

Immediately after cruciate ligament rupture, the knee should be in an elevated position.In addition, a cooling compress should be applied to the knee. About 10 days after the operation, the stitches are removed, after which you can take a shower.

To avoid possible complications, the knee should be at rest for approximately 6 weeks. During this time, you will be discharged from the hospital and given elbow crutches. Prevention of thrombosis during the impossibility of performing full loads on the knee is a necessary procedure. To prevent muscle loss and preserve the natural functions of the knee joint, physiotherapy is given.

You can plan your flight back home no earlier than 10 days later. However, we recommend leaving the clinic at least two weeks later.

  • Inpatient treatment: 3-4 days
  • Recommended length of hospital stay: 10-14 days
  • When to book a return ticket: 10 days after transaction
  • When is it recommended to leave the clinic: after 2 weeks
  • When can I take a shower: after 10 days
  • How long sick leave is issued: 6-8 weeks (depending on professional activity)
  • When stitches are removed: after 10 days
  • Outpatient physiotherapy: 2 weeks
  • When is it allowed to drive again: after 6 weeks
  • Light sports activity: 3-6 months after surgery
  • Habitual sports: after 9 months

Cost of knee surgery

In addition to the cost of surgery, cruciate ligament rupture, additional costs for diagnostics, medical appointments and aids (e.g.elbow crutches), which range from approximately 1,500 to 2,000 euros. If you plan to undergo physiotherapy after the operation, we will draw up a cost estimate for you and send it to you by e-mail.

For information on the cost of staying at the hotel, as well as possible additional treatment, please visit the website of the service provider.

How can a foreign patient make an appointment and the operation itself?

You will first be asked to provide up-to-date MRI scans and X-ray results.Thus, the doctor will be able to assess the condition of the knee joint. After we receive all the necessary documents through our website, within 1-2 days we will send you a preliminary treatment plan and cost estimate.

The Gelenk-Klinka Orthopedic Medical Center provides foreign patients with the opportunity to make an appointment in a short time. We will be happy to help you with visa processing, after the prepayment specified in the preliminary cost estimate is received on our account. In case of refusal to issue a visa, the prepayment is refunded in full.

For patients from abroad, we try to reduce the time between the preliminary examination and the operation itself. Thus, you will not need to come to the clinic several times. During both outpatient and inpatient treatment, you will be accompanied by qualified medical personnel speaking several foreign languages ​​(English, Russian, Spanish, Portuguese). We also provide assistance in finding an interpreter (eg in Arabic), the payment of which is made by the patient on a separate basis.We will be happy to help you organize a transfer, find a hotel and show you how to spend your free time in Germany interestingly for you and your family members.

90,000 Treatment Damage to the lateral ligaments of the knee joint (internal and external collateral ligaments)

The lateral ligaments of the knee joint include the medial collateral and lateral collateral ligaments. A ruptured knee ligament is a common sports injury that is treated by an orthopedic surgeon.

The internal ligament is more likely to be injured, given the peculiarities of the anatomy of the knee joint. Typically when practicing active sports such as skiing, football, squash or tennis.

Usually the fibers of the bundles are strong enough to withstand this kind of stress. However, as a result of their strong pulling due to improper unnatural movement in the knee joint, such as twisting the knee, the fibers can break. As a rule, this can cause a characteristic crunch.The rupture is always accompanied by bleeding.

The lateral collateral ligament of the knee joint is damaged less often than the internal one, but more often the entire ligament is torn completely or completely detached from the place of its attachment to the femoral condyle.

The medial collateral ligament is more likely to be traumatized. However, it usually breaks partially. Part of the fibers of the inner lateral ligament is woven into the joint capsule and into the tissue of the inner meniscus of the knee joint.This attachment of the ligament leads to possible damage to the internal meniscus of the knee joint with ligament injuries.

Distinguish between partial and complete rupture of the internal lateral ligament. Partial rupture often occurs at the site of its attachment to the inner meniscus.

Immediately after the injury, there is a restriction of the function of the joint, sometimes there may be hemarthrosis – the accumulation of blood in the joint cavity. In the area of ​​the damaged ligament, there may be swelling of the soft tissues.Feeling of this area is painful.

A complete rupture leads to instability of the knee joint. The internal lateral ligament is often torn.

With excessive force applied to the inner surface of the knee joint, other elements of the knee joint (cruciate ligaments, menisci) and the peroneal nerve can often be damaged.

Diagnostics

Based on the symptoms and clinical examination, an orthopedic surgeon may prescribe examinations such as radiography, magnetic resonance imaging (MRI), and ultrasound diagnostics (US).

