5 Common Knee Problems Treated by an Orthopaedic Knee Surgeon
Knee pain can affect confidence, mobility and day-to-day activity. Many people only notice how much they rely on their knees once pain or stiffness starts interfering with normal movement. When this happens, patients often seek advice from an orthopaedic knee surgeon such as Mr Vishal Pai to understand the cause and discuss treatment options.
Below are five common knee conditions that Mr Pai assesses and treats:
1. ACL Tear
The anterior cruciate ligament (ACL) helps keep the knee stable. A tear may occur during sport, sudden twisting, or occasionally with a simple awkward step.
Typical symptoms include:
A popping sensation at the time of injury
Rapid swelling
A feeling of the knee giving way
Difficulty trusting the leg
Treatment:
Management depends on symptoms, activity level and instability. Some patients respond well to rehabilitation alone, while others may discuss ACL reconstruction surgery. In general, patients looking to return to sporting and other pivoting activities are likely to benefit from ACL surgery. Early assessment helps prevent further damage to the knee and guides treatment.
2. Meniscus Tear
The menisci act as shock absorbers within the knee. Tears may occur with twisting movements or develop gradually due to age-related change.
Common signs:
Pain along the inside or outside of the knee
Clicking or catching
Swelling following activity
Difficulty bending deeply or twisting
Inability to extend the knee
Treatment:
Some meniscal tears settle with strengthening and activity modification. Persistent or mechanical symptoms may require knee arthroscopy. Certain types of tear patterns benefit from a meniscal repair, as this can restore the function of the meniscal and reduce the risk of osteoarthritis (cartilage degradation). Other meniscal tear patterns are not suitable for repair, and the meniscal flap is removed (meniscectomy).
3. Knee Osteoarthritis
Osteoarthritis develops when cartilage gradually wears down, causing discomfort, stiffness and difficulty with day-to-day activities.
How osteoarthritis may present:
Stiffness after sitting
Aching with everyday movement
Difficulty kneeling or squatting
A grinding or catching sensation
Pain affecting the ability to sleep
Reduced ability to walk long distances
Walking with a limp
Treatment:
Management focuses on reducing discomfort and improving function. This may include physiotherapy, lifestyle modification, injections or medications. In advanced cases, knee replacement surgery may be considered depending on severity and symptoms.
If knee replacement is required, Mr Pai ensures postoperative discomfort is carefully managed. With the combination of robotic-assisted surgery, targeted local anaesthetic infiltration and modern regional anaesthesia techniques (including spinal anaesthesia and nerve blocks), most patients report that their recovery after knee replacement is significantly more comfortable and far better than they anticipated.
Understanding osteoarthritis at a glance
Stage: Early
What patients may notice: Mild stiffness, occasional swelling
Possible management: Strengthening, medications, lifestyle changes
Stage: Moderate
What patients may notice: Frequent aches, reduced mobility
Possible management: Physiotherapy, injections
Stage: Advanced
What patients may notice: Ongoing pain affecting daily life
Possible management: Consideration of surgical options
4. Kneecap Instability
Kneecap instability occurs when the patella moves out of its normal position, often slipping to the outer side of the knee. This may happen after an injury, during sport, or sometimes without a clear cause.
Patients often describe a feeling that the kneecap is “going to pop out”, especially during twisting or side-to-side movements.
Common symptoms include:
Pain at the front of the knee
Swelling after activity
Episodes of giving way or dislocation
Anxiety when changing direction or playing a sport
Difficulty with stairs and squatting
Treatment:
The options may include strengthening physiotherapy, bracing, taping and activity modification. In recurrent or severe cases, surgical options may be discussed to stabilise the kneecap and protect joint cartilage. This can involve reconstruction the medial patellofemoral ligament (MPFL) or addressing a high-riding kneecap (patella alta) by pulling it down with a tibial tuberosity osteotomy.
Trochlea dysplasia is when the groove that the kneecap sits in is abnormally shaped (flat or dome-like). Reconstructing the groove (trochleoplasty) is a highly specialised procedure for severe trochlea dysplasia that Mr Pai performs.
5. Acute Cartilage Injury
Cartilage is the smooth surface that lines the knee joint and allows the bones to move easily without friction. An acute cartilage injury occurs when this surface is damaged suddenly, often during sport, twisting movements or impact injuries. Unlike other tissues, cartilage does not heal well on its own, which is why early assessment is important.
Typical symptoms include:
Sharp pain during activity
Swelling after exercise
Catching or locking
Discomfort with deep bending
A feeling of something “not sliding smoothly”
Treatment:
Management of cartilage injuries depends on the location and size of the cartilage defect. Smaller injuries may improve with physiotherapy, activity adjustments and time, while larger defects or ongoing symptoms may require cartilage-specific procedures.
Mr Pai may discuss procedures such as OATS (Osteochondral Autograft Transfer System), where small plugs of healthy cartilage and bone are transferred to the damaged area, or AutoCart (minced cartilage implantation), a modern technique that uses a patient’s own cartilage fragments mixed with biological glue to repair the defect.
The aim is to restore smooth joint movement, reduce pain and protect the knee from further damage. Early diagnosis and appropriate treatment often lead to better long-term outcomes, particularly for active individuals.
The impact of knee pain
Knee problems affect more than physical movement; they can also impact confidence, independence and daily routines. Many patients delay seeking help, but a clear diagnosis from Mr Pai provides direction and a structured management plan rather than uncertainty. Having a diagnosis from the outset will help you have a structured plan with realistic expectations about your recovery.
Mr Pai provides balanced advice and has no hesitation in recommending non-surgical management when appropriate. Clear expectations and personalised treatment plans help patients feel informed and supported throughout their recovery.
How Mr Pai supports patients
During consultation, Mr Pai discusses symptoms, lifestyle demands and personal goals. Imaging is arranged only when clinically necessary, and treatment options are explained clearly, including both non-surgical and surgical approaches. The aim is always improved comfort, mobility and confidence. With appropriate treatment, most individuals experience meaningful improvement over time.
About Mr Vishal Pai
Mr Vishal Pai is an orthopaedic knee surgeon in Melbourne who treats ACL injuries, meniscus tears, knee osteoarthritis, tendon conditions and bursitis. He focuses on identifying the underlying cause of knee symptoms and tailoring treatment based on each patient’s lifestyle and goals.
To discuss knee pain or injury, patients can arrange a consultation with Mr Pai.
