Left Knee Pain: Causes, Treatments, and Surgery Options

Left knee pain?

Hello, doctor: I have been experiencing pain in my left knee since the beginning of this year.
I visited the orthopedic department at Chang Gung Memorial Hospital, where they diagnosed me with a ligament injury.
An X-ray showed that there is a bone fragment present.
On rainy days, the pain becomes sharp and achy, and medication has not been effective.
Is surgery an option?

Jia, 10~19 year old female. Ask Date: 2002/12/24

Dr. Luo Zhongwei reply Orthopedics

Dear Jia,
(1) The diagnosis you mentioned, "ligament injury," does not exist as a medical term.

(2) The X-ray shows a bone, but its exact location in the knee can only be determined by reviewing the X-ray film in person.

(3) There are many potential causes for knee pain, and a personal examination is necessary for differential diagnosis.
I recommend seeking opinions and explanations from multiple physicians to accurately identify the underlying cause and provide appropriate treatment.

Reply Date: 2002/12/24

More Info

Left knee pain can be a complex issue with various underlying causes, and understanding these can help in determining the appropriate treatment options, including the possibility of surgery. Based on your description, it seems that you have been experiencing persistent pain in your left knee, which has been exacerbated by weather changes and has not responded well to medication.

Causes of Left Knee Pain
1. Ligament Injuries: As you mentioned, a ligament injury, such as a sprain or tear of the medial collateral ligament (MCL) or anterior cruciate ligament (ACL), can lead to significant pain and instability in the knee. These injuries often occur during sports or physical activities that involve sudden stops or changes in direction.

2. Meniscus Tears: The meniscus is a cartilage structure that acts as a cushion between the femur and tibia. A tear in the meniscus can cause pain, swelling, and difficulty moving the knee. Symptoms may include a locking sensation or a feeling of instability.

3. Patellar Issues: Conditions such as patellar tendinitis or patellofemoral pain syndrome can cause pain in the knee, particularly around the kneecap. This pain may worsen with activities that involve bending the knee, such as climbing stairs or squatting.

4. Osteoarthritis: This degenerative joint disease is common in older adults and can lead to pain, stiffness, and swelling in the knee. It is characterized by the breakdown of cartilage, leading to bone-on-bone contact.

5. Bursitis: Inflammation of the bursae (small fluid-filled sacs that cushion the knee joint) can result in pain and swelling, particularly on the outer side of the knee.

6. Bone Fractures: A fracture in the knee area, such as a Stieda fracture or other bone injuries, can cause severe pain and may require surgical intervention.

Treatment Options
1. Conservative Management: Initially, conservative treatments are recommended. This includes rest, ice application, compression, and elevation (RICE). Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation.

2. Physical Therapy: Engaging in physical therapy can strengthen the muscles around the knee, improve flexibility, and enhance stability. A physical therapist can design a tailored exercise program to address your specific needs.

3. Injections: Corticosteroid injections can provide temporary relief from inflammation and pain. In some cases, hyaluronic acid injections may be considered to lubricate the joint.

4. Surgery: If conservative treatments fail to alleviate symptoms, surgical options may be explored. Common procedures include arthroscopy to repair or remove damaged cartilage, ligament reconstruction, or, in severe cases, knee replacement surgery.

When to Consider Surgery
Surgery may be indicated if:
- There is a significant tear in a ligament or meniscus that is causing instability.

- Pain persists despite conservative treatments.

- Imaging studies reveal structural damage that can be corrected surgically.

- Your quality of life is severely impacted by the pain and functional limitations.

Conclusion
Given your ongoing pain and the fact that medications have not provided relief, it is advisable to consult with an orthopedic surgeon who can evaluate your knee through a physical examination and imaging studies. They can provide a comprehensive assessment and discuss the potential benefits and risks of surgical intervention if necessary. Remember, it is essential to address any underlying issues to ensure a successful recovery and return to normal activities.

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