Treatment

The tactics of treatment in most cases is conservative: wearing a special orthosis with lateral stability, local cold, elevated position of the limb, limiting the load on the injured limb for 4 weeks. During this period, most of the gaps grow together. In cases where conservative treatment did not help, they resort to surgical treatment. Reconstruction of the lateral ligament is performed with an autograft from the tendons of the muscles of the posterior surface of the thigh.

Prophylaxis

It is recommended to pay special attention to thoroughly warming up and warming up the muscles before playing sports. Well-trained muscles are already a good defense against injury.

TRUST YOUR HEALTH CARE TO REAL PROFESSIONALS!

90,000 Menisci in the knee joint – what is it, why is it, how is it treated if it is damaged?

Today I decided to share with the community a small article that continues my acquaintance with orthopedics and biomechanics.The topic of conversation is the menisci of the knee joint. What is it, why are they needed, why are they so important and what are the current trends in the treatment of meniscus injuries.

The purpose of this article is to inform people.

Who cares – go under cat.

The Latin word meniscus comes from the Greek μηνίσκος (meniskos), which translates as “crescent” – if you look at the picture below, you can understand where this name came from (red arrow – inner meniscus, green – outer).

Originally, the menisci in the knee joint were described by Sutton in 1897 as vestigial structures. Gradually, with the growing understanding in medicine and research, the opinion about the “rudimentarity” of the menisci has changed dramatically, and they are now considered an important structure of the knee joint. Menisci are semilunar cartilage structures, triangular in cross-section, a kind of “spacer” between the articular surfaces of the femur and tibia.

The knee joint is complex in its biomechanics, flexion / extension, external and internal rotation are possible in it.The articular surfaces are not entirely congruent to each other (that is, the articular surface of the femur does not repeat 1 in 1 articular surface of the tibia).

Menisci are needed to:

  • stabilize the joint, especially in rotational movements (Shoemaker and Markolf 1986)
  • increase the area of ​​contact between the articular surfaces of the femur and tibia, distributing the resulting load evenly over the entire surface of the joint (Arnoczky et al 1987)
  • Participate in meniscus shock absorption (Fithian et al 1990)
  • participate in joint lubrication and nutrition (Renstrom and Johnson 1990), proprioception (Karahan et al 2010)

Since the menisci are mobile (the outer one is more mobile than the inner one) and are displaced during flexion and extension in the joint, then p.2 works in different positions of the joint (black arrows – load distribution).

In order to understand a little better in numbers – the removal of the external meniscus leads to a decrease in the contact area of ​​the articular surfaces by 40-50% and to an increase in the load in the “cartilage-cartilage” contact zone by 200-300% of what considered normal (Bedi et al 2012, Henning et al 1987).

Meniscus injury is most common in young people (4 times more common in men than in women) between the ages of 21-30 (Drosos and Pozo, 2004) – at least when we talk about traumatic ruptures.In addition to the traumatic, there are so-called. “Degenerative” ruptures, that is, chronic damage to the menisci due to local inadequate loads on this part of the joint or due to changes in the structure of the meniscus with increasing age of the person.

Taking into account that meniscus injuries are quite common, it is necessary to understand how they are treated.

Meniscus damage

Load with a long excursion into anatomy, damage classification, etc. I will not.Globally, there are complete ruptures (when the rupture line extends to the articular surface) and incomplete (the rupture line does not extend to the articular surface). Very often, according to the classification of MRI lesions according to Stoller, complete ruptures are IIIa-IIIb, incomplete – I-II degrees. The joint can hurt with all types of ruptures, but incomplete ones rarely require surgical intervention. Complete tears due to instability of the meniscus and maintenance of inflammation in the joint can be detrimental and cause persistent pain.

Conservative (non-operative) treatment most often includes joint stabilization in specialized orthoses (fixators), which restrict certain movements in the joint, anti-inflammatory therapy, physiotherapy exercises in the non-acute period. Injections into the joint with hyaluronic acid (outside the acute period of inflammation) can be used – at the same time, many studies are being carried out, for some of which it is impossible to speak of the high effectiveness of these drugs. Also, in recent years, the use of biological preparations (from adipose tissue, platelet-rich plasma, etc.) has been actively studied.etc.). It should be understood that in many respects the research data are contradictory. One of the latest sufficiently high-quality studies, albeit with a small sample of patients, on the effectiveness of PRP in surgical restoration of menisci – DOI: 10.1155 / 2018/9315815
Conservative therapy rarely lasts more than 4-6 weeks; if it is ineffective, it is recommended to discuss surgical options with your doctor.

