Knee problems (including knee osteoarthritis)
Knee injury assessment, both acute and chronic overuse injury
Dr Davies has wide clinical experience of managing a wide variety of knee injuries throughout all age groups. He will make a thorough assessment of your knee injury. If any further tests are needed (eg x-rays, MRI scans etc) he will arrange these and feedback the results to you. Ongoing management will be discussed as part of a multi-disciplinary team as required, often involving physiotherapy colleagues and occasionally a knee surgeon.
Meniscal / cartilage problems
These problems can occur within the knee both acutely, often associated with a twisting injury but they can also occur without significant injury, particularly in the more mature knee. Not all cartilage injuries require surgical intervention but they do need thorough assessment by an experienced clinician. MRI scans & x-rays are sometimes needed. Dr Davies will provide a holistic approach to your ongoing injury / knee problem.
ITB Friction Syndrome
This common problem often occurs in distance runners and is commonly seen in Dr Davies’s clinic at marathon time. Often a training error associated with some biomechanical issues may be the trigger for the symptoms starting. A clinical assessment will usual establish the diagnosis and also assess for associated contributory biomechanical factors. Scans are not usually required, however, an ultrasound scan would confirm the diagnosis if needed. Occasionally, a lateral meniscus tear may present in a similar fashion. If there is diagnostic doubt, particularly if meniscal surgery is being considered, an MRI scan may be very helpful.
There are a variety of bursae around the knee. These fluid filled sacs which provide lubrication between moving structures within the body, particularly around joints. Bursae are normal structures. However, they can sometimes become inflamed and swollen. In these situations significant pain and reduced function can result. There are several around the knee, including prepatella and retropatella bursa as well as the pes anserine bursa. When these structures become inflamed predisposing factors need to be identified and addressed. Ultrasound scans can confirm the diagnosis in difficult cases. Most respond to appropriate rehabilitation and use of anti-inflammatory tablets (NSAID’s). Occasionally, fluid may need to be drained from the bursa then injected with steroid. Surgery is rarely required for these problems.
Osteoarthritis of the knee
Dr Davies has wide ranging experience in the diagnosis and medical management of knee osteoarthritis (OA). This common condition needs to be managed in a holistic fashion addressing the various contributing factors where possible. Clinical assessment and sometimes x-rays will help to confirm the diagnosis. Management includes weight loss, the use of NSAIDs, a lower limb rehabilitation programme, low impact CV exercises. Sometimes injection therapy can help with symptoms management. Injections include steroid as well as viscosupplement injections (eg Monovisc, synvisc etc). In general terms, keyhole surgery (arthroscopy) has little role to play in the routine management of knee OA. If a surgical opinion is required to consider a form of arthroplasty (replacement) surgery Dr Davies will involve the skills of an orthopaedic colleague.
Assessment and management of knee ligament injuries
Dr Davies has widespread experience of managing knee injuries within the NHS, the military and professional sport. He will make a thorough assessment, arrange appropriate investigations and oversee your rehabilitation as part of a multi-disciplinary team when needed.