The Doctor is In: Common Reasons for Knee Pain

The Doctor Is In

MOBILE COUNTY, Ala. (WKRG) — Dr. Trevor Stubbs with Bayside Orthopaedic Sports Medicine & Rehab discusses knee pain in today’s “Doctor is In.”

For the viewers, if they have knee pain, what is the most common reason?

            – The answer really depends on age. For our more mature patients, the answer is arthritis. That tends to be pain and soreness around the knee that gets worse with activity. Patients can also have stiffness in the morning or after being seated for a long period of time. This usually comes on gradually and gets worse with time.

We hear about arthritis all of the time. What exactly is arthritis?

            – Arthritis at the basics is a lack of cartilage. Cartilage is a smooth and shiny covering on the end of the bone which helps the bones glide across each other. When the cartilage wears out, the ends of the bone are exposed. There is more friction and less cushion.

What about bone bone spurs?

            – Bone spurs are one of the signs we see on X-ray as an indicator of arthritis. The bone spurs aren’t necessarily the problem but more a sign that the patient has damage to the cartilage. Other signs are decreased space between the bones and sclerosis or hardening of the bones.

What about people with injuries? If someone has an injury, how do they know if they need to see a doctor?

            – That is a great question. If someone has a fall and cannot put weight on their leg due to pain, they should definitely be evaluated. There could be a fracture of the bone which requires treatment. For less severe injuries, signs and symptoms like sharp pain with activity, pain and swelling that doesn’t improve in a few days, and the inability with either straightening or bending the knee would all be reasons to schedule an appointment. Also the sensation of the knee buckling, locking, or catching would be reasons to come in and see us.

Besides breaking a bone, what else can be damaged when someone is injured?

            – There are multiple ligaments in the knee which can be torn, depending on how someone is injured. Most people have heard of the ACL which is 1 of the 2 ligaments in the center of the knee. You can also tear the meniscus , the patellar or quadriceps tendon, dislocate the kneecap, or damage the cartilage.

What can people do to prevent knee pain or problems in the future?

            – Preventative knee health is very important. One of the most important things is weight control. The less weight you carry, the less force that your knees see with every step. Also important is to maintain your flexibility. One thing to consider is to adjust your exercise routine, working in days where you avoid high impact exercises like running and jumping and trying things like biking, elliptical, swimming.

What about supplements?

            – This is a question we are asked frequently. The two most common supplements are glucosamine and chondroitin. These are both naturally found substances in the body and are thought to be important in the processes of cartilage formation, repair, and preventing cartilage degradation. As supplements, the jury is still out if they are useful in preventing arthritis or the progression of arthritis. There is thought that they have anti-inflammatory properties which might help with joint pain. Although there is no proof of long term benefit, there are very few reported side effects. Of note, these supplements are not regulated by the FDA so make sure to do some research and buy from a reputable company.

Why can viewers do who have knee pain but aren’t interested in a surgery?

            – Nonsurgical treatment is always preferred when possible. To treat something effectively, we have to know what we are dealing with. Depending on the problem, typical treatment options include rest, ice, medications, bracing, physical therapy, and injections. But it’s important to know what the problem is in order to target the treatment plan.

For patients who are thinking about having a knee replacement, how long will a knee replacement last?

            -The best data that we have now shows that there is a 90-95% chance that a joint replacement will last 10 years and a 80-85% that it will last 20 years. Those numbers are averages and predictions might be altered some based on patient factors. Another consideration is that orthopedic implant companies keep modifying and improving the implants, so those numbers might improve as the technology and implants improve.

What about the robotic assisted joint replacements? How does that work?

            – The robot assisted joint replacements are an incredible use of technology in medicine.  Using computer software, we create a 3d model of the patient’s knee and then plan the surgery based on that person’s anatomy. The software can be adjusted if needed in surgery. The robotic arm helps the surgeon take that plan from the computer and very precisely put the implants in the position that is desired.

What if someone tears that ACL? Does that need to be fixed?

            – The ACL is critical for knee stability. If someone is young or looking to live an active lifestyle, we usually recommend surgery to reconstruct the torn ACL, usually using tissue from the same leg like a part of their patellar tendon, hamstring, or quadriceps tendon.

Is cartilage replacement surgery an option?

            – Cartilage replacement surgery is a great option for certain patients. They typically are younger patients with one lesion or area of cartilage damage. The surgery is to remove the area of damaged cartilage and bone and replace that with healthy bone and cartilage, usually obtained from a deceased donor.

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