Surgical operations on the menisci are currently performed minimally invasive – that is, several (2-3) small “punctures” 1 cm long are made in the knee joint, a camera and instruments are inserted – this is called “arthroscopy”.

Even 5-10 years ago, resection of the meniscus was common in our country – that is, the removal of the torn part, which, in theory, should eliminate instability in the joint. Sometimes the meniscus is removed completely (meniscectomy). Such operations had a great advantage – the patient was activated early, quickly recovered and returned to an active life.
Nevertheless, trends in the world are changing. Now the meniscus suture is considered the “gold standard” – with the help of tools, the torn part of the meniscus is sutured (or sutured to the joint capsule), thereby the meniscus is preserved, and with a favorable type of rupture it also grows together.After such operations, long-term rehabilitation is required (with limited load, and sometimes movements in the joint for 4-6 weeks).

At first glance, the option of removing a torn part of the meniscus looks more interesting (faster recovery of a person, no specific rehabilitation is required) – but in some European countries, resection of the meniscus is removed from the interventions paid by insurance “by default”. That is, the surgeon must very strongly justify why in this case he did not sew the meniscus (data personally from one professor of orthopedic surgeon from the UK about the actual state of the problem in the UK).

Are the Europeans stupid? No.

Faucett SC et al
“Meniscus Root Repair vs Meniscectomy or Nonoperative Management to Prevent Knee Osteoarthritis After Medial Meniscus Root Tears: Clinical and Economic Effectiveness.”
Am J Sports Med. 2019 Mar; 47 (3): 762-769. doi: 10.1177 / 0363546518755754. Epub 2018 Mar 8.

It has been reliably shown that the development of osteoarthritis (arthrosis “the old way”) is two times lower in the 10-year perspective in the group where the meniscus was sutured compared to the groups where the meniscus was resected (partially or completely removed) or not touched and left the patient to walk with a gap.

That is, with the technical capability and desire of the patient, all other things being equal, it is right to sew the meniscus for the life of the joint. Unfortunately, in our country, not all institutions sew menisci (we sew, and I am proud of the department).

Under the spoiler I will hide the youtube link with the animation of the meniscus seam.

There are two more options for the surgical treatment of meniscus, on which there is no point in dwelling in detail – this is the transplantation of the donor meniscus and the stitching of the artificial meniscus.The first option is not considered in Russia due to the state of transplantation. The second option is theoretically possible, but extremely expensive.

Thank you for your attention!

UPD I am answering the comment of yavdoshenko, as the questions he asked may be of interest to many.

How are meniscus problems diagnosed? Who makes the diagnosis?

Diagnostics follows the path “orthopedist-traumatologist – examination, clinical tests, collection of anamnesis, etc. – if there is a suspicion of damage to the meniscus (and pain in the knee joint is for various reasons), MRI is valid, and preferably of good quality – the resolution of the tomograph is from 1.5 Tesla.And take the disk, because all the operating surgeons known to me (including myself) always look at all the sections – the decision on the issue of conservative treatment or recommendations for surgery. In case of doubts (and the ineffectiveness of conservative therapy), diagnostic arthroscopy (examination of the joint with a camera from the inside) can really be recommended, which easily turns into a medical one right away.

the accuracy of the diagnosis is

Once, a long time ago, my friend on MRI saw a rupture of the anterior cruciate ligament, there was no clinical instability, he doubted, the patient redid the MRI on a higher-quality tomograph – indeed, a ligament rupture.Since there was still a meniscus rupture, we went for arthroscopy. As a result, the meniscus was sutured, and the ligament was intact.

In the article I did not see a clear explanation of why go to the operation?

First, the patient goes to the doctor when something hurts him. In this case, the knee joint. Without pain, there will be no diagnosis, and we will not know if everything is fine with the meniscus.

Secondly, the torn meniscus by itself does not particularly “wear out” the cartilage. Simply by not performing a stabilizing function, the load on the articular cartilage becomes local and very high – from there damage to the cartilage, chronic inflammation and the development of osteoarthritis.

Well, and so – above I wrote the meniscus functions, which to one degree or another are lost when breaking. Of course, this will make the joint feel bad)

At the expense of injections, it is also not quite clearly described.

Hyaluronic acid injections are indeed sometimes questionable now. I cannot completely rule out and brand them as ineffective, especially since there are studies that speak of the anti-inflammatory effect of these drugs. There is also about the nutrition of cartilage and the inhibition of the development of osteoarthritis.They are not the main method of treatment, they are contraindicated in active inflammation (synovitis), in other cases they can be considered by a doctor.

