Anterior cruciate ligament (ACL) injuries

A ligament is a structure that spans a joint from bone to bone to provide stability. The anterior cruciate ligament (ACL) is one of 4 major stabilisers of the knee joint and slightly unusually for a ligament, it is situated in the centre of the joint. It has a major role in providing support for knee rotational movements.

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Medial Collateral Ligament

The medial collateral ligament (MCL) is situated along the inner (medial) side of the knee. It stretches as a band between its attachments on the femur (thigh bone) down onto the tibia (shin bone). The primary role of the MCL is to stabilise the knee joint against forces pushing the knee inwards.

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Patellofemoral instability (kneecap dislocation)

The patellofemoral joint consists of the meeting area and articulation between the patella (kneecap) and the front of the femur (thigh bone) called the trochlea.

This area of the knee joint is very important in transmitting the force from the big thigh muscle (quadriceps) across the knee joint. It can become troublesome after an injury or when an individual’s natural anatomical make up makes it inherently more unstable.

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Anterolateral ligament (ALL) / complex

This is relatively controversial topic that is undergoing continued investigation and study. It is a region on the lateral (outer) side of the knee that seems to work in conjunction with the anterior cruciate ligament (ACL) to control the rotational movement at the knee joint.

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Osteoarthritis

Osteoarthritis (OA) is the commonest form of chronic arthritis to affect joint function and is often simply referred to as “wear and tear”. This means that the normal smooth and low friction surfaces of the joint have steadily worn down and the natural ability of the joint to share and absorb shock and loads decreases.

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Posterior Cruciate Ligament

A posterior cruciate ligament (PCL) tear is a more unusual injury than the anterior cruciate ligament (ACL). The PCL is situated towards the back of the knee joint and similarly to the ACL spans the knee joint from femur to tibia. It is a bigger ligament than the ACL and appears to be much harder to tear.

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Patellofemoral pain

The patellofemoral joint (PFJ) is at the front of the knee and is formed between the meeting of the back of the patella (kneecap) and the trochlea (front of the femur). It is a very important part of the knee for good function and a complex area.

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Miscellaneous conditions

There are several other conditions which we frequently see around the knee. These can include; tendinopathies (quadriceps or patella tendons), tendon ruptures, bursal pathology, bone pathology and pes anserine bursitis. The appropriate management of these conditions can be discussed.

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A Meniscal Cartilage tear

The meniscus is often simply referred to as “a cartilage”. They are made of a tough and robust material called collagen but can be damaged through injury or as part of a degenerative process. The knee contains 2 meniscal cartilages, the inner (medial) and the outer (lateral) and they are best thought of as shock absorbers.

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Lateral collateral ligament and posterolateral corner injuries

The stabilising structures on the outer (lateral) side of the knee form a very complicated arrangement but fortunately it is relatively unusual to damage them extensively. They include the lateral collateral ligament (LCL), popliteal tendon, popliteofibular ligament, the long head of biceps attachment and more. Injury can also sometimes involve damage to an important nerve called the common peroneal nerve.

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Articular cartilage / chondral injuries

The articular cartilage is a specialised protective layer over the bone ends within a joint. The term “chondral” is often used to refer to this cartilage. It has a role in spreading load and can be thought of as a low friction and smooth surface to allow the gliding motion to occur between the bones.

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