The older you get, the more likely you are to have stiff, creaky and painful knees. Knee pain is often caused by osteoarthritis, a wearing away of the cartilage that acts as a cushion between the thigh and calf bones.
Knee osteoarthritis (arthritis of the knee) is very common – 14 million Americans have the condition – but that doesn"t mean you have to live with it. We talked to Dr. John McClellan, an independent orthopedic surgeon who chooses to practice at Franciscan Health in Olympia Fields, Illinois, about what you can do to feel better.
Q: What Are the Most Common Causes of Arthritis in the Knee?
A: Well, for some people, arthritis can be caused by being slightly bowlegged or slightly knock-kneed. Over time, that can lead to arthritis of the knee. Because of the misalignment of the knee, one side of the joint can wear out more quickly than the other side.
Having a history of knee injuries that didn't receive proper care also can contribute to getting arthritis. This is something I see a lot with people who are athletes or were athletic in their younger days.
Another common cause of arthritis in the knee is weight gain. Carrying around extra weight places additional stress on the knees. It's like driving a truck on car tires – the tires are going to wear out.
Q: Are There Non-Surgical Treatment Options for Arthritis in the Knee?
A: Often times I start treating patients with oral pain relievers. I also may prescribe oral, non-steroidal, anti-inflammatory medication to bring down internal irritation of the tissues around the joints. I'll occasionally give a cortisone injection too to ease inflammation.
Cortisones are a broad category of steroid-based, anti-inflammatory medications. But they’re not the type of steroids you hear about athletes taking to build muscle. The kind used in orthopedic medicine help reduce inflammation around the joints.
A new type of non-invasive treatment for arthritis in the knee that's very effective is called viscosupplementation. You receive an injection of hyaluronic acid into the knee joint. It's a series of three injections that gradually increase the thickness of your normal joint fluid so there's more of a fluid cushion when you walk. In my practice, two out of three patients find it helps relieve their symptoms for about six months.
Physical therapy services can sometimes be helpful, too. Because many patients reduce their movement when they have knee pain, the knee can become very stiff. Physical therapy can be used to help increase the joint's range of motion.
Q: When Do You Need Knee Surgery?
A: When the cartilage in your knee is severely worn away or not there at all anymore, you’re a good candidate for surgery. A lot depends on the stage of osteoarthritis your doctor sees during your exam and in the X-rays.
Q: What Are the Common Knee Surgery Options?
A: For some patients, arthroscopic surgery can be a good option. It's a minimally invasive procedure requiring only two incisions, each measuring less than an inch. The surgeon inserts a tiny camera into your knee to see inside. Using small instruments, the surgeon can remove or smooth damaged tissue, or wash out cartilage fragments.
Arthroscopic surgery is an outpatient procedure with minimal down time. But it might have to be repeated every few years depending on factors such as maintaining a healthy weight. The procedure will definitely offer an improvement in symptoms, but it's not as effective as a knee replacement surgery.
Knee replacement is a traditional surgery and requires two to three months of physical therapy following the procedure. Most people will experience increased range of motion in their knee, but the biggest advantage of the surgery is eliminating pain during activities such as walking.
Q: Does Seeing a Doctor For Knee Pain Early Make a Difference?
A: The earlier you see your doctor for knee pain, the better. Arthritis in the knee can get progressively worse as time goes by because damage continues being done to the joint. The more damage you have, the fewer options you have for treatment – especially non-invasive ones.