PRP is another matter. This is platelet-rich plasma – blood is taken from the patient, centrifuged, plasma with a high platelet content is isolated (due to the “preparation” method) and injected into the joint (this is how not only joints are treated, but also ligaments, by the way). At the injection site, platelets disintegrate, releasing many anti-inflammatory and regenerative factors at once.Pros – complete safety, more and more studies show effectiveness in certain conditions, cons – can be painful. And expensive.

Other variants of biological therapies do not yet have a lot of evidence base and, from my point of view, can only be used in the situation “either we try or operate”.

Chondroprotectors in any case are not considered by me. The evidence base for these drugs is too low.

need to undergo rehabilitation

During meniscus surgery, according to our observations, patients can do simple exercises from rehabilitation protocols themselves.Rehabilitation after reconstruction of the anterior cruciate ligament is another matter.

Most often it makes no sense to look for a center – you need to look for a specialist, a physical therapy and sports medicine doctor or a rehabilitation therapist.

then you still need to take care of your knee all your life and give metered, but regular loads.

In general, as with any problem in the musculoskeletal system, be aware of it and prevent exacerbations.

knee surgery is not a sentence

Absolutely not a sentence.

Marko Todorovic: every Russian tourist can find something suitable in Montenegro

– Speaking about Russia, I have not yet had time to evaluate other cities, usually we come, train, play a game and leave. I can say that I liked St. Petersburg, and, along with Moscow, they certainly differ from other cities, this is true. In Montenegro, even the capital Podgorica is smaller in size than Khimki, it seems to me that less than 200 thousand people live there. Other cities are more likely to appear to you as villages, because they are even smaller.There is a difference between the capital and the province, but not that big. Anyway, Montenegro is a beautiful country, we have mountains, the sea, many places where you can go in summer, and in winter you can have a great time in the mountains. Moreover, it is very convenient to get from the sea to the mountains in a maximum of a couple of hours.

– Name the top 5 places to visit in Montenegro.

– In the summer I met several Russians in Ada Boyana, this is a great place, quite large. Budva is also a good city, there are the best discos, in the open air, in particular, but there are a lot of tourists there.The old town of Kotor is also worth a visit. Personally, I like to visit Zabljak and Lovcen, these are mountainous areas. Montenegro is a small country, but very cozy. Porto Montenegro (in Tivat) is now popular because famous people like Novak Djokovic are buying houses there.

– Where are the best beaches in Montenegro?

– For me, this is Ada Bojana, also Ulcinj, which is located near the border with Albania, where the river flows into the sea, and there are a lot of excellent restaurants on the coast, plus there are not so many people there, so you can have a quiet time with friends and family …

– If we talk about the language, is it difficult for Montenegrins to understand Russians?

– I understand almost everything, but I am not speaking yet. I understand Russian words, but when I start to speak, then all the words are different, it is difficult to explain. After five months here, I already feel much better in this regard.

– How do Montenegrins generally relate to Russians?

– Now that this story has happened with Turkey, I think even more Russians will come to Montenegro.Of course, what the newspapers write about the possible entry into NATO can spoil relations between our countries. However, the Montenegrin president has already said that despite everything, relations with Russia will be excellent next year. Surely they keep Russian tourists in mind (laughs). I hope it will be so, nevertheless we, Serbs and Russians are very similar, I understand the local culture, so I did not have to adapt to the mentality.

– It seems like they promised that visas for Russians will not be introduced even after joining NATO.

– I think this is great, already in the summer, 10 percent of all people in Montenegro are there with a Russian passport. You go out into the street, and there are Russians around, big signs everywhere with the word “Sale”. Now they are building in Budva the largest water park in Europe, which will have a Russian owner. So this is a plus for Montenegro.

Olivier salad is also eaten in Montenegro

– What would you advise Russians to try from traditional Montenegrin dishes?

– Of the traditional Montenegrin dishes, I will single out popeci (Podgorički popeci), this is fried meat with ham and cheese inside, cheese, of course, is not the same as in Russia.Here I like borsch, this dish surprised me. I also tried khachapuri for the first time, and I also really liked them. Plus, wherever you go, if you don’t know what to order, then you need to take the Caesar salad, it is good both in good restaurants and in small cafes, I don’t know how it turns out.

