The Knees and Crepitus

The knee, a complex pivotal hinge joint, is the largest joint in the human body. Permitting flexion (bending) and extension (straightening) as well as slight medial and lateral (side to side) rotation, the knee supports almost the entire weight of the body and is therefore susceptible to acute injury and progressive wear and tear (osteoarthritis).

The knee is made up of:
Four bones

• The Femur
• Tibia
• Fibula
• Patella

Four Ligaments:

• Anterior cruciate ligament (ACL)
• Posterior Cruciate Ligament (PCL)
• Lateral collateral ligament (LCL)
• Medial Collateral Ligament (MCL)

Two muscle groups:

• The Quadriceps
• The hamstrings

Cartilage:

• Medial
• lateral menisci

The meniscus cartilage is a crucial cushioning, providing shock absorption and stability to the entire structure – vital as the knee supports almost all of our body weight.

Crepitus is the medical term given to the sound of crunching, often occurring as the knee goes through flexion and extension. Generally arising in the patella-femoral joint, (the articulation between the knee-cap and thigh bone (femur) non-painful and infrequent crepitus is mostly of little concern. However, more seriously it can sometimes be an indication of early degeneration within the spacing between the femur and tibia (the knee joint itself).

Crepitus can be a sign of wear and tear of the cartilaginous cushioning surfaces of the joint (responsible for smooth gliding movement). This problem can occur due to a bio-mechanical issue, involving foot malalignment such as excessive pronation (rolling in) and associated internal leg rotation, and/or a muscle imbalance due to tight tissue structures on the outer thigh (Illiotibial Band and lateral Quadriceps). Both biomechanical discrepancies will result in gross external or internal rotation of the knee, changing the angle at which the quads cross the knee and adversely affecting the harmony and quality of the patella-femoral joint.

To correct shearing forces, alignment of the patella-femoral joint is critical.

Treatment

Abnormal internal and external rotation of the knee wears at the cartilage until the grinding sensation is felt or heard. The problem can be managed very effectively in the early stages by:
• Using prescribed correctional prescription orthotics to address foot malalignment following full assessment by a qualified Podiatrist.
• Correcting imbalances between muscle groups and soft tissue release through stretching and strengthening exercises.
• Body weight management.

Even if asymptomatic, early treatment and management is the key to prevention.

Make an appointment with the foot and leg expert Podiatrists at Dubai Podiatry Centre Call: +971 4 3435390| WhatsApp:+971 50 3553024.