Skip to content

A Short Primer on Knee Injuries & Knee Replacement

dr andrew dutton a short primer on knee injuries & knee replacement
Share on facebook
Share on twitter
Share on linkedin
The knees are some of the body’s hardest working joints and are critical to everyday movement. To form the knee joint, three bones meet — the femur (thighbone), tibia (shinbone), and patella (kneecap). These bones are connected by four primary ligaments, which act like strong ropes to keep the bones intact. The primary ligaments include:
  • Medial collateral ligament (MCL)
  • Lateral collateral ligament (LCL)
  • Anterior cruciate ligament (ACL)
  • Posterior cruciate ligament (PCL)
Knee Pain Illustration

When the knee is injured there’s no ignoring the pain. However, some injuries can take some time to make themselves known. You may need to go to the orthopaedic doctor if your knees have been in pain for 3 days, and it’s not getting better.

READ: Knee Pain Treatment In Singapore

Common Symptoms of Injured Knees

  • Knee pain
  • Swelling and stiffness
  • Redness and warmth to the touch
  • Weakness or instability
  • Popping or crunching noises
  • Inability to fully straighten the knee

Other symptoms that may come with knee pain include difficulty moving the knee, catching or locking of the knee, tenderness, decreased ability to move the knee, decreased strength of the knee, and pain when pressure is applied to the knee or it is in motion.

Types of Knee Injuries: ACL Tears

A/Professor Andrew Dutton Ligament Reconstruction Illustration

One of the most common injuries to the knee ligaments is an anterior cruciate ligament (ACL) injury. Typically, this injury is caused by the overstretching or tearing of the ligament, which can be partial or complete. A study conducted in Singapore revealed that ACL tears are more common in males and those who are overweight. ACL injuries are relatively common in sports that involve jumping, cutting, and pivoting movements.

Types of Knee Injuries: Meniscus Tears

Drdutton Illustration Meniscus Tears Knee anatomy

The meniscus, a crescent-shaped cartilage between the shinbone and the thigh bone on both sides of the knee joint, is pivotal in maintaining joint stability, reducing friction, and balancing the weight exerted on the knee. In younger patients, meniscal tears often occur when a twisting force is applied to a flexed knee bearing weight — typically resulting in what’s commonly known as a “bucket-handle” tear. Meniscus tears in older patients are usually caused by age-related wear and tear, typically horizontal tears.

Types of Knee Injuries: Overuse

Knee pain often comes from overuse, caused by repetitive activities like running, jumping, or heavy lifting. This can harm the knee’s cartilage and tendons. Common issues include:

  • Jumper’s Knee: Seen in athletes; causes varying knee pain and swelling.
  • Chondromalacia: Softened kneecap cartilage, common in active and overweight people, leading to grinding and pain around the kneecap.
  • IT Band Syndrome: Due to muscle imbalances, causing sharp pain and swelling on the knee’s outer side.
  • Knee Bursitis: Swelling of the knee’s fluid sacs, causing pain, especially when kneeling.

Types of Knee Injuries: The Unhappy Triad

The “unhappy triad” refers to three major knee injuries happening at once, common in high-impact and pivoting sports like football and basketball. About 25% of athletes with knee problems experience this. When someone’s knee is hit or their foot twists while firmly on the ground, they can suffer from the unhappy triad. Symptoms include intense knee pain, swelling, difficulty walking, the knee feeling unstable, and bruising that shows up a few days later.
Dr Andrew Dutton - The Three Components of the Unhappy Triad - Infographics

Severe Knee Injuries That May Merit Knee Replacement

Knee replacement surgery, also known as arthroplasty, is usually considered when there is significant damage or degeneration in the knee joint — causing pain, disability, and reduced quality of life — which cannot be managed by other treatments. Common reasons for needing this surgery include:
  • Osteoarthritis: Worn-out cartilage causing pain and stiffness
  • Rheumatoid Arthritis: An immune system problem damaging the joint
  • Post-traumatic Arthritis: Arthritis due to a severe knee injury
  • Avascular Necrosis: Dead bone tissue causing joint problems
  • Bone Deformities: Abnormally shaped bones from birth
  • Tumours: Rare but serious, can require knee replacement
  • Failed Past Surgeries: When earlier treatments or surgeries didn’t work

Knee Replacement 101

Pain and disability are the main reasons behind a knee replacement. Replacing the knee is not always the first treatment of choice. In fact, doctors will first consider conservative treatment options such as oral medications, topical ointments or creams, medications injected into the joint, weight loss, exercise and physical therapy, or nutritional supplements. However, if these are not sufficient then knee replacement surgery may be considered.

The knee replacement procedure begins with the surgeon removing the damaged bone and cartilage from your thigh and shin bones. Metal implants are then placed to replace the removed parts, and are either glued or tightly fitted into the bone. In some cases, the bottom of the kneecap is also reshaped. Finally, a plastic piece is added between the metal parts for smooth movement in the new joint.

a/professor andrew dutton types of knee replacement surgery infographic

Recovering From Knee Replacement

Patients typically may feel some sort of pain up until 6 months after the surgery. Crutches will be required for the first 6 weeks to help with mobility. Full recovery can take a year, and some patients report taking even longer to get used to the feel of the prosthesis. The stages of knee replacement recovery are:
  • Immediate Recovery: Pain and swelling are common in the first few days. Patients often start walking with aids shortly after.
  • Physical Therapy: This starts soon after surgery to strengthen the knee and restore movement, continuing for weeks or months.
  • Home Recovery: After leaving the hospital in about a week, it’s vital to follow doctor’s advice on wound care, exercise, and activity restrictions.
  • Pain Management: Pain can be managed with medications and simple home remedies.
  • Activity Limits: Patients should avoid high-impact activities and heavy lifting for some weeks or months.
  • Regular Check-ups: Patients need to see their surgeon for follow-up visits to track healing.
  • Long-term Recovery: While daily activities can often resume within 6 weeks, full recovery can take a few months to a year.
READ: Knee Replacement in Singapore: Surgery Pain, Risks & Recovery

Considering your options?

Knee replacement surgery may seem daunting, but many have had their knees replaced and gone on to live more mobile, active lifestyles.

Choosing the right doctor is crucial as it directly impacts the success of the procedure and your overall recovery. With a trained and experienced orthopaedic surgeon, you can rest assured that proper surgical techniques are employed, minimising potential complications and reducing re-injury risks.

Most health insurance plans cover knee replacement surgery. If your plan covers it, your doctor must establish that it is medically necessary. You may call your provider to know the exact coverage available for you.

READ: 12 Insurance Providers Affiliated with Dr Andrew Quoc Dutton Orthopaedic & Sports Clinic

With a medical practice dating back to 1996, A/Professor Dutton completed his subspecialty in hip and knee surgery at Massachusetts General Hospital and Harvard Medical School before opening his clinic in Singapore. To schedule an appointment, call (+65) 6836 8000 or send a message through the inquiry form.

About A/Professor Andrew Quoc Dutton

A/Professor Dutton, also known as, has been in clinical practice since 1996 after graduating from Marist College, Canberra and the University of New South Wales, Sydney, Australia. A/Professor Dutton has worked at the Prince of Wales Hospital, Sydney, and the St. George Hospital, Sydney, before completing his orthopaedic surgery training in Singapore. He is currently an associate professor of orthopaedic surgery at the National University of Singapore (NUS).

Leave a Reply

Your email address will not be published. Required fields are marked *