New Year, New Knee
Knee pain is a very common problem.
If your knee has been bothering you for a while or keeping you from activities
you enjoy, the new year is a good time to take action. I encourage you to resolve to get the right diagnosis; resolve
to take action to relieve the pain; resolve
to live life to the fullest, life pain-free.
For some people, strategies such as
physical therapy and weight loss may bring so much improvement, they will feel
like they have a "new" knee. For others with severe arthritis and
constant pain, a "new knee" in the form of a joint replacement may be
the best option to eliminate the pain once and for all.
Basically, there are two types of knee
pain. "Acute" pain is what we experience after a sudden knee injury. When
this happens, people are advised to follow the regimen known as RICE: Rest, Ice, Compression and Elevation. They
should rest their knee, apply ice on and off, and keep the joint elevated over
the level of their heart. They may consider using a compression bandage, as
well. However, if the injury is really bad and one cannot put weight on the
joint, it is advisable to go to the emergency room or see an orthopedic surgeon
sooner rather than later.
The other
kind of knee pain is called "chronic" because it doesn't go away. It
may be worse on some days, but the discomfort is generally ongoing. The most common
reason for this type of pain is arthritis, which results from wear and tear.
As the joint damage progresses, it can
become increasingly painful, but some simple strategies and good practices could
help you feel better.
The first step is to see a doctor for the
proper diagnosis. Anyone who has pain, stiffness or swelling in or around a
joint for more than a couple of weeks is advised to make an appointment with an
orthopedic surgeon.
When someone is diagnosed with arthritis,
the following strategies may provide some relief:
• Be
careful not to overdo physical activities, and avoid any action, such as
climbing up and down stairs, that may aggravate an arthritic knee.
• Try
to keep your weight down to avoid stress on the joint, or lose weight if you
are overweight. Losing weight takes
pressure off the knee and may slow the progression of arthritis.
• Take
over-the-counter or prescription pain medication, and follow your doctor’s
instructions.
• Start
physical therapy or an exercise program to strengthen muscles around the
joint. Good exercises for people with
arthritis include using a stationary exercise bicycle and swimming or even
walking in a pool. Exercises should be low-impact.
• Use
cold or heat to make a joint feel better.
However, if a joint is hot and swollen, make sure you use a cold
pack. Put a thin towel under the cold
pack. Never put ice directly on your
skin.
• Rest
a joint until it feels better.
• Use
an aid, such as cane, to relieve pressure on your knee when needed.
A doctor may recommend steroid
injections into the knee joint to reduce inflammation. This may provide temporary
relief, but can only be used on a limited basis. Another procedure called
viscosupplementation entails injecting a substance called hyaluronic acid into
the knee to provide lubrication. This procedure may benefit people with mild to
moderate arthritis, but studies have not shown it to be useful for those with
advanced arthritis.
When to Consider Knee Replacement
If someone has severe
arthritis and conservative measures no longer help, knee replacement surgery is
often the best option for permanent pain relief and restored mobility. Major
advances over the past decade have revolutionized the way we perform the
surgery, and nobody should live with unrelenting pain.
More than 700,000 knee replacements are
performed in the United States each year. After the procedure and recovery,
most patients say you cannot put a price on what they gained.
Advances in implant design mean a knee
replacement could last 25 to 30 years. Nowadays, most major joint replacement
centers use regional anesthesia, eliminating the need for general anesthesia. The
patient is still asleep during the surgery.
Minimally invasive knee replacement with
much smaller incisions generally means less pain and a faster recovery. The
procedure entails a three- to four-inch incision instead of the standard 10- to
12-inch incision.
Some patients may qualify for a less
extensive surgery called a "unilateral" or partial joint
replacement. A smaller incision, less
pain after surgery and a quicker recovery are potential advantages of a partial
joint replacement. Many patients say their knee feels perfectly natural after the
procedure.
For the best outcome, people are
advised to carefully choose their orthopedic surgeon. Indeed, when considering any
type of surgery, it is extremely important that people do their homework. Individuals
should choose a surgeon with extensive experience in the procedure they are
having, with whom they feel comfortable, and who takes the time to answer all
of their questions. It is also advisable to select a major hospital in which a
high number of joint replacement surgeries are performed.
If
conservative measures fail to provide arthritis relief, joint replacement can eliminate pain and restore quality of life. For
those able to get back to activities they once loved, it can change their lives
dramatically.
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