Knee osteoarthritis causes pain and limits your mobility. Understand the causes, symptoms and treatments for this joint disease.

These knee strengthening exercises will help prevent common sports knee injuries, strengthen the muscles around the knee and prevent knee pain.

MMA is a physically demanding sport that places significant stress on the joints, particularly the knees. Learn how to strengthen your knee ligaments for MMA training.

Prepare yourself for the winter season with ski injury prevention tips from sports knee injury specialist Dr Owen Wall.

Background: Synovial fluid (SF) mesenchymal stem cells (MSCs) are derived from the synovial membrane and have cartilage repair potential. Their current use in clinical practice is largely exploratory. As their numbers tend to be small, therapeutic procedures using MSCs typically require culture expansion. Previous reports indicate that the stem cell–mobilizing device (STEM device) intraoperatively increases SF-MSCs. Purpose: This study evaluated the chondrogenic potential of non–culture expanded synovium-mobilized MSCs and SF-microfragments obtained after enrichment using the STEM device and ascertained if device-mediated synovial membrane manipulation facilitated ongoing MSC release.

As ski season approaches, leading consultant knee surgeon Mr Owen Wall from The Leeds Knee Clinic discusses how to stay injury free on the slopes and beyond. With autumn now upon us and winter just around the corner, there may be many of you yearning to return to the fresh white peaks of the world’s ski centres for a week or two of healthy outdoor winter activities. Over the past 18 months, many of us have had our usual routines turned upside down and inevitably, for better or worse, this may well have had some impact on the amount and type of regular exercise that would have normally been undertaken. The re-opening of gyms and leisure centres across the UK has allowed many of us to get back to our routines. Running and cycling have again seen a further resurgence. Both of these activities are great for your cardiovascular fitness, but trading either exclusively for specific gym and conditioning routines for the muscles around the knee joint can unfortunately unmask niggles and problems, more of which I will discuss later. Whether you are a keen skier or just enjoy the cold, crisp outdoor air that winter resorts can provide, and prefer to indulge in the apres-ski activities, having optimal knee joint health will help you enjoy yourself to your full potential. You may also like to try other winter activities such as snow-shoeing, hiking and climbing. To minimise your risk of injury or the risk of exacerbating existing knee niggles it is helpful to consider the following advice before you embark. Whatever activities you have planned, try to undertake a six to eight-week plan of specific strengthening and conditioning work for the muscles of the legs before you go. Develop your gluteus muscle power. This muscle group (all around your derriere) is the biggest and most powerful in the body and really helps co-ordination. Concentrate on quadricep and hamstring strength aiming for balance between each muscle group. Develop calf and lower leg muscle conditioning using wobble boards or balance balls. Work on joint flexibility and tendon stretching for the hip, knee and ankle joints. The complex arrangements of the four major knee ligaments provides significant signalling to the brain to maintain balance and whereabouts in space and thus plyometric exercises can enhance this feedback and strengthen the ability of the individual to avoid knee problems. Many gymnasiums and sports clubs now offer specific pre-ski exercise classes where these conditioning exercises are taught, supervised and encouraged. If you haven’t got access to a gym, then a quick google search will bring everything to your fingertips. If you are a skier, whether you are experienced or not, be honest with yourself about your ability. Everyone likes to tell and hear stories of daring-do and crazy skiing exploits – these stories become legend and pass from generation to generation. But unless you are honest about your true ability, you may find yourself getting out of your depth extremely quickly, potentially resulting in serious problems for your knees. If you are hiring ski equipment, go to a five-star rated hire centre where the equipment will be new and well maintained. Being honest about your ability also means that your ski bindings will have been adjusted correctly and release when they should for your expertise level and bodyweight, thus minimising the risk of injury to your knees. Ensure that your ski boots are fastened snugly and not loose – if they aren’t comfortable when fastened snugly then get them changed. Years ago, skis had a very straight cut. This meant even experts found it difficult to get the skis to turn on their edges. The modern development of skis to have increasingly shapely profiles has brought edge carving to within reach of nearly all skiers. While the sensation of turning as if upon rails simply cannot be beaten, there can sometimes be an unfortunate sting in the tail. The last few years has witnessed an increasing number of skiers suffering double ligament injuries to their knees because of incorrectly adjusted ski bindings not releasing the skier beyond the limit of their ability. These injuries require a significant amount of rehabilitation and often surgery to provide long term knee stability. If you enjoy skiing adventure, and love to explore off-piste, hire an off-piste guide. Not only will you be supporting the local economy but you will also be minimising your risk of knee injury. Your guide will not only know where all the best conditions are, thus giving you a fantastic experience, but will probably also have great lift chat (I speak from personal experience!) If you are not a skier and want to instead explore the natural wildlife at a more sedentary pace via snow-shoeing or hiking, ensure you have well-fitted equipment, sturdy boots with outdoor soles and most importantly, when on snow, have two hiking poles. These will of course help you traverse slippery surfaces but more importantly help you prevent innocuous twists to the knees. If you are unfortunate enough to suffer a knee injury while undertaking any of the above activities, or suffer an exacerbation of an existing condition, remember to apply the basic principles of first aid. Extend the joint if you can, apply ice and/or compression bandaging, keep weight bearing to a minimum and seek expert opinion. Most ski centres have dedicated injury clinics where the basics can be undertaken such as provision of a splint, perhaps an x-ray, some even have more sophisticated imaging such as MRI. The important point to remember is to rest and upon your return seek expert clinical assessment and treatment so that you can get back to an active lifestyle as soon as possible. Should you wish to get any ongoing or indeed new problems with your knees sorted out before the commencement of the ski season, then just don’t hesitate to get in touch. Bon ski! Bon après-ski!! To get in touch with The Leeds Knee Clinic, call 0113 388 2009, email elaine.ingham@nuffieldhealth.com, or visit Leedskneeclinic.com

