Overview:
Orthopedic Knee Treatment
Approximately 15% of men and 20% of women experience chronic knee pain in their lives with prevalence increasing with age.
Knee pain and knee-related injuries are among the most common medical situations that occur in the US. These injuries also cause significant levels of chronic pain.
Common treatments in the United States to reduce or eliminate knee pain involve surgical procedures like total knee replacements and total joint replacements. Over 750,000 of these types of surgeries are being performed in the U.S. each year. Other knee pain treatment options include medications, knee injections, and a new procedure gaining traction in the medical community called cooled radiofrequency ablation.
What are the common causes of knee pain?
Knee pain can be triggered by acute injuries, underlying medical conditions and/or repetitive activities which causes a strain of the muscles and ligaments and creates inflammation in the knee joint. Factors, such as obesity, can cause more friction on the knee joints which increases the possibility of knee pain.
The most common causes of knee pain are:
- Osteoarthritis — a degenerative joint disease affecting the knee joint. Also known as “wear and tear arthritis”, osteoarthritis affects over 60 million adults in the U.S.
- Osteochondritis dissecans — occurs when a fragment of the knee bone gets detached from the joint surface
- Patellofemoral Syndrome or Anterior Knee Pain — occurs when the cartilage under the kneecap is damaged due to overuse or injury
- Ligaments sprains and strains (often occurring during physical activities)
- Other overuse syndromes (such as bursitis and tendinitis)
- Referred pain from other parts of the body (such as the hip, spine, femur, etc.)
- Other types of arthritis (such as gout or pseudogout)
- Osgood-Schlatter disorder (common in athletes)
- Fractures in the knee region
- Patellar subluxation
- Patellar tendonitis
- Runner’s knee
- Cartilage tears
- Torn meniscus
There are several rare conditions that are considered extremely serious which are also expressed as knee pain, such as:
- Infections such as septic arthritis and osteomyelitis
- Secondary or primary bone cancers
- Anterior cruciate ligament tear or an ACL injury
- Rheumatoid arthritis
What are the symptoms of knee pain?
Common symptoms of knee pain (which can vary in intensity and duration depending on the location and cause) include:
- Difficulty in bearing any weight on the knee
- Difficulty in taking the stairs
- Sudden locking of the knee
- Feeling of instability
- Weakness
- Popping, clicking, or crunching noises in the knee
- Redness and warmth to the touch
- Inability to straighten the knee
- Tenderness
- Bruising
- Stiffness
- Limping
- Swelling
Chronic knee pain has certain characteristic symptoms, which include:
- Sharp and shooting pain when in use
- Constant ache
- Dull, burning sense of discomfort
- Pain even on light touch
What are the risk factors associated with knee pain?
Not all forms of knee pain are considered serious, although joint damage and long-term disability can occur if left untreated. There are risk factors that can increase the potential for knee pain that include:
- Participation in activities, occupations, and sports that put heavy stress on the knees
- Overuse (due to repetitive motions)
- Low muscle strength and flexibility
- Older age
- Biomechanics (such as changes in gait and length of stride)
- Old knee injuries
- Obesity
When should I see a doctor for knee pain?
The initial protocol to treat and reduce acute knee pain is RICE — Rest, Ice, Compression, and Elevation along with simple over-the-counter pain relievers to help reduce inflammation. If the pain is not reduced with this treatment and additional symptoms occur or persist (which are listed below), treatment should be sought by a healthcare professional.
- Constant pain lasting for more than a few days
- Inability to flex or stretch the leg at the knee
- Decreased sensations in the knee
- Apparent deformity in the knee
- Discomfort and/or instability while walking
- Inability to bear weight on the knee joint
- Feeling of heat on the knee
- Pain that affects sleep
- Significant pain
- Swelling
- Redness
- Fever
While knee pain can be debilitating, it can also cause long-term damage and even disability if left untreated. In some cases, knee pain can be a sign of a more serious underlying condition, such as malignancy, so consult a physician when knee pain persists. Advanced Orthopedics offers same or next day appointments with a team of Orthopedists and Pain Care Management physicians to help diagnose your condition and develop a customized treatment program.
