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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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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Is a nerve block safe for total knee replacement surgery?

June 16th — admin

I’m going to have a total knee replacement next week. The doctor asked me if I want a nerve block before the operation to help stop the pain after the operation. What are the chances of ending up with permanent nerve damage from this?

It’s possible but not likely. Studies show permanent nerve damage after nerve blocks is very low. In fact when nerve damage occurs, most patients recover completely within three months’ time. Minor long-term problems can occur such as mild muscle weakness or a small patch of numbness.

Ask your doctor what his or her experience has been using nerve blocks. Find out what other problems can occur and how often this happens. Consider the benefits of a preoperative nerve block: less pain and less use of morphine or other painkillers after the operation.

Studies show a single-injection femoral nerve block is a simple and safe way to reduce pain after total knee replacement.

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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Can knee meniscus be transplanted?

June 8th — admin

I’ve heard it’s possible to get a new meniscus if your own cartilage is torn beyond repair. Is this true?

Meniscal transplantation is in the works. It’s not done by all surgeons but it’s being studied by some. There are many questions left to answer before using this operation on a routine basis.

For example how much meniscus is really needed? What’s the best way to prepare donated tissue? How should it be put into the knee? How long does it last? What problems come up soon after the operation compared to years later?

Right now this method of meniscal “repair” is used in young patients who have already had the entire meniscus taken out. Pain and joint degeneration are the basic criteria for this treatment method. There’s about a 60 percent success rate. This means about 40 percent (four out of 10) of patients have a failed transplantation.

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 knee pain be arthritis?

April 30th — admin

Whenever we get close to the ski season I start gearing up my exercise program. I notice the last two years I’ve had knee pain when squatting or practicing my wall sits. So far it doesn’t bother me when I ski. What could be causing this pain?

There are several possible causes of knee pain in these positions. Early arthritic changes with thinning of the joint surface is the first that comes to mind. This is more likely in the middle-aged to older adult groups.

Patellofemoral pain syndrome (pain involving the kneecap) is probably the most common in younger people. Muscle weakness or imbalance and postural changes cause the kneecap to slide up and down over the knee slightly off center. Compression and irritation of the soft tissues leads to pain.

If you are planning to continue your skiing activities, it might be a good idea to have this checked out. A specific exercise program may help alleviate the pain and prevent
injury.

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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Knee injuries more common in women. Is a sixth sense to blame?

April 15th — admin

I hear knee injuries are more common in women than men. If that’s true, why are most knee studies just on men?

It’s true studies show female athletes are four to six times more likely to injure the knee. One factor may be the difference in proprioception between men and women. Joint proprioception is the ability to sense joint position.

Fatigue of the leg or overall body fatigue may affect proprioception. Men seem to be affected by this more than women. This factor may help explain injuries in men. Some other mechanism of injury may be important for women.

Researchers get a better picture of results by studying just men or just women instead of a mixed group. Both kinds of studies are underway.

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Pace of rehab after total knee replacement varies

April 1st — admin

I had a total knee replacement six weeks ago. I’m a young (65-years old), active athletic-type. I’d really like to push my rehab ahead and get more aggressive. Is this possible?

Most patients have a fair amount of pain, swelling, and stiffness the first eight weeks. They aren’t always able to advance their rehab program. The first two weeks are usually focused on warm-ups, specific exercises to strengthen the muscles, followed by a cool-down exercise period.

From two to six weeks more time is spent on functional skills like walking and stair climbing. Exercises get harder and last longer starting at five minutes and moving up to 20 minutes. By the end of six weeks the knee joint is ready to handle more demanding activity and exercise.

You’ll want to check with your doctor about how far and how fast you can go now. Having a physical therapist to supervise your home program is often a good idea.

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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