The knee joint is a complex joint made up of three bones – Femur, Tibia and Patella (also known as knee cap). The knee joint acts like a door allowing it to bend and straighten thereby allowing movements like running, jumping, squatting etc. In addition to the bones, there are a lot of soft tissues (ligaments, menisci, muscles, tendons) that surround the knee joint for stability and balance so as to prevent injuries especially during sports such as football, basketball, long distance running etc. Although a majority of knee injuries occur during sports, a large amount of knee problems occur in general population also. Knee osteoarthritis and pain in the knee cap (patellofemoral pain) is a common problem that is regularly seen in general population and is also the second leading cause of disability worldwide. Mostly seen in the middle age women, Knee OA can lead to pain, swelling and difficulty in walking along with decreased balance often leading to falls in the elderly which can also cause additional fractures. There is also a high risk of patellar fracture in osteoporotic population. Many of the knee injuries might be related to hip and ankle and hence a thorough examination of the entire lower leg is essential to understand the underlying cause of knee pain/injuries.
Age, gender, ergonomics, lifestyle, bone mineral density, training techniques, etc are some of the factors to be considered while addressing knee injuries.
The management of knee injuries depend on the severity of the problem. Many a times, the pain or the damaged structure can be managed conservatively through rest, pain management techniques, graded exercises, supportive orthosis etc although surgery might be unavoidable in some cases. Sports related injuries are often require a specialised sports orthopaedic surgeon and sports physiotherapist to address the issue as post injury management, care and rehabilitation has direct effect on return to sports and sports performance. Similarly for other knee conditions such as knee osteoarthritis both surgical and non- surgical management such as graded exercises, balance training and use of assistive devices such as walker/crutch can be helpful depending on the severity of the condition and underlying factors such as age and any other underlying comorbidities such as blood pressure, diabetes, etc.
Often the use of assistive devices such as walker/crutches have been found helpful in improving mobility, balance along with prevention of falls especially in early post-operative phase and in the elderly population. The walking aids reduce the load on the knee and the surrounding structures (also by taking off the load from the entire leg/lower limb), thereby reducing pain and improving mobility. In the early post-operative phase, the walking aids play a crucial role until the operated joint is strong enough to take the load of the body and its weight. This is essential to improve success of surgery, to prevent implant failure (implant giveaway or breakage or giveaway), for healthy recovery of the sutures, skin and the surrounding musculatures and hence aids in higher success rate and improved outcomes after the surgery