Knee Care: Diagnosis and Treatment

Expert Knee Care and Tailored Treatments

Key Takeaways

• ACL tears, meniscus injuries, patellar instability and cartilage damage are among the most common knee conditions we treat and many respond well to minimally invasive arthroscopic surgery.
• We prioritize nonsurgical care first, including physical therapy, which is the cornerstone of most knee treatment plans. 
• When surgery is needed, our specialists use techniques designed to minimize recovery time and get you back to sports and daily activities sooner.
• From sports medicine and arthroscopic procedures to knee replacement and cartilage restoration, UChicago Medicine offers the full spectrum of knee care.

When knee pain limits what you can do, the orthopaedic and sports medicine specialists at the University of Chicago Medicine’s Musculoskeletal Center can help. We treat the full range of knee conditions — from sports injuries and cartilage damage to arthritis and complex reconstruction — with a personalized plan designed around your goals.

The knee is the largest joint in the body and absorbs a lot of force with every step, making it one of the most injury-prone joints. Our team is experienced in both sports medicine and joint replacement, so you get expert care no matter what brought you in.

Common Knee Pain Causes

Knee pain can come from sports injuries, wear and tear over time, falls, accidents and more. Below are the conditions we most commonly treat.

Sports Medicine and Active Patients

• ACL tears: The anterior cruciate ligament (ACL) is one of the main ligaments that keeps your knee stable when you twist, pivot or change direction quickly. ACL tears are common in athletes and can cause sudden pain, swelling and a feeling of instability. Surgery is often recommended for active patients who want to return to sport.
• Other ligament injuries: The knee has 4 main ligaments — the ACL, PCL (posterior cruciate ligament), MCL (medial collateral ligament) and LCL (lateral collateral ligament). Any of these can be sprained or torn, causing pain, swelling and instability.
• Meniscus tears: The meniscus is a C-shaped piece of rubbery cartilage that acts as a shock absorber between the thigh bone and shin bone. Tears often happen from twisting or sudden stops. Symptoms include pain, swelling and a catching or locking sensation in the knee.
• Patellar instability / patellofemoral pain syndrome: The patella (kneecap) sits in a groove at the front of the thigh bone and glides up and down as the knee bends and straightens. When it tracks incorrectly or slips out of the groove (dislocates), it causes pain, swelling and a feeling of instability. This is especially common in younger, active patients.
• Cartilage injuries: Articular cartilage is the smooth, slippery tissue that covers the ends of bones in the knee. When it is damaged — from an injury or wear over time — it can cause pain, swelling and limited movement. Left untreated, cartilage damage can worsen over time.
• Sports-related knee injuries: Including injuries from running, jumping, contact sports and other athletic activities that cause overuse or trauma to the knee.
• Patellar or quadriceps tendonitis: An overuse injury that causes inflammation and pain where the tendons attach to the kneecap. Often called “jumper’s knee,” it is common in athletes but can affect people of all activity levels.

Arthritis and Other Knee Conditions

• Knee arthritis (osteoarthritis): Caused by the gradual breakdown of cartilage in the knee over time. It is the most common cause of knee pain in people over 40. Symptoms — pain, stiffness and swelling — tend to come and go at first but often worsen gradually.
• Rheumatoid arthritis: An autoimmune condition in which the body’s immune system attacks the joint lining, causing chronic pain and swelling.
• Avascular necrosis (osteonecrosis): When the blood supply to the bone is cut off, causing bone tissue to die and the joint surface to collapse.
• Bursitis: Inflammation of the small fluid-filled sacs (bursae) that cushion the knee joint, causing localized pain and swelling.

We also treat patients with chronic knee pain or disability from cancer, deformities, failed joint replacements and traumatic injuries.

Knee Pain Symptoms

Depending on your condition, you may notice one or more of the following:

• Swelling of the knee
• Stiffness or aching
• Weakness, instability or reduced flexibility
• Redness and warmth around the knee
• A popping or clicking sound when you move
• Limited motion — for example, not being able to fully straighten the knee
• A catching, locking or giving-way sensation

When to See a Doctor

For minor knee pain, try self-care first: rest, ice, compression, elevation (RICE) and over-the-counter anti-inflammatory medications. If your pain doesn’t improve, or if the injury is severe, our knee specialists can evaluate you and recommend the right treatment.

If you have sudden, severe pain, a visible deformity or cannot put any weight on your leg, go to the nearest emergency room right away.

Knee Pain Treatment

Not every knee condition requires surgery. We always start with the least invasive options and move to surgery only when needed. Physical therapy is a cornerstone of almost every knee treatment plan — whether you are recovering from an injury, preparing for surgery or healing after it.