How is knee pain diagnosed?
The Orthopedists and Pain Care Management doctors at Advanced Othopedics will begin a diagnosis by asking the following questions:
- Nature of the knee pain experienced — duration, intensity, etc.
- Specific signs and symptoms
- General medical history
After that, a physical examination will be conducted to check for:
- Push and pull exercises to check the integrity and stability of the knee structures
- Pain, swelling, warmth, tenderness, and bruising on the knee
- Range of motion of the knee
The physician may also recommend specific imaging tests to detect specific causes of the knee pain. Commonly tests that are often recommended include:
- X-rays — Useful in detecting fractures and degenerative joint disease.
- CT scans — Helpful with identifying fractures and diagnosing bone-related issues.
- Ultrasound — Produce real-time images of the soft tissue structures in and around the knee.
- MRIs — Also useful in detecting soft tissue injuries, diagnosing different knee problems (including damaged cartilage, bone fractures, infections, tumors, osteoarthritis, torn ligaments, and torn tendons), and assisting the physician when knee replacement surgery is considered to be a knee pain treatment option.
- Blood tests — Your physician may order blood tests in case of a suspected infection or condition.
How is knee pain treated?
Total joint replacement (or knee replacement) is one of the most common surgeries for treating knee pain today. Surgery is not the only option, and the specialists at Advanced Orthopedics may recommend other non-invasive or minimally invasive treatment options to address a patient’s knee pain.
Knee pain treatment will vary based on the diagnosis. More conservative treatments include:
- Medications — Over-the-Counter (OTC) medications, Non-steroidal anti-inflammatory drugs (NSAIDs) (such as ibuprofen) are usually effective to reduce mild to moderate knee pain and inflammation. If your condition requires stronger medication, your physician may prescribe stronger, prescription pain medications.
- Injections — In case of severe knee pain and inflammation, the physician may decide to inject medicines directly into the knee joint. The most effective injections are:
-
- Corticosteroids — These help to reduce inflammation and pain. As they do not enable permanent pain relief, they are administered once every few months (maximum of 4 per year).
- Hyaluronic acid — This acid matches the fluid that naturally lubricates the knee joints and helps improve mobility. This process is known as “viscosupplementation” and is usually taken as a series of injections.
- Physical therapy
Water-cooled radiofrequency ablation is also gaining adoption as a treatment option for knee pain. In this procedure, the nerves in the knee that are sending pain signals to the brain are targeted and destroyed. Originally used for treating back pain, this option is now also being used for knee pain.
When is surgery recommended for knee treatment?
If the above conservative treatments fail, surgery may be an option. Your physician may recommend knee surgery as the best option if you are experiencing any of these symptoms:
- Prolonged inflammation and redness that does not improve even with medications
- No pain relief from any medications
- Severe, debilitating knee pain even sitting down
- Instability of the legs
Common surgeries include:
- Meniscectomy — Procedure to remove a portion of the meniscus cartilage from the knee joint to relieve symptoms of a torn meniscus.
- Meniscus repair — Procedure to repair a damaged meniscus. While more successful than a meniscectomy, the recovery is also significantly longer.
- ACL reconstruction — The anterior cruciate ligament is important for knee stability, and this procedure is done to repair any damage to the ligament.
- Patellar/quadriceps tendon repair — Any damage to tendons in the legs can cause a loss of strength in its overall strength. This procedure helps restore the knee joint so patients can straighten their knee joints.
- Lateral release — Procedure to loosen the ligaments that support the kneecap.
- Arthroscopy — Procedure to remove damaged cartilage or loose particles of bones and soft tissue. Performed using a small telescope or arthroscope.
- Plica excision — Procedure to remove irritated tissue in the knee joints.
- Osteotomy — Procedure to improve the alignment of the knee by changing the shape of the bones.
