Knee

Most knee complaints can be narrowed considerably before any imaging is ordered. The history matters: whether the injury happened in a single moment or built up over months, whether the knee swelled within hours or the next day, whether it catches, gives way, or simply aches after activity. Each of those patterns points toward different structures.

Examination then tests the knee directly — ligament stability, joint line tenderness, patellar tracking, alignment and the way the hip and ankle contribute to how the knee loads. Radiographs are usually the first imaging step, and MRI is added when the result would actually change the plan rather than as a reflex.

A large share of knee problems improve without surgery. Structured physical therapy that addresses quadriceps strength, hip control and movement mechanics is the foundation. Activity modification, bracing, and injections have defined roles depending on the diagnosis.

Degenerative meniscus tears in a knee with arthritic change, patellofemoral pain, early arthritis and many tendon problems typically respond better to rehabilitation than to arthroscopy. Where injections are considered, options and their limits are discussed openly — including cortisone, viscosupplementation for knee arthritis, and platelet-rich plasma.

Surgery is recommended when the structural problem will not resolve on its own and it is limiting the knee in a way that matters to the patient. A complete ACL tear in someone who cuts and pivots, a displaced meniscus tear that locks the knee, recurrent patellar dislocation and symptomatic cartilage defects are the common examples.

Most of this work is done arthroscopically through small incisions. Before scheduling, the conversation covers what is being repaired versus removed, what the recovery actually looks like week by week, what could go differently, and what the alternatives are if surgery is declined or delayed.

Rehabilitation is planned alongside the procedure, not after it. Written protocols are shared with the patient and their therapist so everyone is working from the same timeline, and they are available on the patient resources page.

Return to sport is decided on objective criteria — restored motion, strength symmetry compared with the other leg, control on single-leg and landing tasks, and confidence in the knee — rather than the calendar alone. For athletes, milestones are tied to the demands of their position and coordinated with their trainer or coach.