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Stress Fracture Of The Knee

See An Orthopaedic Surgeon For Ankle Fractures

Stress fracture of knee and migratory osteoporosis

An orthopaedic surgeon with expertise in the intricate workings of the bones, tendons, ligaments, and muscles of the ankle should be consulted if you have a fracture in your ankle. A hairline fracture of the ankle is less severe than a major ankle fracture that can cause significant pain but should not be ignored. If you have a hairline fracture in your foot, you may experience difficulty walking, but it will not cause you to miss work.

Causes Of Knee Fractures

Knee fractures are not common and are usually caused by direct impact to the kneecap. This can happen from a car accident, a hard fall, or a sports injury. If you suffer from osteoporosis or a bone infection you may be at higher risk of a knee fracture from seemingly minor injuries. Stress fractures in the knee are more common among long-distance athletes like runners. The repetitive movement causes trauma to the bones that make up the knee structure. Other risk factors for knee stress fractures include obesity, poor diet, low vitamin D levels, ill-fitting or worn-out footwear, and poor technique when doing physical activity.

Citation Doi & Article Data

Citation:DOI:Frank GaillardRevisions:see full revision historySystem:

  • Spontaneous osteonecrosis of the knee
  • Subchondral insufficiency fracture of the knee
  • Spontaneous insufficiency fracture of the knee
  • Spontaneous osteonecrosis of the knee
  • Spontaneous osteonecrosis of the knee
  • Spontaneous osteonecrosis of the knee
  • Ahlback disease

Subchondral insufficiency fracture of the knee are stress fractures in the femoral condyles or tibial plateau that occur in the absence of acute trauma, typically affecting older adults.

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Atlanta Knee Stress Fracture Treatment

The board-certified, fellowship-trained orthopedic surgeons at Ortho Sport & Spine Physicians are Atlantas trusted source for state-of-the-art knee stress fracture treatment. We specialize in knee treatments resulting from injuries and conditions, including stress fractures. By utilizing the most advanced treatments and techniques, we have helped countless individuals in Atlanta find relief from their pain and other symptoms so they can return to a healthy and active lifestyle.

Stress fractures are injuries that occur due to overuse and are very common among athletes. They occur when tired muscles lose the ability to absorb shock, and instead transfer the vibrations to the bone, thus causing stress fractures. This painful condition can also occur as a result of an injury or fall. The majority of stress fractures occur in the lower leg or foot. The most common symptom is pain that lessens with rest. To treat stress fractures, our doctors offer a number of non-surgical and surgical solutions. After a thorough evaluation, we can recommend a customized treatment plan that is tailored to your specific age, lifestyle goals and activity level.

Where Do Stress Fractures Happen


Stress fractures can occur anywhere there is overuse, but theyre most commonly found in the lower extremity as a result of impact and weight bearing activities. The most common bone is the shin bone or tibia . Stress fractures can also occur in the foot. The foot is made up of several small bones. The bones running to the toes are called metatarsals. There are five metatarsals in each foot. It is most common for a stress fracture to happen in the second and third metatarsals. Stress fractures can also be seen in the heel , hip and even the lower back.

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What Causes Stress Fractures

Many sports raise the risk of stress fractures. Activities that require running and jumping may cause fractures in the legs or feet. More than half of all adult and adolescent stress fractures occur in the lower leg bones. Of these, fractures of the tibia — the long bone of our lower leg — are the most common at about 24% of all stress fractures.

Other sports that require repetitive movements — like pitching or rowing — can result in stress fractures of the humerus , but these are much rarer.

What Is The Treatment For Stress Fractures

First aid for stress fractures

Itâs important to see your doctor, because the bone could break completely without treatment. In the meantime, follow the RICE guidelines:

  • Rest. Avoid weight-bearing activities. Wear a stiff-soled, supportive shoe if necessary.
  • Ice. To ease swelling, ice the area for 24 to 48 hours. Wrap an ice pack in a towel and apply for 20 minutes at a time. Never put ice directly on your skin.
  • Compression. Wrap a soft bandage around the area to ease swelling.
  • Elevation. Use pillows to raise your foot or leg higher than your heart.

