Best options for treating knee osteoarthritis

August 16th — admin

My doctor has given me several options for treating the moderate osteoarthritis in my right knee. I can keep active and “do nothing” while waiting to see what will happen. I can have the joint scraped of any rough edges and torn pieces of ligament. Or I can have the joint replaced. Any advice for me?

All of those options are possible. In fact, you may want to use them all one at a time. Usually the wait-and-see approach is accompanied by an exercise program to keep the muscles around your knee toned and strong. Some of the medications available control both the pain and the disease.

If the joint starts to deteriorate more, then surgery to keep the joint surfaces clean and smooth may be the next step. The doctor may put a special fluid called hyaluronan in the joint to keep the tissue from sticking together.

When the joint space narrows too much and the bone is in danger of rubbing against bone, a joint replacement will be needed. Today’s treatment approach for osteoarthritis is to save the bone and joint for as long as possible. Taking it one step at a time is a good way to accomplish this goal.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Could arthritic knee cancel exercise program?

August 6th — admin

I joined a group of seniors in an exercise group at the local seniors’ center. I was doing good until last week when my arthritic knee started acting up again. Does this mean I just won’t be able to exercise anymore?

Not at all. You may have just done a bit too much or progressed your exercises too fast. Once your arthritic symptoms are under control, try again. Start at a very slow pace with only a few repetitions of each exercise. Wait a day to see how you feel. Most people don’t know they’ve done too much while they are exercising. It’s not until 24 to 36 hours later that the body shows signs of distress from overdoing it.

Give some thought to the kind of exercise you are doing. Arthritic knees do respond well to the right kind of movement and exercise. Using a stationary bike is a good idea. This keeps the knee in a straight plane of motion without any twisting motions. It keeps the joint moving through its range of motion without the weight of your body putting a load on it.

An aquatics program is also ideal. If you have one in your area, this is an excellent way to exercise while “unloading” or taking the pressure off the joint. In the pool, the effects of gravity are eliminated. At the same time, the joint is supported by the buoyancy and warmth of the water.

If none of these options work for you, see your doctor or a physical therapist. They are trained to find out what exercise is best for each individual based on their age, weight, overall health, and level of fitness.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Do you need resurfacing before knee joint replacement?

July 21st — admin

What is selective resurfacing? I know it has something to do with knee joint replacements.

The knee joint consists of three parts: the knee cap (patella), the femur (thigh bone), and the tibia (lower leg bone). A knee joint replacement is done when arthritic changes cause pain, swelling, and loss of knee function.

Arthritic changes occur inside the knee joint as well as behind the patella. The patella may need to be resurfaced for a successful joint replacement. This means a metal or plastic backing is added to the patella. This helps it ride smoothly over the other parts of the implant when the knee moves.

Not every patient needs patellar resurfacing. Doctors decide whether or not to do this when they look at the back of the patella during the operation. The doctor looks at the shape of the patella and the condition of the cartilage when making this decision.

Selective resurfacing refers to the fact that not all patients have the patella resurfaced, only those who need it based on the surgeon’s exam.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Will arthroscopic surgery solve problems with knee arthritis?

July 13th — admin

I have some mild, but painful arthritis in my left knee. I’m thinking about having arthroscopic surgery done. The doctor wants to take a look inside and smooth out any rough edges. Will that take care of the problem?

Short-term results (six months to two years) after arthroscopic surgery for mild to moderate arthritis are good. Reports show at least 75 percent (three-fourths) of all patients get better. The have less pain and more function.

After three years, only half the patients stay pain free. Those with rough cartilage behind the knee cap (a condition called chondromalacia) often have return of painful symptoms. Patients who are overweight have pain much more often than patients of normal weight.

Patients with mild degenerative changes but no arthritis who aren’t overweight have the best results with arthroscopic surgery.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Source of knee pain best discovered by MRI

June 21st — admin

I am only 48 years old, but I have severe knee pain from years of running marathons and participating in triathlons. The first doctor I saw took an X-ray and said there’s some narrowing of the joint space, but nothing to worry about. Would an MRI (magnetic resonance imaging) show anything else the X-ray didn’t show?

For years doctors have used X-rays to help diagnose osteoarthritis (OA). Recently, researchers have started to call this practice into question. An X-ray reading of the joint may not be valid in predicting pain and function. In other words, the joint looks fine but the pain is very limiting all the same.

More and more doctors are using MRIs to find OA. MRIs can image cartilage and soft tissues. The more the doctor knows about the soft tissues involved, the more direct and specific treatment can be.

Ask your doctor about having an MRI. You may be a good candidate.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Arthritis in knee may cause a misstep

May 10th — admin

I have severe osteoarthritis in my left knee. I notice sometimes I misjudge how far to extend my knee when stepping off a curb. Is that caused by the arthritis?

The sense of joint position is called proprioception. Research shows that proprioception is altered with osteoarthritis. The more severe the patient’s symptoms, the longer it takes for the knee to register its position.

Scientists aren’t sure if the arthritic changes cause the change in joint position sense or the other way around. There could be other causes for your problem such as loss of joint motion and muscle weakness. It might be a good idea to have this checked out before a misstep causes a serious problem.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Athletes’ knee injuries more likely in afternoon

April 19th — admin

Is there any truth to the idea that ski injuries are more likely in the afternoon than in the morning? I would have thought injuries occur in the morning before skiers are warmed up.

Studies do indeed show the greatest chances of injury to skiers occur in the afternoon. It’s also true that injuries to football players are higher in the third quarter of a game. Coincidence?

Researchers don’t think so. They say general fatigue in athletes may be the key factor in these injuries. Fatigue leads to a decline in knee proprioception. Proprioception is the joint’s sense of position. Fatigue and then decreased proprioception can result in ligament injuries.

Change in neuromuscular control may be a factor, too. This is the link between messages to the nerve telling the muscle what to do and when to do it. Special exercise to improve motor control may help reduce these “third quarter” injuries.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Do injections to lubricate the knee really work?

March 11th — admin

I heard a report that knee injections to lubricate the joint are more and more popular. Do they work? And how?

Hyaluronic acid (HA) can be injected into the knee to restore the joint’s ability to move and glide easily. The knee already has some of its own HA. By injecting more, the HA already in the joint improves the flow of the synovial fluid. Injected HA also helps keep the naturally present HA from breaking down.

Overall, studies show that HA is both safe and effective. It seems to work better for younger patients (under 65 years) and for patients with only mild to moderate disease. Patients with severe osteoarthritis may not have any natural lubrication left in the joint. It seems without some HA, the injection doesn’t work as well.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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What does “advanced” osteoarthritis mean?

March 8th — admin

My doctor told me I have advanced osteoarthritis. What does this mean?

Osteoarthritis (OA) is staged according to how much damage has occurred in the joint and how much joint space is left. X-rays are used most often to stage OA. In advanced stages of OA, there is a complete loss of joint space.

The femur (thigh bone) and the tibia (lower leg bone) have no cushion between them. When you use the knee, the bones slide across each other without any protection or lubrication. We call this bone-on-bone.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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How old is too old for a total knee replacement?

February 19th — admin

My 92-year old mother has severe knee arthritis. It seems to me she could sure benefit from a knee replacement. Is she too old?

Maybe not! A recent study from Mayo Clinic reports good results for adults over age 90 getting their first total knee replacement (TKR). They also report on patients ages 90 to 102 who had a repair or replacement of a previous TKR.

Doctors are expecting to see more and more adults in their 90s (and older) outliving the TKR put in when they were in their 70s. Likewise, as more people live longer, first timers in need of a joint replacement may show up in their 90s.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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