WhatsAppDiagnosis, Surgical Treatment and Return to Sport for the Knee Joint
The Academic Hospital Sports and Knee Injuries Department diagnoses and treats knee joint injuries and degenerative knee diseases in a wide patient group, from athletes to active older adults. With a full-spectrum treatment approach covering arthroscopic (keyhole) surgery, meniscus repair, ligament reconstruction, cartilage repair and knee replacement, the department aims to help patients return safely both to daily life and to sport. Rehabilitation and return-to-sport protocols are planned together with surgery.
Contents
What Are Sports and Knee Injuries?
Sports and knee injuries is the subspecialty of orthopaedics that focuses on the diagnosis and treatment of acute traumatic and chronic degenerative conditions affecting the ligaments, menisci, cartilage and bone structures surrounding the knee joint. The knee is the largest and most heavily loaded joint in the body, and it is frequently injured during sporting activities through sudden twisting, collision or jumping movements. In addition to sports injuries, the field covers the non-surgical and surgical treatment of damaged structures, as well as age-related cartilage wear and osteoarthritis (wear-and-tear arthritis).
Which Diseases and Conditions Are Treated?
- Anterior cruciate ligament (ACL) tear: one of the most common sports injuries, occurring during a sudden twist or a fall
- Posterior cruciate ligament (PCL) injury: usually caused by a direct blow
- Medial collateral ligament (MCL) injury: stretching and tearing of the ligament on the inner side of the knee
- Lateral collateral ligament (LCL) and posterolateral corner injuries
- Meniscus tears: of the inner (medial) and outer (lateral) meniscus; radial, longitudinal (bucket-handle) and horizontal types
- Patella (kneecap) fracture and kneecap dislocation (medial patellofemoral ligament (MPFL) rupture)
- Patellofemoral pain syndrome: pain caused by the kneecap rubbing against the thigh bone
- Cartilage damage (osteochondral defect): focal loss of cartilage and subchondral bone
- Knee osteoarthritis (wear-and-tear arthritis): a degenerative disease that develops as the joint cartilage wears away
- Patellar tendon and quadriceps tendon tears
- Bursitis and plica syndrome (inflammation of a fold in the lining of the knee joint)
- Tibial plateau fractures (fractures of the tibia involving the knee joint surface)
When Should You Consult Us?
The following symptoms call for a visit to the Sports and Knee Injuries Department:
- A sudden "popping" sound during sport followed by swelling of the knee: this should be assessed for an ACL tear
- Difficulty putting weight on the knee or a feeling of the knee "giving way" (instability)
- Pain around the kneecap when going down stairs, squatting or getting up from a seated position
- Locking of the knee or being unable to fully straighten or bend it: this may be a sign of a meniscus tear
- Morning stiffness and pain that eases with rest: consistent with osteoarthritis
- Recurrent knee swelling and pain after sport
- Visible deformity of the kneecap or its displacement to the outside (laterally) (patellar dislocation, that is, kneecap dislocation)
- Severe pain, swelling and inability to walk after an injury: emergency assessment is needed
In acute injuries such as a kneecap dislocation or a serious ligament injury, go to the emergency department; for other complaints, an outpatient appointment is sufficient.
Diagnostic Methods
| Method | What it is used for |
|---|---|
| The basic initial imaging for assessing joint space narrowing, osteoarthritis and bone pathology. Radiographs taken while bearing weight give more realistic information in osteoarthritis. | |
| The gold standard for assessing ACL, PCL, meniscus and cartilage damage; it is used for treatment planning before surgery. | |
| Used for the dynamic assessment of tendon and ligament injuries, for detecting fluid inside the joint and for guiding injections. | |
| Provides additional information for the three-dimensional assessment of tibial plateau fractures, the femur and the patella, and for the detailed examination of joint surface pathologies. | |
| Diagnostic arthroscopy may be performed in cases that cannot be confirmed by imaging; treatment can also be carried out in the same session. (Meniscus tears, cruciate ligament and cartilage pathologies) |
Treatment Approaches
Arthroscopic ACL Reconstruction
A torn anterior cruciate ligament does not heal on its own; in active patients, surgical reconstruction is the standard treatment. The ligament is rebuilt using grafts taken from the patient's own tissue (autograft: patellar tendon, hamstring, quadriceps tendon, peroneal tendon) or donor grafts (allograft). The procedure is performed arthroscopically and requires an overnight stay; rehabilitation takes 6-9 months. With appropriate surgery and rehabilitation, people can return to their sporting life.