With the great British summer ahead of us, leading Yorkshire consultant knee surgeon Mr Owen Wall explores how to protect our joints when enjoying our favourite outdoor sports and advises us when to seek help. After a long winter had turned to a wet spring, the hope for a classic British summer is on everyone’s mind. Who doesn’t yearn for long summer days filled with plenty of sunshine and dry weather? As we all know, a British summer is often used as a euphemism for a wash out, but without those showers we wouldn’t be able to enjoy such fantastic Yorkshire countryside. As the days grow longer and evenings lighter, there is once again the opportunity to re-engage with those quintessential summer pastimes that are so ever popular in our region. The reassuring sound of leather on willow, the rhythm of baseline returns, the quiet hush before the thwack of club against ball. Cricket, tennis and golf are all popular summer sports and a healthy way of enjoying the great outdoors with friends and family. If you are keen to start playing, how can you maximise your enjoyment without incurring injury or problems to your knees? Well, the classic advice of doing some gentle stretching and warm-up exercises pre-activity is always a good start. Stretch and activate those muscles which you’ll use most frequently in order to provide them with maximum protection. Stretching thighs and calves and doing some rotatory torso warmups to activate your core will ready your body for the challenges ahead. Tennis, golf and cricket all provide plenty of opportunity for rotation of bodyweight about the knee, so it’s important to anticipate these movements which will help minimise the risk of injury. Should you be unfortunate enough to develop problems with your knees, first apply the RICE principles (rest, ice, compression and elevation). Perhaps try a graduated, gentle reintroduction into your activities to gauge whether the issue has resolved, and if so, slowly increase your demand while keeping a careful eye on how your knee responds. If you find that after a short period of time this does not improve the situation, then you may of course need professional help. Sports knee injuries are a particular specialist interest of my professional expertise. I help all patients from keen sporting enthusiasts through to elite world-class athletes. Providing you with an expert opinion and diagnosis can go a long way to helping you understand why you may have developed the issues and what methods you can undertake to correct the underlying causes and help treat the current problems. Access to rapid diagnostic imaging, along with the help and assistance of expert physiotherapy teams, will give you options regarding such treatment. Working closely with the two leading independent sector hospitals in the Leeds area (Spire Leeds Hospital and Nuffield Health Leeds Hospital) will also give you fantastic access to surgical treatment facilities should you need. To seek expert advice concerning your knees, visit Leedskneeclinic.com, or call Mr Wall’s secretary, Elaine Ingham on 0113 388 2009 where you can discuss your requirements for an outpatient appointment.

