Other ligaments are less commonly injured. The medial colateral ligament (ligament on the side of the knee closest to the opposite knee) can be injured along with the cruciate ligament, but this generally does not require surgery. Ligament injuries on the outside of the knee can be more serious and require an open surgery.
Meniscus
This is a piece of cartilage that separates the shin bone from the thigh bone. It is important in weight transfer and stability and is frequently injured. Mechanism of Injury: In young people it takes relatively major trauma such as an athletic injury to damage the meniscus. As we age, relatively minor injuries such as walking and stopping suddenly, twisting or squatting can tear the meniscus.
Symptoms
* Pain
* Swelling
* Locking
Positive Tests
* Tenderness over the inside of the joint line
* McMurray test
* Swelling in the knee
Treatment
Generally in people who are symptomatic, arthroscopic surgery is the treatment of choice. In young people, sometimes it is possible to repair the meniscus, but the majority have the torn portion excised.
Results
If there is no chondral damage (that is no damage to the cartilage on the end of the bones), early results are usually excellent. There is a risk that many years later degenerative joint disease can develop. Generally speaking, the more cartilage that has to be removed, the greater the chances of getting degenerative joint disease. If there is chondral damage at the time of surgery, the recovery is usually not as complete, takes longer, and people tend to get occasional aching and swelling in the knee. This is outpatient surgery, and you can walk right away on the knee.
Degenerative Joint Disease
Degenerative Joint Disease is a form of arthritis. It can occur on its own or as a result of a previous injury. It is usually gradual in onset. It is rarely seen before the age of 30. It is more frequent as one gets older.
Treatment
Nonoperative
Nonoperative treatment includes decreasing activities, taking oral anti-inflammatory medication, a cortisone injection into the knee, physical therapy and wearing rubber-heeled shoes.
Operative
1. Arthroscopic surgery can be very useful if there is a definite mechanical problem such as a torn meniscus. If no acute problem has occurred, arthroscopic surgery has been shown to give satisfactory relief of pain for 3 years in 70% of people.
2. High Tibial Osteotomy: This means cutting the shin bone and bending it towards the outside so that the weight is taken off the inside of the knee and placed on the outside of the knee. This is very useful for patients who have most of their problem on the inside of the knee, and the outside of the knee is relatively healthy. This surgery does require a hospital stay of a day or two and a regular incision in addition to arthroscopy.
Symptoms
* Pain
* Deformity
* Decreased range of movement
* Grinding
* Swelling
* Locking
3. If arthritis of the patellofemoral joint (the joint between the kneecap and the thigh) is the major problem, then the bone where the patella tendon goes into the shin bone will be brought forward or elevated to try and decrease the pressure on the back of the kneecap.
4. Knee Replacement: In severe cases, total knee replacement gives very satisfactory results. This is done very infrequently below the age of 50. After having had a knee replacement, one is not supposed to run on the knee, although sports such as golf, bike riding, and swimming are appropriate. Full range of movement of the knee is not restored by knee replacement, but pain relief is generally excellent.
Synovitis
Synovitis (inflammation of the lining membrane of the knee) can be the result of an injury, in which case it will often get better with physical therapy, anti-inflammatory medication and cortisone injections. It can result from degenerative joint disease or chondrosis, and the same type treatment is often successful. It can also result from rheumatoid arthritis. Where nonoperative means fail, and particularly in rheumatoid disease, arthroscopic excision of the inflamed synovium can give very good relief, often for many years.
Symptoms
* Pain
* Swelling
* Stiffness
Loose Body
Loose body is when a small piece of cartilage or bone breaks off and is loose in the knee like a pea or a marble. With time it can grow bigger, acting kind of like a pearl. Unfortunately, it will cause intermittent pain due to locking, jamming, or giving out, and swelling. Arthroscopic removal is usually a relatively minor surgery performed as an outpatient and gives excellent results. Results can be compromised depending on the initial cause of the loose body.
Symptoms
* Movable knot can sometimes be felt in the joint
* Pain
* Swelling
* Giving Out
RSD
RSD (Reflex Sympathetic Dystrophy) is a condition of the knee which can result on its own, or often follows a minor injury, and sometimes follows a surgery. It is where the nerves and vessels in the leg are adversely affected. The knee becomes chronically painful. The skin feels cold and sweaty. It is very important, in these conditions, to keep the knee moving. Sometimes just physical therapy and medication will be enough; often it is necessary to use a CPM (continuous passive motion machine), which keeps the knee moving. RSD is sometimes helped by a longterm spinal anesthetic in the hospital. This disease can take months or longer to clear up.
Baker's Cyst
Patients are often very concerned to hear they have a Baker's cyst. Often Baker's cyst is the result of a problem in the knee that causes swelling. The "soft" part of the knee is at the back, so the fluid goes out the back and can form a cyst. Often, the cyst is not removed; rather, one pays attention to finding out the cause of the cyst in the knee and fixes that. The cyst, takes care of itself.
Symptom
* Swelling or a knot behind the knee
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 