Medications for stress fractures

You can take over-the-counter medications to manage pain. Doctors suggest acetaminophen instead of nonsteroidal anti-inflammatory drugs , which may reduce your boneâs ability to heal.

Nonsurgical treatments for stress fractures

Most people donât need surgery to repair a stress fracture. Along with the RICE plan to reduce pain, your doctor may try one or more of these treatments while your fracture heals:

  • Crutches or a cane for support
  • Protective footwear like a boot or brace to lessen stress on the fracture
  • Casts to keep your fracture in a fixed position while it heals

Theyâll also advise you to skip high-impact physical activities like running for 6 to 8 weeks. Try lower-impact exercises like swimming or cycling instead.

Surgery for stress fractures

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What Are The Symptoms Of A Stress Fracture

The symptoms of a stress fracture can include:

  • Pain, swelling or aching at the site of fracture.
  • Tenderness or pinpoint pain when touched on the bone.
  • Pain that begins after starting an activity and then resolves with rest.
  • Pain thats present throughout the activity and does not go away after the activity has ended.
  • Pain which occurs while at rest, during normal activity or with everyday walking.
  • Pain which is worse with hopping on one leg or an inability to shift weight/hop on affected leg/foot.

If a stress fracture is not treated at an early stage , the pain can become severe. There is also a risk that the fracture may become displaced . Certain stress fractures are considered high risk stress fractures because they may have a poor outcome if not identified early.

What You Need To Know

Stress fracture of knee and meniscus tear
  • Patella fractures are common injuries. About 1% of all broken bones are broken kneecaps.
  • Fractures of the patella are most often caused by a direct blow to the knee, such as a fall or motor vehicle accident.
  • Kneecap fractures can be simple or complex. Complicated patella fractures, which result in displaced pieces of bone, may require surgery.
  • Rehabilitation focuses on improving range of motion, building up muscle strength and decreasing knee stiffness. Recovery can take several months.

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What To Discuss With Your Orthopaedic Surgeon

  • What are my unique risks and benefits with nonsurgical and surgical treatment?
  • How might this injury affect my long-term expectations for daily living activities, work, and recreational activities?
  • Do I have a medical or social history that might have an impact on my treatment or outcome?
  • If I get arthritis, what can I expect and what are my options?
  • After treatment begins when can I expect to bear weight and bend my knee?
  • How will the recovery phase affect work and family responsibilities?
  • What kind of help, if any, will I need during my recovery?
  • If I have surgical treatment and a bone filler or substitute is used, what are my options? What are the risks and benefits?
  • Will I be on anticoagulation medications ? If yes, which one and for how long?
  • Hairline Fracture Ankle Recovery Time

    A hairline fracture is a very fine break in the bone. It usually takes around six weeks to recover from a hairline fracture. However, depending on the severity of the fracture, the recovery time can vary. With a hairline fracture, it is important to rest the ankle and avoid putting any weight on it. You may also need to wear a splint or cast to immobilize the ankle. Physical therapy may also be recommended to help with the healing process.

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    Can You Walk With A Kneecap Fracture

    crutches, walkers, or canes are commonly used as crutches or walkers during healing. A kneecap fracture occurs when a joint is damaged in the kneecap.

    Treatment For Unstable Fractures

    Surgery may be required to repair a broken bone and ensure that it heals properly. Patients are most likely able to walk as long as the brace maintains a straight line while walking.

    The Most Common Knee Stress Fracture Symptoms

    Orthopedic Stress Fractures

    A stress fracture is a minuscule crack in the bone that is caused by repetitive use or trauma. Commonly seen in athletes, stress fractures occur over time and are often in the shins, foot, heel, and knee. Because the crack is so small, pain from a stress fracture tends to be less severe than broken bone pain and the problem is sometimes harder to diagnose.