Abstract New TKA are designed to optimize patient outcomes and improve implant longevity such as the Attune TKA. Concerns have been raised regarding a potentially high rate of early de-bonding at the implant–cement interface of the tibial component. Our study aimed to prospectively assess the clinical outcomes and radiographs of a consecutive series of patients undergoing either Attune TKA or another modern TKA for OA to establish failure rates and compare radiological abnormalities. 96 Attune TKA performed by three surgeons at our local center were matched to 96 control TKA (PFC/Vanguard) performed between 2015 and 2017. Day one, one year and two year post surgery radiographs were analyzed by two independent, blinded assessors. Clinical outcome was assessed using the Oxford Knee Score and survival of the implant recorded. Patients were contacted two years from surgery, 93 Attune and 92 control TKAs attended for clinical and radiological assessment by the same independent assessors. No TKA in either group were revised. No significant radiolucencies (≥2 mm) at the cement-bone or implant-cement interfaces were encountered in either group. The incidence of radiolucencies (<2 mm) across both interfaces was similar between both groups and did not affect clinical outcome. There was no significant difference between the incidence, progression and extent of radiolucencies at two years follow-up in either of the groups as compared with one year. No clinically relevant adverse radiographic features were found in this prospective cohort study comparing a consecutive series of Attune TKA with a matched group of established, modern TKA designs. Read more: https://www.sciencedirect.com/science/article/abs/pii/S2214963521000377

As our gardens have bloomed over lockdown, leading Yorkshire consultant knee surgeon Mr Owen Wall explores how to protect our joints when tending our patch, and encourages those suffering painful conditions to seek medical solutions to enjoy our new-found freedoms to the full. As I’m sure you would all agree, the past 12 months have been some of the most unusual we’ve experienced since the cessation of the Second World War. Who would have predicted that back in March 2020, we would all be subjected to restrictions at variable levels, on our personal freedoms because of the global health pandemic caused by the SARS-Cov-2 virus, commonly known as COVID-19? We are still not yet out of the woods by any means but there is now significant hope that ‘normality’ may slowly return as we progress through 2021 because of a very well planned and executed vaccine rollout. ‘What did you do during the great pandemic Grandad?’ This may be a typical question that is asked by our grandchildren in the years to come, and what will our answers be? Well, for many, especially those of us lucky enough to have gardens or allotments, we certainly did a lot of gardening. Throughout those first few months during the first lockdown, as the weather improved and the sun shone, lawnmowers, hedge trimmers and strimmers could be heard with regularity. Borders were turned, shrubs and flowers planted and lawns manicured. Allotments were busy with keen gardeners readying their plots with vegetables and fruit for the summer and autumn harvest. As a nation, we were probably busier with our gardens over the last 12 months than at any time before. However, the increase in time spent in the garden can unfortunately lead to detrimental problems for your back and your joints, especially your knees. If you have pre-existing wear and tear problems, or you already have arthritis of your knees, the crouching, twisting and loading that comes with keeping your borders weed free can exacerbate symptoms of pain and stiffness so much that you may need a considerable period of rest before things settle down, and of course, they may not. How can you protect your knees whilst gardening? Knee pads or thick foam pads can certainly help relieve the pressure on the kneecaps (patellae) while kneeling, and taking care not to crouch and twist with full bodyweight loading can also help to prevent torn cartilage pads within the joint. If you have taken care but still have caused problems how do you recognise when to seek professional help? If you have torn a cartilage or have exacerbated a pre-existing knee condition, then you may experience a general or localised pain in or around the knee. You may notice a swelling or a feeling of tightness and restriction when bending your knee. You may notice that you can’t fully straighten your knee or it gets stuck (locked). Some people may feel a clunking or clicking within the joint when moving the knee in a certain way. If these symptoms are recurring or seem to be getting worse over time rather than improving, then it would be advisable to seek expert help. A prompt diagnosis and tailored solution may help you significantly and get your knees ready for your summer gardening sooner than you think. You may already have arthritis of your knee and have been previously advised that you may benefit from total or partial knee replacement but have been putting this off because of the pressures put on the health service secondary to the pandemic. Now that the winter pressures are all but over, this spring or summer would be the ideal time to get rid of those nagging arthritic pains and stiffness by having your knee treated. Do so while you are still able to enjoy the new-found freedom that a pain-free joint replacement can give you. Many patients have been forced to delay treatment for their arthritic joints over this past year and demand is ever growing, but the opportunity to seek a solution is available to you. If either of the above scenarios are relevant to you, please make contact with my secretary, or directly with myself via my website, and book your consultation with me at Leeds Spire Hospital or Leeds Nuffield Hospital today. Call Mr Wall’s secretary Elaine Ingham on 0113 3882009, email elaine.ingham@nuffieldhealth.com or visit Leedskneeclinic.com.