Patient Education
Knee conditions
What causes each knee condition, how it feels, and the treatment options available. Select a condition to read more.
Knee Care3 min readAnterior Knee Pain
Pain at the front of the knee around the kneecap — common in teenagers, runners and anyone increasing training load quickly.
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What happens
Pain usually relates to how the kneecap tracks in its groove, muscle imbalance between the quadriceps and hip muscles, and training load, rather than to structural damage. In some cases the cartilage behind the kneecap is softened or worn.
Symptoms
Aching at the front of the knee, worse going up or down stairs, squatting, kneeling or sitting for long periods; grinding or creaking; and occasional swelling after activity.
Treatment
Treatment is almost always non-surgical: load management, quadriceps and hip strengthening, taping or orthotics where indicated, and patience — improvement usually takes 3–6 months. Surgery is reserved for the small number with a structural problem such as recurrent kneecap dislocation or a focal cartilage defect.
Knee Care3 min readMeniscus Tears
The meniscus is the knee's shock absorber. Tears happen with twisting injuries in sport, or gradually with age-related wear.
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Symptoms
A popping sensation at the time of injury followed by swelling over 24 hours; pain along the inner or outer joint line; and catching, locking, or a feeling that the knee gives way.
Diagnosis
Clinical examination combined with MRI defines the tear pattern, its location and whether the surrounding cartilage is already worn — all of which determine whether surgery will help.
Treatment
Degenerate tears in an older knee usually settle with physiotherapy, load management and time, and surgery rarely helps. Tears that lock the knee, large unstable tears, and tears in younger patients are treated arthroscopically — repaired with sutures wherever possible to preserve the meniscus, or trimmed if repair is not feasible.
Knee Care3 min readPatella Fracture
A break of the kneecap, usually after a direct fall onto the knee or a dashboard injury, which can stop you straightening the leg.
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Symptoms
Immediate pain and swelling at the front of the knee, a palpable gap, bruising, and — importantly — inability to actively straighten the knee or lift the leg straight.
Treatment
Undisplaced fractures where the extensor mechanism is intact are treated in a brace or cast with protected weight bearing for around six weeks. Displaced fractures need surgical fixation with wires, screws or a plate to restore the joint surface and the ability to straighten the leg.
Recovery
Expect a brace for six weeks with gradually increasing bending, physiotherapy to regain quadriceps strength, and 3–6 months before full function. Prominent metalwork often causes irritation when kneeling and is sometimes removed after healing; some stiffness and later kneecap arthritis are recognised outcomes.
Knee Care3 min readPatella Dislocation (Patellar Instability)
The kneecap slipping out of its groove on the front of the knee — common in young, active people, and often linked to the shape of the joint.
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What happens
The kneecap (patella) glides in a groove at the end of the thigh bone. In some people the groove is shallow, the kneecap sits high, or the soft tissues that hold it in place are loose, so a twist or a direct blow can push the kneecap outwards, out of the groove. Some kneecaps slip fully out of joint (a dislocation); others partially slip and slide back (subluxation), giving a repeated sense of instability.
Symptoms
At the first episode there is sudden pain, swelling, a visible or felt lump of kneecap on the outer side of the knee, and often a feeling of something moving out of place. Many kneecaps reduce on their own as the leg straightens. Afterwards the knee can feel unstable, especially on turning or stepping down, and repeated episodes are common — particularly in teenagers and young adults.
Acute care
The knee is assessed promptly, often with X-rays and an MRI to confirm the kneecap is back in place and to look for a loose fragment of cartilage or bone — these occur in a significant proportion of first dislocations and may need keyhole removal or fixation. Initial treatment is a brace or tubular bandage for comfort, ice, elevation and early physiotherapy to restore movement and strengthen the quadriceps, especially the inner thigh muscle (VMO) that guides the kneecap.
Non-surgical management
Most first dislocations are treated without surgery. A structured rehabilitation programme works on quadriceps and hip strength, kneecap control and return to sport, often with taping or bracing during sport. This succeeds in many patients, though the risk of another dislocation is highest in younger people and those with an unfavourable kneecap shape on imaging.
Surgical management
Surgery is considered after repeated dislocations despite good rehabilitation, where there is a loose fragment needing attention, or where imaging shows a structural problem that bracing cannot overcome. Stabilisation usually involves reconstructing the medial patellofemoral ligament (MPFL) — the strap that holds the kneecap against the inner side of its groove — and, where the kneecap sits high or the groove is unfavourable, moving the attachment of the kneecap tendon on the shin bone (tibial tuberosity osteotomy) to improve tracking. Both are described in the Patella Stabilisation procedure page.
Knee Care3 min readACL Tear
A rupture of the anterior cruciate ligament — the knee's central stabiliser — usually from pivoting, landing or a direct blow in sport.
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Symptoms
An audible pop at the moment of injury, rapid swelling within a few hours, inability to continue playing, and later a sense of the knee giving way when turning or changing direction.
Diagnosis
Clinical examination tests the ligament directly; MRI confirms the tear and identifies associated meniscal, cartilage or other ligament injury, which influences treatment and timing.
Treatment
A torn ACL does not heal. Patients with low demands and a stable knee can do well with structured rehabilitation alone. Those who pivot in sport or work, or whose knee keeps giving way, are advised to have arthroscopic reconstruction with a graft — this restores stability and protects the menisci and cartilage from further damage.
Knee Care3 min readKnee Dislocation
A rare but serious injury in which multiple knee ligaments rupture and the joint comes completely out of place — a surgical emergency.
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What happens
High-energy trauma such as a motor vehicle crash, a sporting collision or a fall — and sometimes low-energy injury in heavier patients — tears two or more major ligaments. The popliteal artery and the common peroneal nerve run right behind the knee and can be injured at the same time.
Why it is urgent
Circulation and nerve function must be assessed immediately, often with vascular imaging, even if the knee has already relocated. A missed arterial injury can threaten the limb. Foot drop or numbness indicates nerve injury.
Treatment
The knee is relocated and stabilised in a brace or external fixator, then reconstructed — usually in stages — with repair or reconstruction of the cruciate and collateral ligaments. Rehabilitation is long, typically 9–12 months, and some permanent stiffness or residual laxity is common.
Knee Care3 min readKnee Osteoarthritis
Gradual loss of the cartilage lining the knee, causing pain, stiffness and reduced walking distance — the most common reason for knee replacement.
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Symptoms
Pain with weight bearing and at the end of the day, morning stiffness, swelling after activity, grinding, difficulty with stairs, and progressive bowing or knock-knee deformity as one side wears more.
Non-surgical treatment
The foundations are weight loss, low-impact exercise such as cycling and swimming, quadriceps strengthening, simple analgesia and anti-inflammatories, walking aids, and corticosteroid or hyaluronic acid injections. These can control symptoms for years.
Surgical options
For younger patients with wear limited to one compartment, high tibial osteotomy redistributes load away from the worn side. For advanced arthritis, partial knee replacement resurfaces a single compartment, and total knee replacement resurfaces the whole joint — both reliably relieving pain and restoring function.
Have questions about your condition?
These articles are for general education only. For personalised advice about your shoulder or knee concern, please contact the rooms or speak with your GP.