Knee Unit

Patients typically report knee pain following a movement of varying intensity. In the following days, this pain may be accompanied by additional symptoms, such as:

• Swelling and inflammation.
• Difficulty bending the knee.
• Difficulty walking and limping.
• Locking and/or difficulty fully extending the knee.

During arthroscopy, a systematic review of the entire joint is performed before proceeding with specific meniscal treatment. Depending on the case, one of the following interventions may be carried out: partial meniscus removal (meniscectomy), meniscus repair, meniscal replacement, or meniscal transplantation.

Anterior cruciate ligament injuries are commonly associated with sports, particularly those requiring pivoting, such as football, basketball, skiing, rugby, etc.

In patients experiencing symptoms of joint instability during daily activities and/or sports, surgical treatment for ligament reconstruction is indicated.

Patellofemoral syndrome pain arises from increased pressure between the patella and the femoral trochlea, causing irritation and, over time, cartilage wear. Pain typically occurs when climbing or descending stairs, squatting, or standing up after sitting for a long time.

Most cases improve with an appropriate physical therapy program. However, in some cases, if pain persists and limb misalignment exists, surgical treatment focuses on correcting the altered anatomical parameters.

Osteoarthritis is the most common cause of disability and chronic knee pain. The articular cartilage, which facilitates proper movement between the knee bones, begins to thin and wear down. Consequently, increased friction between bones causes pain and joint stiffness. Symptoms typically appear after age 50 or 60.

Knee replacement surgery relieves pain, enabling patients to resume daily activities. Success rates are high, with over 90% of patients experiencing significant pain relief and improved functionality in their daily lives.

Knee fractures may result from low-energy mechanisms in older patients or high-energy mechanisms, such as traffic accidents or contact sports.

Treatment depends on the patient’s characteristics and the type of fracture. When surgery is performed, it is common to combine it with arthroscopy to more precisely control fracture reduction and simultaneously repair other affected structures, such as menisci, ligaments, articular cartilage, and to remove loose bodies and the hematoma caused by the fracture.

Due to the lack of blood vessels in cartilage tissue, its capacity for self-repair/regeneration is virtually nonexistent. Surgical treatment aims to create repair or replacement tissue with histological properties as similar as possible to native cartilage or, in severe cases, to completely restore the damaged tissue with an allograft.

Treatment options include advanced bone marrow stimulation techniques, osteochondral transplants (mosaicplasty), direct osteosynthesis, chondrocyte cultures, and mesenchymal cell therapies.

These injuries involve damage to more than one ligament in the knee and often result from high-energy trauma, such as a car accident.

Once the decision is made, surgical planning is essential. Reconstruction of multiple knee ligaments often requires the use of allografts, which are tendons obtained from a tissue bank.

The iliotibial band (IT band) is the tendinous portion of the tensor fascia lata muscle, which originates in the iliac crest of the pelvis, descends along the lateral thigh, and inserts distally in the tibia.

Several factors contribute to the onset of this syndrome, also known as runner’s knee. It primarily affects runners and cyclists who engage in prolonged repetitive knee flexion within the same range of motion.

Initial treatment involves reducing exercise intensity. If needed, local corticosteroid injections may follow, and surgery is the last resort. During surgery, a lateral knee approach is used to perform a partial tenotomy and resection of the inflamed bursa.

These prostheses are a more recent development, allowing replacement of one or two parts of the knee without requiring total joint replacement. Not all osteoarthritis cases qualify for these prostheses. Compared to total knee replacements, the surgical technique is less invasive, resulting in quicker patient recovery.

Some patients who undergo meniscectomy may later develop a painful knee syndrome, including swelling and reduced range of motion, known as post-meniscectomy syndrome. Young, active patients with this condition may benefit from a meniscal transplant.

Meniscal transplantation is a complex surgical technique performed in few centers across Spain. ICATME’s Knee Team, led by Professor Monllau, pioneered this technique in Spain and Europe, receiving referrals from all over Europe for post-meniscectomy syndrome.

Cartilage is a tissue with limited capacity for repair and reconstruction. In recent years, techniques for transplanting fresh cartilage from deceased donors have been developed.

This complex technique is reserved for highly selected cases of knee cartilage injuries. ICATME’s Knee Team was the first to perform this procedure in Spain’s private healthcare sector.

ACL reconstruction in pediatric patients differs from the same procedure in skeletally mature patients. Over the past decade, scientific literature has emphasized the importance of reconstructing the ACL in children rather than waiting for growth to finish, as previously believed.

Surgical techniques in these cases differ significantly from those used in adults and are particularly complex. Therefore, they should only be performed in specialized centers for arthroscopic surgery.

ICATME’s Knee Unit performs complex pediatric ligament surgeries and was the first center in Spain to join the European Society of Knee Surgery (ESSKA) project on pediatric ACL reconstruction (PAMI) since its inception in 2018. Furthermore, it became the first center in Europe to use tendons from one of the child’s parents for ACL reconstruction, a technique in which ICATME is a leader in Spain and Europe.