Nonsurgical Treatment

Many knee injuries and conditions improve without surgery. Nonsurgical options include:

• Physical therapy: Targeted exercises to strengthen the muscles around the knee, restore movement and reduce pain. This is our first-line treatment for most knee conditions.
• Bracing and immobilization: A brace, cast or crutches can stabilize the knee and protect it while it heals.
• Anti-inflammatory medications: Drugs like ibuprofen and naproxen reduce pain and swelling. Acetaminophen is another safe option for most patients.
• Knee joint injections: Steroid or other medication injections can reduce pain and inflammation directly in the joint.

Arthroscopic (Minimally Invasive) Surgery

Arthroscopic surgery uses a tiny camera and small instruments inserted through very small incisions. It is minimally invasive, which means less pain, a shorter hospital stay and faster recovery than open surgery. We offer individual arthroscopic procedures for a wide range of sports medicine conditions:

• ACL reconstruction: Replacing the torn ACL with a new graft — typically taken from the patient’s own hamstring or patellar tendon, or from a donor. We offer multiple graft options tailored to your anatomy and activity goals.
• Lateral extra-articular tenodesis (LET): An additional procedure performed alongside ACL reconstruction to reinforce the outside of the knee and reduce the risk of re-injury. LET adds a second layer of stability for high-demand athletes.
• Meniscus repair or removal: Repairing a torn meniscus when possible to preserve the natural shock absorber, or removing the damaged portion when repair is not an option.
• Meniscus preservation: When appropriate, we prioritize saving as much of the meniscus as possible to protect the knee long-term.
• Patellar stabilization: Repairing or tightening the ligaments and soft tissue around the kneecap to prevent it from slipping out of place.
• Cartilage restoration: Treating damaged areas of articular cartilage using techniques designed to regrow or repair the cartilage surface, reducing pain and improving function.
• Ligament repair (PCL, MCL, LCL): Repairing or reconstructing other knee ligaments damaged by injury.
• Loose body removal: Removing small fragments of bone or cartilage floating in the joint that cause pain and catching.

Cartilage Restoration and Repair

For isolated areas of cartilage damage, our specialists offer advanced cartilage restoration procedures. One approach involves harvesting healthy cartilage cells from a non-weight-bearing area of your knee, sending them to a specialized lab where they are grown over 2 to 3 months, and then using them to regenerate new cartilage in the damaged area. Using your own cells may help the new cartilage integrate better and last longer.

Knee Replacement Surgery

When arthritis or injury has severely damaged the knee and nonsurgical treatments are no longer helping, knee replacement may be the right option. We offer several types:

• Partial knee replacement: Resurfaces only the damaged portion of the knee and preserves healthy cartilage, bone and ligaments. A good option when arthritis is limited to one area of the knee. The knee may feel more natural after recovery.
• Total knee replacement: Resurfaces the entire knee joint — both sides and sometimes the kneecap — when arthritis affects multiple areas. In many cases, this can be done with a minimally invasive approach, robotic assistance or smart implant technology.
• Robotic-assisted knee replacement: UChicago Medicine was the first medical center in Chicago — and one of the first academic centers in the region — to offer robotic-assisted knee and hip replacement. The robotic system uses a 3D model of your knee to help your surgeon plan and perform the procedure with greater precision, which can mean less bone removal, fewer errors and better outcomes.
• Smart knee implants: Some implants include sensors that allow your care team to remotely monitor how your knee is recovering after surgery.

Genicular Artery Embolization (GAE)

GAE is a minimally invasive procedure performed by interventional radiology specialists (not orthopaedic surgeons) that treats chronic knee pain caused by osteoarthritis. It works by blocking blood flow to certain vessels in the knee, which can reduce inflammation and relieve pain. It may be an option for patients who are not ready for or not eligible for knee replacement. UChicago Medicine has received National Institutes of Health (NIH) funding to study GAE for osteoarthritis knee pain.

Knee Pain Symptoms

Depending on the location and severity of your knee condition, you may experience one or more of the following symptoms:

• Swelling of the knee
• Knee stiffness or aching
• Weakness, instability or decreased flexibility of the knee
• Redness around the knee and warm to the touch
• A popping sound from the knee
• Limited motion, such as not being able to fully extend the knee

When to See a Doctor for a Knee Pain Diagnosis

We encourage patients to try self-care remedies — rest, ice, compression, elevation and over-the-counter anti-inflammatory medications — before seeking medical treatment for minor knee pain after an injury. If your pain persists or if the injury is severe, our knee specialists can evaluate the problem and offer the best treatment options for your condition.