Meniscus Repair and Meniscectomy
Meniscus treatment is determined by the type of tear and the patient's age:
- Meniscus repair: Arthroscopic suture repair in younger patients and in tears located in a zone with a suitable blood supply; by preserving the meniscus, it helps prevent cartilage damage in the long term.
- Partial meniscectomy: In tears that cannot be repaired or are advanced, only the damaged part is removed arthroscopically.
Cartilage Repair
Methods used for focal cartilage defects on the joint surface of the knee:
- Mosaicplasty (osteochondral autograft transfer): Small cylinders of bone and cartilage taken from a non-weight-bearing area are placed into the defect.
- Matrix-assisted autologous chondrocyte implantation: The patient's own cartilage cells are multiplied in the laboratory, loaded onto a biomembrane and placed into the defect; this method is preferred for large defects.
- Microfracture: In small defects, holes are made in the subchondral bone to stimulate the healing process.
PRP and Viscosupplementation
Non-surgical treatment options for mild to moderate osteoarthritis and cartilage damage include PRP (platelet-rich plasma) and stem cells, which aim to reduce inflammation and enhance the healing of damaged tissue, and hyaluronic acid injection (viscosupplementation, which mimics joint fluid, improves joint movement and nourishes the cartilage).
Knee Replacement
In advanced knee osteoarthritis, or where the cartilage has been destroyed over a wide area, total knee replacement (replacement of the entire joint surface) or partial (unicondylar) knee replacement is performed. With modern implants, the great majority of patients can maintain a pain-free and active life for 15-20 years. Patients can start walking and going up and down stairs the day after surgery.
Return-to-Sport Protocol
After surgical treatment, structured rehabilitation and return-to-sport protocols are applied. After ACL reconstruction, athletes who pass functional tests (strength symmetry, hop tests) and have completed their psychological preparation return to sport after an average of 9-12 months.
Book an appointment with the Academic Hospital Sports and Knee Injuries Department.
Book an AppointmentSports and Knee Injuries at Academic Hospital
At the Academic Hospital Sports and Knee Injuries Department, the diagnosis of knee injuries, the non-surgical and surgical treatment options, and postoperative rehabilitation and the return to sport are planned together. The department works with the following departments throughout this process:
- Orthopaedics and Traumatology: assessment and treatment of bone and joint injuries outside the knee
- Hip and Knee Replacement Surgery: planning of replacement surgery in advanced knee osteoarthritis
- Physical Medicine and Rehabilitation: rehabilitation before and after surgery and non-surgical treatment programmes
- Sports Medicine: assessment of athletes, functional testing and follow-up of the return to sport
- Radiology: knee X-ray, magnetic resonance imaging, ultrasonography and computed tomography examinations
- Sports Psychology: psychological preparation for returning to sport after an injury
- Emergency: initial assessment of acute injuries such as kneecap dislocation and serious ligament injury
Frequently Asked Questions
References
The general information given on this page about knee injuries, diagnostic methods and treatment approaches is supported by the reliable health sources listed below.
- American Academy of Orthopaedic Surgeons, "Anterior Cruciate Ligament (ACL) Injuries", orthoinfo.aaos.org
- Mayo Clinic, "Meniscus Tear: Diagnosis and Treatment", mayoclinic.org
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, "Sports Injuries", niams.nih.gov
- NHS, "Knee Ligament Surgery", nhs.uk
The information on this page is for informational purposes only; it does not replace medical examination, diagnosis or treatment. Please consult a healthcare institution regarding your complaints.