– Few Russian tourists can imagine a vacation without alcohol, so how will Montenegro please them?

how to choose a knee support

how to choose a knee support

More and more modern people support a healthy lifestyle, which is impossible without intense physical activity.Therefore, a modern person today, instead of spending time in front of the TV, prefers long walks and exciting hikes. As the reviews of most people show about the push med knee brace knee brace, it is he who helps to avoid injury to the knee and prevents the onset of pain after an active rest.

orthoses serpukhov, evs axis knee brace
why do you need a knee support
fg 100 orthosis
Knee Brace buy in Surgut
metal orthosis

Types of knee braces and advice on caring for the product.To understand how to choose and how to properly wear a knee brace, you need to understand the classification of these products. It is carried out according to a number of signs: preventive – they are used when detecting small pathological changes in the joint, as well as in a lifestyle associated with significant physical exertion.In order for the knee joint to quickly recover and return to normal, it is important to provide it with peace, and for this need a knee orthosis. When you may need a knee pad: All types of knee inflammation – for example, arthritis, bursitis, tendinitis, meniscus inflammation.Please tell me how to choose a knee brace. Knee circumference 36 cm, knee circumference in tension 35 cm, I cannot choose the size between S and M. ORTIX (Natalia). 03.03.2021 10:34:07. Quote. Irina wrote: Good afternoon! Please tell me how to choose a knee brace. The knee circumference is 36 cm, the knee circumference is 35 cm in tension, I cannot choose the size between S and M. leads to wear.During training, the intensity of movements increases many times, and the ligamentous apparatus does not always cope and can limit hypermobility. This leads to injury and damage to the knee joint and – depending on the degree – long or short rehabilitation. Given this, you will have to choose from about 5-6 possible options for knee pads, both open and closed. Closed type. Usually elastic, since its task is to softly fix it on all sides in order to facilitate walking. How to choose knee support by size? When choosing a support, it is important to determine the correct size so that the model fits well the knee without interfering with blood circulation in the lower limb.To do this, measure the circumference of your lower thigh with a tape measure. Keep in mind that the length of the caliper depends on the size of the volume – the larger it is, the longer the bandage. In stores, knee pads are presented in four sizes, broken down by the parameters of the circumference of the lower thigh: S – 33-35 cm, M – 36-38 cm, L – 38-42 cm, XL – 42-46 cm. product. Manufacturers. Is it necessary to use knee pads for pain in the knee joints: analysis of prescriptions depending on the specific diagnosis.How to choose and wear a knee pad for knee pain: tips and tricks. When a person has a backache, then, in addition to using ointments and rubbing, he always tries to provide his back with some additional support: older people are wrapped in a warm woolen scarf, and those who are more modern prefer special bandage belts. But the question is: what to do for those who have pain not in the lower back, but in the knee? Content. What is a knee support, why is it needed? Operating principle.The benefits of a bandage. Types of calipers. Soft. Semi-rigid. Tough. What material is the bandage made of? Tips for choosing a caliper. Manufacturers, cost. Contraindications to use. How to use and care properly? Professional sports involves the use of various auxiliary equipment. The most vulnerable part can be called the knee, which is under high stress during squats, long runs, and many other exercises. Eliminate the likelihood of tra.The knees are some of the most stressed joints in our body. They cushion every step, take on all our weight, and if you put on a backpack, took heavy bags or work out in the gym, then the load increases additionally. Knees experience severe overloads when running, active tourism, and playing sports. But it is in our power to help our own knees. The knee support is used for the prevention of injuries, faster recovery after operations and injuries, and also as support for joint diseases (arthritis, arthrosis, etc.)). Contents: What is a bandage for: benefits. Views. Types of knee braces. How to choose a knee brace? Short description. The knee joint is under tremendous stress and we often have to deal with problems in this part of the leg. These can be injuries of varying severity (sprains, sprains, cracks, fractures) or acute and chronic diseases. During treatment, to ensure optimal conditions for the restoration of the knee joint, an immobilizing bandage is used in the form of various types of bandages (or orthoses).Knee arthrosis. Sports pain syndromes: jumper’s knee, runner’s knee, crow’s foot syndrome and others. Synovitis and bursitis of the knee joint. Instability and tears of the knee ligaments. Increased physical activity on the knees: athletes, people engaged in manual labor. In many cases, a good and properly fitted knee pad reduces the need for medication and promotes quick recovery. Types of knee braces. There are hundreds of knee pads for the prevention and treatment of illness and injury.Each manufacturer strives to invent something new and especially effective. Choose goods for sports and recreation on Ozon.ru. Fast shipping. Free shipping. 24/7 support. New promotions every day. Wide range of. Favorable prices Seller: Ozon.ru online store. Address: Russia, Moscow, Presnenskaya embankment, 10. OGRN: 1027739244741

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Compared to my old Thor Force, Asterisk not only offers an order of magnitude more protection.It is much less hot in them. They don’t slip. After a long adjustment, they do not interfere at all when you are sitting on a mote. It so happened that he inadvertently fell on a slippery surface and injured his knee. I had to go through a long period of recovery after surgery. But my body recovered much faster when I started wearing the Knee Brace amplifier. The doctors were amazed at my quick recovery. The purpose of the innovative Knee Brace is to maximize knee joint stabilization, which is achieved through gentle and gentle pressure on the tendon below the kneecap.This medical accessory helps to shorten the rehabilitation period after a knee injury, sprains and dislocations, is an effective therapeutic agent after surgery, reduces pain, heals and helps a person return to their normal life in a short time.

Knee Healing Ointment

Knee Healing Ointment

Knee joint ointment

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What is knee ointment?

Articulat is perfectly combined with the complex therapy prescribed by the doctor, enhances the effectiveness of other medications.

Effect of the application of the healing ointment of the knee joint

Expert opinion

External creams in the treatment of joint diseases are used from the early stages to complete recovery, at any stage of the disease. Articulat is an effective remedy for stiffness, pain, fatigue, discomfort, spasms and other symptoms that affect the joint and the quality of life of a person. Active substances are directed to improve the structure of joint tissues, increasing bone strength, flexibility and elasticity of cartilage.It has a beneficial effect on the work of muscle tissues, the condition of ligaments and tendons.

How to order

In order to place an order for the knee joint ointment, you must leave your contact information on the website. The operator will contact you within 15 minutes. Will clarify all the details with you and we will send your order. In 3-10 days you will receive the parcel and pay for it upon receipt.

Customer Reviews:

Anya

Cream for joints Articulate has anti-inflammatory, regenerating, antioxidant, stimulating, analgesic function.The drug performs the function of a chondroprotector, antibiotic, analgesic, hormonal substance. The cream combines the properties of the listed drugs. Therefore, you do not have to buy these drugs to restore joints – Articulat cream is enough.

Evgeniya

For the first time I learned about Articulat joint cream from a friend, we visit the gym together and share a lot. During training, I turned my arm awkwardly and slightly injured my elbow joint. I consulted a doctor and applied such a cream twice a day.The pain after application passes quickly, there are no side effects, and after three weeks the joint has recovered. And it’s not expensive.

Useful properties of Articulat ointment saturates inflamed tissues with vitamins and microelements necessary for their restoration; controls the synthesis of synovial fluid; accelerates metabolism in tissues; helps to cleanse structures from slagging; acts comfortably, gradually relieving discomfort. Where to buy Knee Ointment? External creams in the treatment of joint diseases are used, from the early stages to complete recovery, at any stage of the disease.Articulat is an effective remedy for stiffness, pain, fatigue, discomfort, spasms and other symptoms that affect the joint and the quality of life of a person. Active substances are directed to improve the structure of joint tissues, increasing bone strength, flexibility and elasticity of cartilage. It has a beneficial effect on the work of muscle tissues, the condition of ligaments and tendons.

Before treating knee pain, you need to consider what causes it. This determines which type of cream or ointment works best.So, there are such reasons for the appearance of pain. Ointment for pain in the knee joints is the best first aid to reduce swelling, relieve pain, and partially restore cartilage tissue. What ointment to choose is decided by the attending physician. How to choose an ointment to treat knee pain? … Viprosal is prescribed as an ointment for pain in the knee joints, if the patient has arthritis, problems with. Now you know how to treat specific diseases that limit the work of the knees. Effective pharmacy ointments for the treatment of the knee joint.Knee joint pathology is an ailment not only for the elderly, but also for young people. Pain and crunching sensations can appear for various reasons, regardless of gender and age. The unpleasant symptoms are significant. Ointments for pain in the knee joints are local (external) treatment. They are good for relieving pain in case of joint diseases, as well as in case of their injuries. The ointment provides symptomatic therapy – relieving knee pain. It is part of the complex treatment, which is most often.Knee Ointment is a mild dosage form designed to be applied to the skin of the affected knee. Modern pharmacology provides a wide range of drug categories. Indications for the use of ointments for knee pain. Painful symptoms limiting joint mobility can occur in a patient for many reasons. Therefore, before proceeding with adequate treatment, it is necessary to establish the source of the problem and only then proceed to. Ointment for pain in the joints of the hands, knees, back based on chondroitin sulfate…. Helps relieve knee pain due to arthritis of the knee joints. … Does not treat age-related joint diseases. A large list of contraindications. For some, it causes a noticeable burning sensation, redness of the skin. Treatment of the knee joint with ointments. For local exposure to the affected area, gels and ointments are widely used. … In order not to endure knee pain, you need to start therapy in a timely manner after consulting your doctor.

