Patient Education

 The knee has two cartilage disks, called menisci, that are attached to the top portion of the tibia (the large lower leg bone). The lateral meniscus is located on the outer side of the knee joint, and the medial meniscus is on the inner side. These two wedge-shaped discs form a cradle for the cartilage covered condyles of the femur. The menisci absorb shock, and serve to cushion the knee. An injury to a meniscus may take the form of a small or large tear, a split in the disc, or a frayed or roughly torn area. This illustration depicts a large tear in the medial meniscus. The knee's lateral meniscus is intact and has a normal crescent-shaped appearance. 

 Alignment problems, wear and tear to the knee joint, and systemic diseases such as osteoarthritis, may contribute to degenerative changes to the joint surfaces of the femur (thigh bone) and the tibia (large lower leg bone). Advanced stages of degeneration include the formation of bone spurs call osteophytes. Pointed bone prominences, called osteophytes, occur in response to the joint degeneration. These growth are frequently seen in those joints undergoing arthritis changes. The normally smooth articular cartilage is worn away due the joint instability and inflammatory process. 

 The repetitive motion of the patella sliding over the condyles of the femur in such fitness activities such as running, jogging, and even walking, may result in a painful inflammation or irritation of the underside of the kneecap. Many conditions with names such as overuse synovitis, patellar tendonitis, and tenosynovitis all are associated with the repeated stresses incurred from running.
This syndrome may also be caused by the way the kneecap aligns itself on the anterior knee during flexion and extension. Alignment problems of the patella at the knee may be caused by anatomical relationships in other parts of the body such as the hips, thighs, or even feet. In most cases of patellar malalignment, the patella subluxes (slips laterally), and may actually dislocate in some individuals.

 Tennis Elbow, also called lateral epicondylitis, is a very common form of tendinitis that occurs in at a specific area on the lateral elbow. The cause of this condition is believed not to be inflammatory in nature, but may be related to sustained overuse of the forearm, called repetitive trauma. In some instances, the condition may be work-related, or sports-related as well. Although the name implies a direct correlation with the sport of tennis, you do not have to play tennis to get this condition.

Sports-related activities such as racquetball, squash, tennis, and even golf may strain the extensor muscles as they attach to the elbow. In addition, carrying heavy loads with the arms extended and palms facing up may cause tennis elbow symptoms. Repeatedly extending the wrists and fingers also may cause symptoms. 

 Repetitive overuse of the knee joint (as in Runner's knee) as well as alignment problems of the kneecap, may lead to inflammation and degenerative changes to the underside of the patella. The patella’s smooth cartilage surface that is designed to glide on the end of the femur may become rough due to the degenerative changes. This knee shows inflammation and degenerative changes to the underside of the patella. The once smooth cartilage has become pitted and worn due to the malalignment. In the normal condition the patella maintains a centralized position on the articular condyles of the femur throughout knee joint flexion. Alignment problems exist when the patella subluxes laterally during flexion as seen on the far left.
 

  Fractures of the base of the foot's fifth metatarsal bone are common fractures seen both in recreational and competitive athletes. This type of fracture is generally referred to as a “Jones Fracture,” named after Sir Robert Jones, who first described this fracture pattern in 1902.  The metatarsal bones are a group of 5 bones in the foot that contribute to the foot's normal arched shape. The fifth metatarsal is located on the little toe side (or lateral side) of the foot, and connects the small toe's proximal phalanx to the cuboid bone near the ankle joint. Strong ligaments attach the base of the fifth metatarsal to the cuboid bone and the fourth metatarsal bone. 

Some of the more minor fractures that are stable, and not displaced, may be successfully treated with bracing or casting. At times, however, these fractures may require surgery to fix (or reduce) the fracture. This surgery may include the placing of an intramedullary screw (much like a long wood screw) into the bone’s shaft. This procedure stabilizes the fractured bone, and holds it securely in place while healing occurs. This internal fixation technique frequently enhances bone healing, and allows for an earlier return to athletic activities.  Intramedullary screw are placed into the shaft of the metatarsal to fix (or reduce) the fracture. The final x-ray shows complete bone healing with new bone formation at the site of the original fracture.