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Oh, My Achin’ Knees!

While many of us will experience aches and pains in our knees as we age, almost all knee issues are related to the degenerative process or osteoarthritis.

What is osteoarthritis?

Osteoarthritis is the wearing away of the cartilage on the ends of the thigh and/or shin bone. While it is part of the aging process, osteoarthritis can be accelerated by weight, genetics, a history of injury, or activity.

Conservative Treatment for Knee Pain

The two most important things you can do to help manage pain associated with osteoarthritis is to maintain an ideal body weight, and engage in a low-impact exercise regiment, such as swimming, biking, walking or yoga.

Other Options for Treating Knee Pain:

  • Periodic steroid injections
  • Viscosupplementation – “jelly shots” that augments the body’s joint fluid
  • Bracing
  • Topical NSAIDs (a cream that is applied directly to sore area)
  • Platelet-Rich Plasma (PRP) – an injection of your own blood. *Not typically covered by insurance
  • Radiofrequency Ablation (RFA) – “turns off” knee pain nerves
  • Natural anti-inflammatories – fish oil, curcumin

While anti-inflammatories can be prescribed for pain, I do not recommend using them for chronic pain over a long time period because of side effects of chronic use of the medications. Instead, I recommend taking the max dosage for only for one to three days. If that doesn’t help, try other options.


Surgical Options for Knee Pain

If conservative treatment doesn’t alleviate symptoms, and activity level is negatively impacted by pain, then surgery can be an option.

Meniscal Debridement

  • Best candidates: Mild to moderate osteoarthritis, experienced an injury, mechanical, guarded prognosis
  • Procedure: Damaged meniscus is cut away and removed
  • Recovery: Typically 4 to 6 weeks

Subchondroplasty (SCP)

  • Best candidates: Stress fracture shows up on MRI
  • Procedure: Drill tiny holes and inject calcium phosphate to build new bone around the fracture
  • Recovery: Progress as tolerated

Partial Knee Replacement

  • Best candidates: Osteoarthritis and pain limited to one compartment
  • Procedure: Customized to each patient.
  • Recovery: 6 to 12 weeks
  • *90 percent of patients are still happy after 12 to 15 years

Total Knee Replacement

  • Best candidates: Moderate to severe osteoarthritis spread throughout the knee; have tried all other options
  • Procedure: Instruments and procedure customized for each patient
  • Recovery: Off walker within 1 month, can’t return to high impact
  • *90 percent of patients are still happy after 12 to 15 years

*Learn more about knee replacement.

About Mark Galland, MD

Dr. Mark Galland is a orthopedic surgeon with the Orthopaedic Specialists of North Carolina. He sees patients at WakeMed North Hospital. Find out more about the orthopaedic services offered at WakeMed, and request an appointment today.