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Knee Conditions

There are many conditions and injuries that affect the knee. Please use the list below for more specific information about each condition.
For a general overview of knee injuries and conditions, please click here.

Kneecap Dislocation and Instability

The kneecap (patella) can sometimes dislocate out of its position in the middle of the knee, usually to the outer side. This injury can then result in kneecap instability, or repeated dislocations. This instability can be frustrating and dangerous, as patients never know when their knee will “give out.” Sometimes, a dislocation can be successfully treated with a brace. Other times, however, the dislocation requires surgery to rebuild the ligaments that stabilize the kneecap. A cartilage injury to the kneecap may also have occurred during the dislocation, and these injuries are also treated as part of the same surgery.

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Knee Fracture

Fractures around the knee can involve the thigh bone (femur), the kneecap (patella), or the shin bone (tibia) – or a combination of these bones.  Knee fractures sometimes do not require anything more than a brace or a cast and a few weeks on crutches.  Many times, however, fractures of the knee bones can be very serious injuries that require major surgery to repair.  Dr. Bushnell has extensive experience with the treatment of knee fractures.

For more information about Knee Fractures, please visit:

Femur/Thighbone Fracture at the Knee

Tibia/Shinbone Fracture at the Knee

Knee Cartilage Injury

Meniscus Tear

One of the most common injuries in the knee involves tearing of the meniscus. The meniscus is a thick, rubbery “shock absorber” made of fibrocartilage, which is a different type of cartilage than the articular cartilage that lines the ends of the bones. Tears of the meniscus can happen suddenly, from a fall or accident, or from a sports injury. Sometimes the meniscus may heal on its own. In younger patients, the meniscus can sometimes be repaired if the tear has a good blood supply. In older patients, however, a tear of the meniscus usually requires a partial meniscectomy – a surgical procedure in which the torn part of the meniscus is removed from the knee using special arthroscopic instruments and a minimally-invasive approach. Arthroscopic surgery is the most common procedure that Dr. Bushnell performs in the knee.

For more information about meniscus tears, please visit:

Chondral Defect

The ends of the bones in the knee are covered with smooth articular cartilage, which is different from the fibrocartilage of the meniscus. This cartilage can be injured and develop a chondral defect. A chondral defect must be diagnosed by an MRI, and the thighbone (the femur) is the most common site of injury. These defects are essentially “holes” in the cartilage, and can be a major source of pain and disability. These holes can be “patched” using a surgical technique known as microfracture. Dr. Bushnell trained at the Denver branch of the Steadman-Hawkins Clinic in Colorado – the institution where the microfracture technique was invented by Dr. Richard Steadman.

For more information about knee cartilage injury, please visit:

Multi-Ligament Injuries

Many times, knee injuries involve tears of more than one ligament at a time. These multi-ligament injuries often require surgical treatment and extensive rehabilitation after surgery to prevent stiffness. Dr. Bushnell and the sports medicine team at Harbin Clinic have handled some of the toughest multi-ligament knee cases in the region with a successful record of returning patients to work and to play.

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Combined Knee Ligament Injuries

Knee Ligament Injury

The knee has several important ligaments, which are thick cords of tissue that connect the bones to each other.  These ligaments can be injured in sports, work, recreation, or even everyday activities.  Some ligaments may heal on their own with appropriate braces.  Other ligament injuries, however, usually require surgical repair or reconstruction.  Dr. Bushnell maintains an active interest in ligament surgery since his training at the Steadman-Hawkins Clinic in Denver, a busy ligament reconstruction center where he was also able to publish research about ligament injuries in professional athletes.

ACL Tear

The anterior cruciate ligament (ACL) is the most commonly torn ligament in the knee. It usually tears from a twisting and/or hyperextension injury. It is more common in younger patients and in female athletes, but it can affect patients of any age and activity level. Once torn, the ACL usually requires surgical reconstruction. Various surgical techniques exist to reconstruct the ACL, and Dr. Bushnell has training and experience in all of the major methods of ACL reconstruction. He has performed ACL surgery on patients as young as 11 years old and as old as 63. He meets with each patient individually to discuss the most ideal choice of reconstruction technique, based on each patient’s age, activity level, athletic goals, and other factors.

For more information about ACL tears, please visit:

MCL Tear

The medial collateral ligament (MCL) is the second-most commonly torn ligament in the knee. It stabilizes the knee from side to side and is located on the inner side of the knee. Injury to the MCL is very common in contact sports in which athletes are tackled or impacted from the side. A tear of the MCL is usually treated without surgery, using a hinged brace to protect the joint while the ligament heals.

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PCL Tear

The posterior cruciate ligament (PCL) is another major ligament in the knee that can frequently be torn in athletic or recreational activities. The injury usually occurs when a person falls and strikes the front of their knee hard against the ground or another object. While this injury may occasionally need surgery, it can usually be managed with an appropriate brace.

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LCL Tear

The lateral collateral ligament (LCL) also stabilizes the knee from side to side, just like the MCL, but the LCL is located on the outer side of the knee. Isolated injuries to the LCL usually do not need surgery, but often they are part of a more complicated injury to the knee involving more than one ligament. Dr. Bushnell has published research about LCL injuries in professional football players.

For more information about LCL tears, please visit:

MPFL Tear

The medial patellofemoral ligament (MPFL) stabilizes the kneecap and keeps it from slipping out to the side.  When an injury results in a full patella dislocation, the MPFL can be torn.  In some cases, the tear of the MPFL can be treated successfully with a brace.  In other situations, the MPFL must be repaired or reconstructed.  In association with his partner, Dr. Piller, Dr. Bushnell has developed a minimally-invasive technique for MPFL reconstruction that has had great success.

For more information about MPFL tears, please visit:

Knee Arthritis

Arthritis of the knee is a debilitating breakdown of the joint that affects millions of Americans every year. Symptoms include pain, swelling, clicking or popping, a sense of instability, soreness, throbbing, and other problems. Treatments for arthritis of the knee include injections, medications, exercises, therapy, and weight loss. Sometimes, the arthritis can get bad enough to justify surgical treatment. Dr. Bushnell performs knee replacement on select patients with good success rates. He has never had an infection of a total knee replacement.

For more information about knee arthritis, please visit:

Arthritis of the Knee (AAOS OrthoInfo)

Arthritis of the Knee (AAOS OrthoInfo – Spanish)

Knee Arthritis (WebMD)

Knee Tendon Tear

There are two main tendons in the knee – the quadriceps tendon that connects the thigh muscles to the kneecap, and the patellar tendon that connects the kneecap to the shin bone (tibia). These tendons can be torn through a fall or a sports injury, and they must be reattached to the bone. Surgery for knee tendon injuries is usually an outpatient procedure with a high success rate. Dr. Bushnell has published extensive research about knee tendon injuries and repair using suture anchors – a minimally-invasive technique that he helped develop while in training at the University of North Carolina.

For more information about knee tendon injuries, please visit:

Patellar Tendon Tear

Quadriceps Tendon Tear

Suture Anchor Repairs