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Knee joint ointment

Articulat is perfectly combined with the complex therapy prescribed by the doctor, enhances the effectiveness of other medications.
Reviews are sorted by creation date. Joint Balm 911 is your service. Is that as a means for pain relief, but not for treatment. … I had severe pain in my joints for two months, I tried different ointments, but they did not help me, and then I began to ask my friends, mine. The best ointment for knee joints: which one to choose for knee pain. … Naturally, the treatment of pathology and the restoration of mobility of the knee joint is necessary.The knee joint is a very vulnerable place. Injuries can also occur in people who do not lead an active lifestyle, but are different. Pharmacy counters are full of names. But not all knee ointments are equally effective. It is necessary to establish a diagnosis and begin therapy with that drug. All treatment, including the ointment for arthrosis of the knee joint, should be prescribed by the attending physician after the diagnosis. … Chondroprotective ointments for arthrosis of the knee joint or other joints are most often recommended for use.According to pharmacists, such drugs penetrate into. We analyzed reviews of joint pain ointments and ranked the best models. … The best ointments for joint pain in the NSAID group. Ointments of the group of non-steroidal anti-inflammatory drugs are designed to relieve pain syndrome provoked by destructive ones. 12 Causes of knee pain. 13 Types of ointments for knee joints. 14 Anti-inflammatory ointments for pain c. The best ointments to treat knee pain. Unpleasant pain sensations and stiffness in the knees are a fairly common reason for a person to turn to.Joints are parts of the human body that carry enormous loads during. Ointments for the treatment of joints are chosen based on the severity of the pain syndrome. In addition, reviews on the Sustamag cream state that it is not dangerous for the gastrointestinal tract, unlike classic drugs based on NSAIDs. Chondroprotectors. 6 The best ointment for arthrosis of the knee joint: a review of drugs, application features and reviews. … All ointments that are present in pharmacies today and help with pain in the shoulder joint or knee can be roughly divided into 4 types: Anti-inflammatory ointments.Preparations for ligaments and joints. Found 596 properties. … 1 review. Body balm in the area of ​​joints KorolevFarm “Zhivokost” with snake venom. … 1 review. Ointment Tula pharmaceutical factory “Gevkamen”. The left knee joint hurts constantly, I even limp. … Hello, local NSAID ointments, such as Nurofen Nise, fastgel, apply to the knee, after the injections, you can continue taking diclofenac inside with omez.

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article at reviews

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What is the article number reviews?

The natural formula of Articulat cream includes extracts and extracts: oils from Siberian fir needles; rosemary; antlers of the Altai maral.It is fortified with vitamin D, calcium, camphor.

Effect of the use of article at reviews

For several years I have been suffering from osteochondrosis of the cervical spine. It is especially difficult to endure the period of spring and autumn. Of course, during this time she adapted and found a remedy for herself that somewhat alleviates the pain. But frankly, that didn’t solve the problem. Having looked on the Internet about the Articulat joint ointment, I bought it and I do not regret it, it relieves pain in a matter of minutes.

Expert opinion

As a chondroprotective drug Articulat provides recovery.The drug blocks the focus of inflammation, activates the supply of chondroitin, collagen, glucosamine, elastin and other necessary components to increase the density of the cartilage layer and its volume. It stimulates an improvement in the quality and quantity of synovial lubrication, which prevents friction and wear. Eliminates the effect of destructive changes that cause cartilage looseness and wear. As a result, the joint regains its former shock-absorbing properties, and the person can walk easily.

How to order

In order to place an order for an article at reviews, you must leave your contact information on the site.The operator will contact you within 15 minutes. Will clarify all the details with you and we will send your order. In 3-10 days you will receive the parcel and pay for it upon receipt.

Customer Reviews:

Tata

I bought

Articulat on the manufacturer’s website, and after 2 days the order was delivered directly home. Considering that I had osteochondrosis for a long time, the fact that the cream eliminated it in 21 days is a real miracle. I didn’t even have to go to the doctors.Excellent tool

Vika

They found a cyst under my knee, the doctor said that he could not do anything, could not get it. I went to another doctor, prescribed Articulat to smear my knee. It became easier somehow at once, in three weeks the pain disappeared altogether. Six months later, it turned out that the cyst miraculously resolved! Where to buy article at reviews? As a chondroprotective agent, Articulat provides recovery. The drug blocks the focus of inflammation, activates the supply of chondroitin, collagen, glucosamine, elastin and other necessary components to increase the density of the cartilage layer and its volume.It stimulates an improvement in the quality and quantity of synovial lubrication, which prevents friction and wear. Eliminates the effect of destructive changes that cause cartilage looseness and wear. As a result, the joint regains its former shock-absorbing properties, and the person can walk easily.

