Knee problems

Knee problems are very common and cover a wide range of conditions. Osteoarthritis of the knee is the most common joint disease in older people, while ligament injuries and meniscal injuries are among the most common injuries in athletes. An estimated one in five Finns over the age of 45 has some degree of knee osteoarthritis.

The most typical symptoms are pain in the knee, swelling, stiffness especially in the morning or after prolonged sitting, and reduced mobility. In osteoarthritis, the pain worsens on stairs and uneven ground. In an acute injury, such as an anterior cruciate ligament tear, the knee may give way and swell rapidly. With a meniscal injury, the pain is often located on the inner or outer side of the knee.

In young athletes, the most common cause is acute trauma, such as a contact injury or a jump-landing injury, which may damage the anterior cruciate ligament, meniscus or ligaments. In middle-aged and older people, the most common cause is progression of osteoarthritis due to wear of the cartilage surface. Risk factors include overweight, repetitive movements, previous knee injuries and a hereditary predisposition to osteoarthritis.

Diagnosis is based on a clinical examination, including measurement of mobility, stability testing and pain provocation tests. X-ray shows narrowing of the joint space in osteoarthritis, while MRI is needed to identify soft tissue injuries such as meniscal or cruciate ligament damage. An orthopedist or sports medicine specialist assesses the need for surgical treatment.

Conservative treatment is first-line both in osteoarthritis and in many acute injuries: physiotherapy, strengthening of the thigh muscles, weight management and, if needed, anti-inflammatory painkillers or corticosteroid injections. An ACL tear can be treated conservatively in less active patients or surgically with arthroscopy in athletes. In osteoarthritis, joint replacement surgery is a highly effective treatment when conservative care is no longer enough.

The prognosis is generally good when treatment is started early. Physiotherapy after surgery is essential for restoring function. Pain in the knee area should not be ignored if it lasts longer than a month, if the knee swells repeatedly, or if walking ability declines.