    Stress fractures that occur in the knee are normally harder to diagnose than a stress fracture in the tibia or foot. The most common knee stress fracture symptoms include:

    • Pain and swelling in your knee
    • A pinpoint pain when touching your knee bone
    • Dull pain that gets worse during activity and goes away with rest
    • Pain that occurs whether you are resting, doing normal activities, or walking
    • An inability to put weight on one leg
    • Bruising around the knee

    If you are experiencing any of these symptoms, you may have a knee stress fracture and should contact an orthopedic knee specialist at OrthoConnecticut as soon as possible.

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    Whos At Risk For A Stress Fracture

    Unlike acute bone fractures that occur as the result of an accident and cause sudden intense pain, a stress fracture starts with a small hairline fissure in the bone, which bring on non-distinct pain slowly.

    Stress fractures often occur in the lower limbs and feet, which is why athletes who put repetitive stress of their legs and feet are most vulnerable: runners, dancers, soccer players and basketball players.

    See Stress Fracture Risk Factors

    This is particularly true for these athletes during times when some aspect of their training is changedlike new shoes or a different running surfaceor drastically intensifiedlike longer or more frequent workouts in preparation for a race or event.

    Make An Appointment With An Orthoneuro Knee Specialist Today

    If you are suffering from symptoms of a knee stress fracture, schedule an appointment with one of our Board Certified Orthopedic Knee Specialists at one of our 7 convenient locations throughout Greater Columbus.

    We will evaluate your unique lifestyle and goals to determine which type of treatment is best for you.

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    What Does A Stress Fracture Feel Like In Knee

    A stress fracture in the knee can cause pain in the front, outside, or inside of the knee. The pain is usually worse when walking, running, or standing on the affected leg. The pain may also get worse when going up and down stairs.

    When you have a stress fracture, it is a repetitive motion or overuse injury in the weight-bearing bones of your body, resulting in a hairline crack. If left untreated, this injury can cause foot and ankle pain, putting you at risk of a more serious injury. The most common type of stress fracture is found in the legs, ankles, and feet. Your local Foot and Ankle Center can help you identify stress fractures as soon as possible. A stress fracture, such as one in the hip, is a risk factor for certain conditions. If you are a professional athlete, take a look at our five preventive foot care tips.

    What Causes A Stress Fracture

    Pain in knee with running. Rule out stress fracture.

    Risk factors for stress fractures can be divided into two basic categories: extrinsic and intrinsic.

    Extrinsic factors happen outside of the body. These can also be called environmental factors. These factors can include:

    • Practicing incorrect training or sport technique.
    • Having too rapid of a training program or volume of activity or changing your activity level without a gradual break-in period.
    • Changing the surface you exercise on, such as going from a soft surface to outside on gravel or concrete.
    • Running on a track or road with sloped surface.
    • Using poor equipment or improper footwear .
    • Doing repetitive activity in certain high-impact sports, such as:
    • Long-distance running .
  • Having a poor diet that has inadequate caloric intake for volume of sport.
  • Having a low vitamin D level.
  • Experiencing early specialization in sports. Youth who play one sport year-round without a break are at risk of stress fractures.
  • Intrinsic factors are things that are related to the athlete or patient and arent impacted by outside forces. These factors can include:

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    How To Heal A Stress Fracture Of The Knee

    A stress fracture of the knee is a common injury that can cause immense pain and discomfort. It is important to rest and ice the knee as soon as possible after the injury to promote healing. You may also need to wear a knee brace or splint to immobilize the knee and prevent further injury. Physical therapy can also be helpful in healing a stress fracture of the knee.

    A fractured bone is a medical term that refers to a broken or cracked bone. The majority of fractures occur as a result of a high-force impact or strain. A bone fracture is also thought to be caused by certain medical conditions, such as osteoporosis, that weaken the bones. Overuse injuries are a common cause of stress fractures in athletes.

