1.
Patella Alta
This is where the kneecap sits higher than normal. Treatment is similar to #3 above, but at the time of surgery, the knee-cap is moved closer to the shin bone.
Symptoms
Often similar to malalignment, though catching can be more prominent.
2.
Chondrosis
This is chondromalacia or damage to the cartilage either on the back of the kneecap or of the corresponding cartilage at the bottom of the thigh bone that the kneecap rubs on, or in both areas. This can result from malalignment, a blow to the kneecap such as falling on the kneecap or hitting it on a dashboard. In some people it occurs without any injury or malalignment.
Symptoms
Similar to malalignment
Damage to Cartilage = Chondrosis
Treatment
Nonoperative
This can include stretching and strengthening exercises, physical therapy, cortisone injections, or anti-inflammatory medications taken by mouth.
Operative
Patients who do not respond to nonoperative treatment undergo arthroscopic surgery where the cartilage is shaved. If there is very severe damage, they will have a tibial tubercle osteotomy and anteriorization.
3.
Plica
Painful snapping and catching of the knee. Most people have bands of tissue in the knee. Sometimes these bands swell due to injury or they get jammed between the kneecap and thigh bone (like biting the side of your cheek). This is common in teens through 30 years of age.
Treatment
Initially is physical therapy, but those who don't get better have arthroscopic surgery. This is outpatient surgery and generally gives good results. Patients can walk on the knee right away after surgery.
4.
Osteochondritis Dissecans
Most common in teenagers and occurs when a segment of cartilage and the underlying bone in the knee lose blood supply and can break loose.<>/font
Treatment
In very early cases, treatment is rest. More commonly, arthroscopic surgery is required. At surgery, the piece is either drilled, removed or screwed back into position. Occasionally, a bone graft is applied.
Symptoms
Pain
Jamming of the knee
5.
Osgood-Schiatter's Disease
This is common in physically active teenagers. A little bump forms where the tendon from the kneecap (patella tendon) goes into the tibia (shin bone). A problem is caused when the muscle pulling on the tendon gets stronger than the bone the tendon attaches to, causing it to separate from the underlying growth plate and making a painful bump. When growth stops (usually between ages 15 and 17), the growth plate becomes strong and pain will disappear. The bump, however, will remain, and sometimes it is necessary to surgically remove it. Occasionally, the separation becomes complete before growth stops, which necessitates surgery at an earlier age.
6.
Hoffa's Disease
This is when the normal fat pad that is behind the patella tendon (tendon attaching the kneecap to the shin bone) becomes swollen and enlarged causing pain and inability to partake in normal sporting and other physical activities.
Treatment
Rest, anti-inflammatory medication, physical therapy and cortisone injection. Occasionally, if symptoms persist, treatment will be arthroscopic surgery to excise the enlarged part of the fat pad.
7.
Jumper's Knee
This is tendonitis of the patella tendon. It is common in athletes.
Treatment
Rest, stretching the tendon, physical therapy and anti-inflammatory medication.
8.
Other Causes of Pain
Other causes of pain in front of the knee include patellofemoral arthritis, tumors, bipartite patella (which is where the knee-cap that is normally one bone is two bones), synovitis (inflammation of the lining membrane of the knee) and bursitis (inflammation of the fluid filled cavities about the knee). Also pain in the knee can actually come from the hip. This needs to be watched out for in the early teens, particularly in overweight patients.
Check these links for more information concerning specific types of knee problems:
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Chondromalacia patella
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Other causes of knee pain
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Anterior cruciate ligament
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Other ligament injuries
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Advantages of arthroscopic surgery
