Knees and Hips

How can I relieve knee pain from chondromalacia?

DEAR DOCTOR K: I saw my doctor because of aching pain in my knee, which sometimes buckles unexpectedly. He says I have chondromalacia. What is this, and what can I do to relieve the pain?

DEAR READER: The joints in your body are cushioned by cartilage. This tough, rubbery tissue covers and protects the ends of bones inside a joint, allowing them to glide smoothly against one another as the joint moves. With chondromalacia, the cartilage inside a joint softens and breaks down. The ends of the bones can rub together, causing pain. Chondromalacia can affect any joint, but the most common location is inside the knee, see the illustration on the right.

What is a Baker’s cyst and how is it treated?

DEAR DOCTOR K: I just found out I have a Baker's cyst. Is it serious? How is it treated?

DEAR READER: A Baker's cyst is a fluid-filled sac that can form in the popliteal space, the hollow at the back of the knee joint. A Baker's cyst is filled with synovial fluid, a viscous material that lubricates the knee joint. I spoke to my colleague Dr. Celeste Robb-Nicholson, associate professor of medicine at Harvard Medical School, about this condition.

What is knee bursitis and how do I relieve my discomfort?

DEAR DOCTOR K: I have knee bursitis. What is bursitis? What can I do to relieve my discomfort?

DEAR READER: A bursa is a sac-like structure that sits over large joints such as the knee or hip joints. Bursae act as cushions between muscle and bone and reduce friction during movement. When a bursa becomes painful or inflamed, the condition is called bursitis. The symptoms of knee bursitis include pain made worse by movement of the knee, but which is still present even when the knee is not moving.

I have knee osteoarthritis. Are there exercises that could relieve my pain?

DEAR DOCTOR K: I have knee osteoarthritis. Are there exercises that could relieve my pain?

DEAR READER: As a fellow sufferer, I know that joint pain from osteoarthritis can really interfere with life. Since putting pressure on the joint can make it hurt more, you might think that exercises would only make the pain worse, and so you might be tempted to avoid exercising altogether.

If my joints hurt does that mean I have osteoarthritis?

DEAR DOCTOR K: My joints hurt. Does that mean I have osteoarthritis?

DEAR READER: Your knee aches from time to time, or maybe your fingers don't seem as nimble as they used to be. That doesn't mean you have osteoarthritis -- but you might.

There are many different kinds of arthritis. They all damage the cartilage, the flexible tissue lining joints. Every joint is a spot where two (or more) bones meet. The cartilage in a joint keeps bone from rubbing against bone.

I need a double knee replacement — should I have both replaced at one time, or separately?

DEAR DOCTOR K: I have severe osteoarthritis in both knees. Should I have both knees replaced at one time, or separately?

DEAR READER: Knee replacement is a major operation and requires a hospital stay. During the procedure, the surgeon removes damaged sections of your shin bone and thigh bone. He or she carefully cuts the bone to precisely fit the shape of the replacement implants, then attaches the artificial joint at the knee.

Do I need treatment for a torn meniscus in my knee, even if I’m not in pain?

DEAR DOCTOR K: I'm 72 years old. I've had left knee pain on and off for several months. My doctor sent me for an MRI of both knees. It showed "mild to moderate osteoarthritis" in both knees and a torn meniscus in my right knee, which feels fine. Do I need to do anything about the torn meniscus in my "good" knee?

DEAR READER: The meniscus is a crescent-shaped disk of fibrous tissue and cartilage. Each knee has two menisci located between the thighbone (femur) and the lower leg bone (tibia). In older people the meniscus becomes more prone to injury; it can tear for no apparent reason.

Are there exercises I can do to relieve my knee pain?

DEAR DOCTOR K: I have pain in my kneecap, right in front of my knee. It hurts to walk down the stairs or even sit for too long. What can I do?

DEAR READER: It sounds like you have what is called patellofemoral pain. That's pain where your kneecap (patella) meets your thighbone (femur). It usually results from overdoing exercise. Fortunately, there's a lot you can do to prevent and relieve this pain.

Do I need surgery for a torn ACL?

DEAR DOCTOR K: I tore my ACL. Is surgery inevitable?

DEAR READER: The anterior cruciate ligament (ACL) is a band of tissue that runs through the middle of the knee joint and keeps the shinbone from sliding forward past the thighbone. The ACL can tear during a sudden or awkward twist, turn or stop. More often than not, it's these non-contact injuries that injure an ACL. Between 100,000 and 200,000 ACL injuries occur each year in the United States.