By Darcie Fisher, Tufts Medical Center Correspondent
Our knees are likely the part of our body subject to the most wear and tear – and they’re also crucial to almost every move we make. Whether you’re walking, bending or turning, you need your knees to make it happen. Which is why knee pain can be such a literal and figurative pain!
Arthritis is the most common cause of knee pain and is also the most common cause of disability in the United States. It’s not just the elderly feeling this pain. More and more young, active patients are seeking help for painful inflammation and stiffness caused by arthritis in their joints.
There are three types of arthritis:
- Osteoarthritis (OA) - OA is a wearing-out condition involving the breakdown of joint cartilage, making the bones rub against one another, causing inflammation, pain, and stiffness. This is the most common type.
- Rheumatoid arthritis (RA) - RA is an autoimmune disease in which the body’s immune system mistakenly attacks the joints, causing chronic inflammation and pain
- Post-traumatic arthritis - Post-traumatic arthritis may develop after an injury when bones and cartilage don’t heal properly.
No matter the type of arthritis, there are things you can do to ease your pain. Weight loss can make a major difference for many. For every pound you lose, your will feel four pounds less pressure on your knee joint!
Other non-surgical approaches include: physical therapy, walking aids, heat/cold therapy, and medications like NSAIDS, cortisone injections, and joint fluid therapies. Most people will be able to get some relief with these treatments for some period of time.
Is it time for surgery?
Knee replacement surgery might be an option if the cartilage damage from arthritis is no longer manageable with non-surgical treatment approaches, said Joseph Kavolus, MD, Orthopedic Surgeon at Tufts Medical Center’s Department of Orthopedic Surgery. The operation involves placing a new surface—made of metal and plastic—on the damaged part of the knee. A partial knee replacement surgery addresses the inside (medial), outside (lateral), or kneecap (patella). A total knee replacement resurfaces all three compartments of the knee.
Cutting-edge technology is available to help surgeons place knee implants with greatly improved precision. At Tufts Medical Center, for example, Dr. Kavolus uses the Mako robotic-arm assisted technique
, proven in clinical studies to significantly improve patient-specific implant sizing and alignment.
Stem cell therapy
“Stem cells are a hot topic in the news and in medicine currently,” noted Dr. Kavolus. “While there is a lot of promise in the field, to date there are no studies demonstrating a clinical benefit beyond current FDA regulated therapies.”
Dr. Kavolus adds that he would advise patients to speak with a trusted physician prior to undergoing stem cell therapy as there can be complications and the costs quite substantial. Since stem cell treatments are not regulated by the FDA, results can be inconsistent.
A smoother recovery: Why pre-operative care matters
If and when you and physician decide surgery is the answer, much progress has been made over the last few years regarding pain management and getting you back on your feet faster.
“We are making efforts to optimize patients before they even have surgery,” explained Dr. Kavolus. “We want to ensure patients have the best outcome and as smooth a recovery as possible. We used to just do surgery. Now we make sure you have everything else in order before you get into the operating room.”
Dr. Kavolus says this includes helping manage a patient’s diet. Losing weight is often a huge factor in an easier recovery. It helps control issues with diabetes and high blood pressure which can lead to complications post-operatively.
“Anesthesia techniques have taken huge strides recently,” explained Dr. Kavolus. “These updates mean the pain receptors are blocked, so your brain doesn’t recognize the pain. This also helps lessen nausea.”
It can also mean using less narcotics post-operatively. Today it’s not uncommon for even total hip patients to need little to no narcotics after surgery.
Many patients today are deemed acceptable for same day discharge, as opposed to spending days in the hospital after knee surgery. This holds true for partial-knee and some total knee- replacement patients, depending on your ability to manage pain.
“Our goal is to have knee-replacement patients up and walking within three hours of surgery,” said Dr. Kavolus.
To make an appointment with a joint specialist
at Tufts Medical Center call 617-636-5160.
Updated January 2020
The above content is provided for educational purposes by Tufts Medical Center. It is free for educational use. For information about your own health, contact your physician.