While knee pain is a common complaint doctors hear, the causes aren't always so common. If you suffer chronic knee pain and conservative treatments for the usual causes of knee pain offer little or no relief, your knee doctor will begin looking for rarer sources that may be causing your pain and any mobility impairment.
Tibial Collateral Ligament Bursitis
This condition can be the cause of medial joint pain in the knee. Since the tibial collateral ligament bursa is located underneath the ligament that sits on the inside of the knee joint, if the bursa becomes irritated, symptoms including pain, tenderness, and decreased knee movement and function can occur.
Treatment includes icing and applying heat, taking nonsteroidal anti-inflammatory medications, completing stretching and range-of-motion exercises, and wearing a compressive knee sleeve when exercising. In some cases, a knee doctor may recommend corticosteroid injections to reduce inflammation.
Sometimes referred to as stiff knee syndrome, anthrofibrosis is an inflammatory condition that causes excess scar tissue to build up in and around the knee joint. Frequently a complication of ACL (anterior cruciate ligament) reconstruction surgery, the condition can be debilitating and difficult to treat. The condition is also the most common complication following total knee replacement, occurring in about 10 percent of cases.
Symptoms of anthrofibrosis include worsening pain following surgery, limited range of motion, swelling around the knee, weakness in the muscles of the front of the leg, and walking with your knee bent. Treatment includes manipulation of the knee under anesthesia to break up scar tissue or arthroscopic surgery to remove scar tissue. If your case is severe, you may require more invasive open surgery after which you will receive physical therapy for a time.
Also known as fat pad impingement, Hoffa's syndrome is characterized by inflammation and swelling of the infrapatella fat pad which is located behind and under the patella bone (kneecap). A fall or blunt force impact to the area can cause the bottom front of the kneecap to pinch the fat pad.
Standing for long periods of time or other activities, such as jumping, that require extending or straightening the knee can make the pain worse. Treatment generally includes applying ice to the area, rest, and physical therapy. In rare cases, you may need surgery to remove part or all of the fat pad.
Infrapatellar Contracture Syndrome
Although an uncommon condition, infrapetellar contracture syndrome can cause knee stiffness and decreased range of motion in the knee joint following knee surgery or an injury to the knee. The condition sometimes develops as a result of prolonged immobility – particularly lack of knee extension – following surgery.
Treatment includes rehabilitative therapies to return knee range of motion to normal. In more severe cases, arthroscopic or open debridement to remove debris around the knee joint is used along with physical therapy to restore movement.
Soft Tissue Tumors
While there are many types of soft tissue tumors – most of which develop in the arms or legs – not all these tumors are malignant. However, adult fibrosarcoma is a type of soft tissue sarcoma, or cancerous tumor, that affects connective tissue, including in the legs.
Symptoms include a lump that grows in an arm or leg. Although the cause is unknown, the disease can occur at any age. A family history of cancer syndromes, chronic lymphedema or other damage to the lymph system, or radiation therapy to treat other types of cancers are risk factors for developing a soft tissue sarcoma.
Treatment includes chemotherapy to shrink the tumor, surgical excision of the tumor, and preoperative or postoperative radiation therapy.
For more information, contact Pottstown Surgical Associates or a similar organization.