The knee carries three to four times body weight with every step, and considerably more on stairs. Its problems fall into two families: traumatic injuries, which mainly affect younger and sporting patients, and degenerative disease, dominated by osteoarthritis.
What the symptom tells you
Where and how the knee hurts has real diagnostic value. Joint line pain on twisting and squatting points to the meniscus. A distinct pop at the moment of injury with swelling within hours points to the anterior cruciate ligament. Pain around the kneecap on descending stairs and after prolonged sitting points to the patellofemoral joint. And true locking — an inability to fully straighten the knee — means a mechanical block inside the joint.
The MRI trap
MRI shows degenerative meniscal tears in a very large proportion of asymptomatic adults over forty. The finding is not the same as the cause of pain, and this is precisely why so many arthroscopies performed in the past did not help. Imaging is always read alongside the clinical picture.
From conservative care to surgery
Quadriceps and hip abductor strengthening, weight reduction and low-impact activity have stronger evidence behind them than any other intervention in knee arthritis. Surgery enters the conversation when those have been exhausted, or when there is a mechanical problem that cannot be solved any other way.
Conditions of the knee
See also the knee surgery techniques, from arthroscopy to robotic-assisted replacement.
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