The drug Articulat receives positive reviews because it helps to remove. Negative reviews about Articulat. Igor, 32 years old: I bought for my wife, especially recently she began to complain of severe joint pain.Reviews. Today on the Internet you can find only advertising articles about Articulate, flavored with dozens of fake positive reviews. However, just like us, some are trying to warn about divorce. Add review All reviews: 28. Reviews (28) Where to buy Photo gallery. … Hello! I also ordered an ointment. Then I came across reviews. And I refused. Now they are intimidatedCan they sue me? to answer. Please write your review or comment. The VseAfery.ru website does not collect, process or store information about users, so all comments are posted without registration! To protect against spam and.Date of last revocation: 04 November 2020. Articulat is the latest development of scientists aimed at treating the spine and joints. Some reviews write that Articulate does not work. … The manufacturer analyzed some of the real negative reviews, and named several main reasons for their appearance. ✅ Official site of the cream for joints Articulat: reviews of doctors, divorce or truth. Where to buy Articulat: the price in the pharmacy and from the manufacturer. For this reason, many buyers in their real reviews are interested in which pharmacies in Moscow can buy Articulat.Composition of the drug Articulat. The formula for the preparation of Articulat gel contains proven. The manufacturing company presented the ARTICULAT joint cream to the public. This is a drug, the main purpose of which is targeted treatment and preventive measures of musculoskeletal ailments. Therefore, many people recommend ordering Articulat, and you can make sure of the effectiveness of the product by reading reviews on the Internet. Reviews. A plant-based product is in demand. It is acquired by people who are faced with dysfunction of the joints.Articulate is not a Divorce! Price, reviews, instructions for use, where to buy Articulat in the pharmacy? This article provides the most complete information about such a drug as Articulat for joints. For the best. Article: AT-12/30 (black). Product code: 771493. stabilized, 50 Hz 100.240 V, output. Comes as a gift with: Reviews ↓. Short description All characteristics. Description.

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For several years now I have been suffering from osteochondrosis of the cervical spine. It is especially difficult to endure the period of spring and autumn. Of course, during this time she adapted and found a remedy for herself that somewhat alleviates the pain.But frankly, that didn’t solve the problem. Having looked on the Internet about the Articulat joint ointment, I bought it and I do not regret it, it relieves pain in a matter of minutes.

article at reviews

The natural formula of Articulat cream includes extracts and extracts: oils from Siberian fir needles; rosemary; antlers of the Altai maral. It is fortified with vitamin D, calcium, camphor.

Reviews are sorted by creation date. Joint balm 911 is your rescue service Sabelnik…. The balm really works, but they have better ones. Despite my age, my knees sometimes bother me and then these gels help me out a lot. I have known this company for a long time and I can do it. My father’s joints ache terribly, knees, elbows, swell, the pain cannot be relieved by anything, that’s all. can I get a wedge in the conversation about the joints. my husband has pain in his elbows and hands. we believe this is a professional illness (he is a system administrator). what is the best way to smear and which doctor to turn to ?. rheumatologist? surgeon.The knee joint and the joints on the fingers began to hurt. … Hello everyone today, my review of chondroxide ointment for joints. Not long ago, I did not successfully fall at the stadium while playing football, injured my leg, did not go to the hospital and decided to be treated with ointments I found on the Internet. Read full review Review. The best ointment for knee joints: which one to choose for knee pain. Content. … Synthetic factory products. Finalgon has good reviews, especially among the elderly, as well as athletes. It helped her a lot from joint pain.Reviewed by: Kira. Date of withdrawal: 12 July. The pain in my knee was very painful. That just did not try. This balm helped. … It will be rather weak for joints during an exacerbation, but as a preventive or auxiliary agent, it is perfect, slightly warms up and. Girls, who was prescribed what for joint pain? … Of course, you cannot start problems with joints, since the consequences can be irreversible. … The knees do not bother as much as they used to, and can walk normally, even over longer distances.Wow, I didn’t even know about that. What is the most effective knee ointment. The list of creams and gels with a warming effect, chondroprotectors, anti-inflammatory. … The best ointment for knee joints to choose for pain in knee joints. Table of contents. 1 What ointments are indicated for elderly patients? Ointment for arthritis of the knee joint, elbow, finger joints should help in the treatment of the disease. … Chondroprotective ointments for arthrosis of the knee joint or other joints are most often recommended for use.According to pharmacists, such agents penetrate the joint and. Ointments will not help much; in order to relieve pain, you need to change the metabolism and remove all salts and all microorganisms that have led. No ointment will help.