Hip & Knee
The hip and the knee are among the largest joints in the body. At the Columbia University Division of Orthopedics at Mount Sinai, our highly trained surgeons perform the most technologically advanced procedures using minimally invasive surgical techniques, including the new anterior hip replacement approach, as well as the use of robotics. This translates into less postoperative pain, lower risk of complications, and a quicker recovery.
Injury, Trauma, & Overuse Conditions
Injuries from household accidents, sports, trauma, and overuse cause many problems that can be treated by the Mount Sinai orthopedic team.
When it comes to treating orthopedic injuries of the hip and knee, our team uses advanced diagnostic tools, including powerful MRI, to see microscopic tears in tendons (which connect muscles to bone) and damage to ligaments (which connect bones to bones), as well as tiny fractures to bones. These diagnostic imaging tools allow the Mount Sinai team to choose the most appropriate treatment approach, which may include:
- Hard casts to immobilize the injured bones
- Slings or braces to minimize movement and strain
- Physical therapy
- Injections of steroids and other medicines to promote healing and reduce pain
- Minimally invasive arthroscopic surgery
- Surgery using metal plates and screws
- Tendon transfers and reconstruction
The physicians, technologists, and other providers on the Mount Sinai orthopedic team use these treatments in addition to other approaches for nearly every type of upper knee injury, including the following:
Hip Fracture
Older people frequently break their hips from a fall. We consider a broken hip a medical emergency that needs to be fixed within 24-48 hours to ensure the best results. Delaying care can negatively affect the results from treatment. If you or a loved one falls and may have a broken hip with symptoms like pain and an inability to bear weight, call 9-1-1, or go to the emergency room. Treatment for a broken hip usually requires surgery and extensive rehabilitation.Knee ACL Injuries
The ACL, or anterior cruciate ligament, connects the thigh bone to the shin bone. ACL injuries are one of the most common knee ligament injuries in athletes. They typically don’t result from an impact, but instead when the knee “buckles.” Patients often describe hearing or feeling a “pop,” and then the knee becomes swollen and painful. At Mount Sinai, we almost always treat torn ACLs with surgery to reconstruct the damaged ligament.Knee Cartilage Defects
Defects in isolated areas of cartilage in the knees can happen as a result of a traumatic event like a sports injury, or from repetitive movements that “grind” down the cartilage. We treat these isolated defects differently than whole-knee arthritis. Instead, these isolated defects can be treated with special cartilage restoration surgeries.Knee Collateral Ligament Injuries (LCL/MCL)
The MCL, or medial collateral ligament, is the most commonly injured ligament in the knee. The injury happens when the knee gets bent inward. An MCL injury can happen by itself or can happen along with an ACL injury. If only the MCL is injured, surgery is rarely required. Instead, we use a knee brace and physical therapy. Injuries to the LCL, or lateral collateral ligament, happen when the knee is bent outward, usually from a direct blow to the inside of the knee. An LCL injury is a serious condition that often happens with knee ligament injuries. When multiple ligaments get injured, we call it “multiligament knee injuries,” and usually have to perform surgery to fix the injury.Knee Meniscal Injuries
The meniscus are two C-shaped structures in the knee that act as shock absorbers. Meniscal injuries are common in younger patients from playing sports. In older patients, we see meniscal injuries as a result of “wear and tear” or degeneration. Patients often experience sharp pain and knee mechanical symptoms such as “locking” or “clicking,” especially with squatting. Traumatic meniscal injuries often require surgery to repair the meniscus or remove the torn piece. Degenerative meniscal tears may respond well without the need for surgery.Knee PCL Injuries
The PCL, or posterior cruciate ligament, connects the thigh bone to the shin bone behind the knee. Injuries to the PCL can happen from a direct blow to the knee or from a hyperextension injury. More severe injuries may occur with knee dislocations. Isolated PCL injuries can be treated without surgery with physical therapy and bracing.Labrum Tear
The labrum is a type of cartilage found in the hip joint. It helps keep the “ball” of the thigh bone centered and aligned with the hip “socket.” Sometimes the labrum can tear, causing groin pain and painful clicking in the front side of the hip joint. Most labrum injuries are due to sports injuries in young adults. Conditions such as hip dysplasia, femora-acetabular impingement, and other defects of the hip joint can also contribute to labrum tears. When the labrum tears, we often need to repair it with surgery.Patella Instability and Dislocations
The patella is often referred to as the “knee cap.” It can become dislocated from trauma like a sports injury, or a patient may have anatomy that increases their risk of patella instability. If someone’s patella dislocates many times, it requires surgery to stabilize the patella.Arthritis
Arthritis is a general term used to describe joint pain or joint damage. It can be caused by a wide range of conditions, including degeneration that increases with age, inflammation – sometimes from an auto-immune disease like rheumatoid arthritis – or various types of infection.
At Mount Sinai Medical Center, we treat nearly all forms of arthritis, including those that affect the hip and knee. Our specialists treat arthritis based on which joint or joints are affected. Many kinds of arthritis can be effectively controlled with anti-inflammatory medications, such as a non-steroidal anti-inflammatory like ibuprofen. Topical anti-inflammatory medications can also help. Our physicians also use steroid injections and physical therapy.
For more severe cases, joint replacement surgery can eliminate pain and help a patient gain their lost range of motion. Joint replacement is especially useful for larger joints like hips and knees. Mount Sinai’s orthopedic surgeons also use advanced surgeries like tendon grafts to reconstruct certain joints. Our interventions treat both hip and knee arthritis.
Orthopedic Defects & Deformities
Some patients are born with certain deformities. These cases are known as congenital, which means “from birth.” Other deformities can occur later in life as the result of injuries, disease, or overuse. They can also occur spontaneously without any easily identifiable cause. Mount Sinai’s team of orthopedic specialists provides treatments to address a variety of defects and deformities, including: