My colleague,
Dr. John Schultz, recently posted a succinct blog on a culprit causing knee pain that may have you referred for a surgery. It’s such a good article, that I thought I’d re-print it here.
Knee pain can arise from many sources: osteoarthritis, torn ligaments, excessive wear of the cartilage and improper tracking of the knee cap due to muscle imbalance. All too often an x-ray is taken which demonstrates osteoarthritis and the patient is scheduled for knee arthroscopic surgery.
There are other causes of knee pain which need to be evaluated which include the bursa. Bursa are saclike structures between skin and bone or between tendons, ligaments, and bone. They are lined by synovial tissue, which produces fluid that lubricates and reduces friction between these structures. Bursitis occurs when the synovial lining becomes thickened and produces excessive fluid, leading to localized swelling and pain.
A very common cause of anterior knee pain is inflammation of the pes anserine bursa.
Pes anserine bursitis presents as pain, tenderness and swelling over the anteromedial aspect of the knee, 4 to 5 cm below the joint line. Pain typically increases with flexion of the knee and climbing of stairs.
The pes anserine bursa lies behind the medial hamstring, which is composed of the tendons of the sartorius, gracilis and semitendinosus (SGT) muscles. Because these 3 tendons splay out on the anterior aspect of the tibia and give the appearance of the foot of a goose, pes anserine bursitis is also known as goosefoot bursitis.
Treatment consists of decreasing the muscle tension of the affected muscles through IMS and possible prolotherapy both available at the Centeno-Schultz Clinic.
So the next time you are scheduled for knee arthroscopic surgery, knee ligament surgery or arthroscopic meniscus surgery, please make sure that the cause of your pain is not an inflammed bursa which can be easily treated without arthroscopic knee surgery.
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