Knee pain can affect your confidence, mobility and daily activity. Many people only realise how much they rely on their knees once pain or stiffness starts to interfere with normal movement.
This article outlines five common knee problems that Dr Vishal Pai assesses and treats, their typical symptoms and the main treatment options, both non-surgical and surgical.
At a Glance
- ACL tears often cause a pop, rapid swelling and giving way; people returning to pivoting sport often benefit from reconstruction.
- Many meniscus tears, especially degenerative ones, settle with strengthening; some injury-related tears need repair.
- Osteoarthritis is managed with exercise, weight management, medicines and injections, with knee replacement for advanced cases.
- Kneecap instability is treated with physiotherapy first, and surgery for recurrent dislocation.
- Cartilage injuries do not heal well on their own, so early assessment matters.
What is an ACL tear?
The anterior cruciate ligament (ACL) helps keep the knee stable. It can tear during sport, a sudden twist or occasionally an awkward step. Typical symptoms include a popping sensation at the time of injury, rapid swelling, the knee giving way and difficulty trusting the leg.
Treatment. Management depends on your symptoms, activity level and instability. Some people do well with rehabilitation alone, while people returning to sport and other pivoting activities often benefit from ACL surgery. Early assessment helps guide treatment and reduce the risk of further damage.
What is a meniscus tear?
The menisci are shock absorbers inside the knee. Tears can happen with a twisting injury or develop gradually with age. Common signs include pain on the inner or outer side of the knee, clicking or catching, swelling after activity, difficulty bending deeply or twisting, and being unable to fully straighten the knee.
Treatment. Many meniscal tears, particularly degenerative tears, settle with strengthening and activity changes, and physiotherapy is usually the first step. Tears that cause persistent mechanical symptoms, such as locking, may need keyhole surgery. Some injury-related tear patterns can be repaired, which helps preserve the meniscus and may reduce the risk of arthritis; you can read more about meniscal repair. Tears that cannot be repaired may need the unstable fragment removed.
What is knee osteoarthritis?
Osteoarthritis develops when the cartilage gradually wears down, causing pain, stiffness and difficulty with daily activities. It may cause stiffness after sitting, aching with everyday movement, difficulty kneeling or squatting, grinding, pain that disturbs sleep, reduced walking distance and a limp.
Treatment. Management focuses on reducing pain and improving function with physiotherapy, weight management, lifestyle changes, medicines and injections. In advanced cases, knee replacement may be considered. If you have a knee replacement, pain relief is carefully planned, including local anaesthetic infiltration and regional anaesthesia, such as a spinal anaesthetic and nerve blocks.
| Stage | What you may notice | Possible management |
|---|---|---|
| Early | Mild stiffness, occasional swelling | Strengthening, weight management, medicines, lifestyle changes |
| Moderate | Frequent aches, reduced mobility | Physiotherapy, injections |
| Advanced | Ongoing pain affecting daily life | Consideration of surgical options |
What is kneecap instability?
Kneecap (patella) instability is when the kneecap moves out of its normal groove, usually towards the outer side of the knee. It can happen after an injury, during sport or sometimes without a clear cause. People often describe a feeling that the kneecap is about to pop out, especially when twisting or changing direction. Symptoms include pain at the front of the knee, swelling after activity, giving way or dislocation, anxiety when changing direction, and difficulty with stairs and squatting.
Treatment. Options include strengthening physiotherapy, bracing, taping and activity changes. For recurrent or severe instability, surgery may be discussed to stabilise the kneecap and protect the cartilage. This can involve reconstructing the medial patellofemoral ligament (MPFL) or, for a high-riding kneecap (patella alta), moving the bony attachment of the kneecap tendon (a tibial tubercle osteotomy).
Trochlear dysplasia is when the groove the kneecap sits in is abnormally shaped, for example flat or dome-shaped. Reshaping the groove (trochleoplasty) is a specialised procedure that Dr Vishal Pai performs for severe trochlear dysplasia. You can read more in Kneecap Dislocation: What Should You Do Next?
What is an acute cartilage injury?
Cartilage is the smooth surface lining the knee joint that lets the bones glide. An acute cartilage injury is sudden damage to this surface, often from sport, twisting or impact. Cartilage does not heal well on its own, which is why early assessment is important. Symptoms include sharp pain with activity, swelling after exercise, catching or locking, discomfort with deep bending and a feeling that the knee is not moving smoothly.
Treatment. Treatment depends on the size and location of the damage. Smaller injuries may improve with physiotherapy, activity changes and time, while larger defects or ongoing symptoms may need a cartilage procedure. Options Dr Vishal Pai may discuss include osteochondral autograft transfer (OATS), where small plugs of healthy cartilage and bone are moved to the damaged area, and minced cartilage implantation (AutoCart), which uses your own cartilage fragments with a biological glue to fill the defect. You can read more about cartilage repair.
Summary
Knee problems affect more than movement; they can also affect confidence, independence and daily routines. A clear diagnosis gives you a structured plan and realistic expectations. Dr Vishal Pai explains both non-surgical and surgical options, arranges imaging only when needed and recommends non-surgical treatment when it is appropriate.
If you would like to discuss how this applies to your knee, you can book a consultation with Dr Vishal Pai.
Dealing with a knee problem?
Dr Vishal Pai treats ACL injuries, meniscus tears, knee osteoarthritis, kneecap instability and cartilage injuries. You can arrange a consultation to discuss your symptoms and options.
Written by Dr Vishal Pai
Vishal is an experienced knee surgeon based in Bayside, Melbourne. He consults at Sandringham Orthopaedic Specialists and operates at The Avenue Hospital and Calvary Holmesglen Private Hospital. His practice focuses on sports knee surgery, including ACL reconstruction and meniscal repair, as well as robotic knee replacement.