- Partial knee replacement — This procedure is considered effective in treating specific types of arthritis. In this procedure, only the worn-out portion of the joint is repaired.
- Total joint replacement — In this procedure, the damaged bone and cartilage are completely cut away and replaced with an artificial joint.
What is the post-surgery recovery like?
For all knee surgeries, post-operative care and management becomes crucial for a successful recovery. Some pain, bruising, and swelling are expected after knee surgery, along with some additional side effects like:
- Pain (up to a few weeks – especially for a total joint replacement procedure)
- Swelling (up to 3 weeks after surgery and in some cases, as long as 3 to 6 months)
- Bruising (for about 2 weeks after the procedure)
Once these symptoms subside, patients who had a total knee replacement(s) often find significant improvement in the function of their knee joints and a reduction in knee pain.
Surgeons at Advanced Orthopedics consult regularly with their patients to facilitate their effective recovery and rehabilitation after a procedure is performed.
After the initial recovery period after surgery, the rehabilitation period is just as crucial to improve (or even restore) its function, strength and range of motion. Rehabilitation includes physical therapy with trained therapist along with exercises to strengthen and stabilize the knee joint and adjoining muscles.
How can I prevent knee pain?
Knee pain is not always preventable, although precautions can be taken to reduce or prevent this type of pain from occurring. Simple tips include:
If you are experiencing knee pain, there is no need to wait for relief. Advanced Orthopedics offers its patients a team of specialists that include Orthopedic Doctors, Pain Care Physicians, Rheumatologists, Neurosurgeons, Nurses and Physical Therapists who work together to facilitate comprehensive treatment options for you or a family member.
Visit https://austinpaindoctor.com/ or call 512-244-4272 for more information or to schedule a same or next day appointment.
FAQs
Q: Is walking good for knee pain?
A: Walking is considered the best exercise for those with knee pain as it helps send more blood and nutrients to the knee joint to ease the pain while strengthens the muscles and protecting the cartilage.
Q: How can I get relief from knee pain?
A: The best way to find relief from an acute knee injury and/or non-chronic knee pain is to follow the simple RICE protocol – Rest, Ice, Compression, and Elevation. Simple, over-the-counter medications can also help reduce pain and inflammation. If this protocol does not reduce the knee pain after several days, you should seek treatment from a healthcare professional at Advanced Orthopedics.
Q: How do I know if my knee pain is serious?
A: If you experience the following symptoms after several days of experiencing knee pain, it can indicate a more serious condition where medical attention is recommended:
- Fever
- Significant pain
- Swelling
- Discomfort and/or instability while walking
- Inability to flex or stretch the leg at the knee
- Redness
- Inability to bear weight on the knee joint
- Feeling of heat on the knee
- Apparent deformity in the knee
- Decreased sensations in the knee
- Pain that affects sleep
Q: What can cause knee pain without injury?
A: Knee pain can be caused by acute injuries and underlying medical conditions. Examples of underlying medical conditions include:
- Osteoarthritis — A degenerative joint disease affecting the knee joint. Also known as “wear and tear” arthritis, osteoarthritis affects over 32.5 million adults in the U.S.
- Patellofemoral Syndrome or Anterior Knee Pain — occurs when the cartilage under the kneecap is damaged primarily due to overuse because of repetitive activities/motions.
- Other overuse syndromes (such as bursitis and tendinitis)
- Osteochondritis dissecans — occurs when a fragment of the knee bone gets detached from the joint surface
- Referred pain coming from other parts of the body (hip, spine, femur, etc.)
- Patellar subluxation
- Patellar tendonitis
- Other types of arthritis (such as gout and pseudogout)
There are other knee pain-producing conditions that, although rare, are considered extremely serious. These conditions include:
- Secondary or primary bone cancers
- Infections (such as septic arthritis and osteomyelitis)
- Anterior cruciate ligament tear or an ACL injury
- Rheumatoid arthritis