    What Is A Tibia Stress Fracture

    The lower leg consists of two bones, called the tibia and fibula. The tibia is the larger, thicker of the two and its role is load-bearing. The fibula is the smaller, thinner bone. Its purpose is mainly as an area for muscles to attach. Either of these bones can develop stress fractures.

    The most common site, however, is two to three inches above the bony bit on the inside of the ankle on the tibia bone.

    Long bones such as the tibia have an outer sheath surrounding the hard compact bone called the periosteum with the inner core containing bone marrow. Continuous muscle contractions and stress forces of impact cause the tibia to overload.

    In particular, fatigue causes the distribution of forces in the bone to alter. This is because your muscles are unable to absorb some of the load.

    Therefore, there is more load on the bone. Lots of small impacts on the bone even though they may be very small, result in a cumulative build up.

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    Diagnosis Of A Stress Fracture Of The Tibia

    Your doctor will review your medical history and symptoms and based on this a physical examination will be performed. Any swelling or bruising will be noted. Diagnostic tests can include the following:

    • X-rays: During this study, high electromagnetic energy beams are used to produce images of the broken bones. However, stress fractures may be difficult to visualize on X-rays.
    • Bone scan: This is an imaging technique in which a radioactive drug is injected into the bone to detect any damage or disease.
    • CT scan: Detailed images of the tibia are obtained using X-rays from different angles.
    • MRI Scan: An imaging study that uses a large magnetic field and radio waves to produce detailed images of the tibia.

    How Are Stress Fractures Treated


    There are several different treatment options for stress fractures. Stress fractures can be treated non-surgically and surgically. However, surgical treatment is usually not required.

    Depending on the degree of your stress fracture, your specialist will discuss which option best fits your needs and goals and then plan accordingly to help relieve pain.

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    What Activities Make Athletes Most Susceptible To Stress Fractures

    Studies have shown that athletes participating in tennis, track and field, gymnastics, and basketball are very susceptible to stress fractures. In all of these sports, the repetitive stress of the foot striking the ground can cause trauma. Without sufficient rest between workouts or competitions, an athlete is at risk for developing a stress fracture.

    Operative Technique And Follow

    All patients underwent cemented total knee arthroplasty under spinal anesthesia using posterior cruciate sacrificing implants with modular fluted tibial extension rods. An inflatable tourniquet was used in all cases from skin incision to closure, set at 100 mm Hg above the systolic blood pressure of the patient. A standard medial parapatellar arthrotomy approach was used in all cases. After preparing the femoral side with standard measured resection technique, a tibial cut was done using an extramedullary jig and sequential intramedullary reaming done after correction of any deformity at the fracture site.

    A fluted extension rod acting as an internal splint provided excellent intraoperative stability at the fracture site, achieving adequate press fit in the distal tibial fragment ensuring rotational stability. The length of the rod was dictated by the location of the fracture as it was supposed to bypass the fracture site by at least two cortical diameters distally. Only the tibial base plate was cemented, taking care to prevent leakage of cement at the fracture site. Drains were not used.

    Functional outcome assessment was done by recording data on postoperative knee range of motion, Knee Society score, knee functional score, and radiological evaluation using standard AP and lateral projections of the knee. The postoperative tibial alignment was also evaluated using the anatomical axis of the tibia to assess the adequacy of fracture reduction.

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    What Are The Risk Factors For A Knee Fracture

    Common risk factors for a Knee Fracture may include the following:

  • Osteoarthritis patients with osteoarthritis are at a higher risk for knee fractures.
  • Age as the bones age, they become more brittle and are more susceptible to breaking.
  • Sports participating in high-impact sports such as football, basketball, and downhill skiing.
  • Gender females are more likely to suffer from a knee fracture.
  • Smoking and drinking alcohol smoking and drinking alcohol impact hormones and bone structure, increasing the risk of knee fractures.
  • Previous knee injury a previous injury or knee fracture doubles the risk of suffering another injury.
  • However, A simple knee fracture may heal on its own, although a cast may be necessary to keep the pieces from moving around.


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