Dr Lai's Approach to Knee Pain: Causes, Treatment and Surgical Options
Knee pain is a prevalent symptom experienced by individuals in their middle-aged and older years. Often, it results from the natural wear and tear associated with work, daily activities, sports, and exercise.
This discomfort can significantly impact a patient's quality of life because he will find himself unable to walk, run, climb stairs, squat, or kneel. The pain may also manifest as knee swelling, limited motion, and stiffness, occasionally leading to falls and severe injuries.
IDENTIFYING ROOT CAUSES OF KNEE PAIN
Common causes of knee pain include:
Osteoarthritis or degenerative arthritis
Inflammatory arthritis, such as Rheumatoid Arthritis (RA)
Meniscus and ligament injuries, as well as stress or insufficiency fractures in older patients with osteoporosis
My thorough considerations of the patient's particular history and his or her physical examination helps me uncover the underlying cause of the pain. When necessary, I confirm my suspicions with tests like X-rays, MRIs, and blood tests.
TREATMENT OPTIONS FOR KNEE PAIN
To tailor treatment to address the specific cause of the pain, I would turn to the following:
Medication, Supplements & Injections
Medications prescribed may include anti-inflammatory drugs like Celebrex, Arcoxia, or Synflex. However, it's crucial to note that prolonged use of these medications may have side effects on the stomach, heart, and kidneys. Patients with chronic kidney disease, heart problems, or severe gastric issues should avoid them.
Supplements like glucosamine, collagen, and piascledine can be beneficial for individuals with osteoarthritis resulting from wear and tear.
When oral medications fail to provide relief, injections such as intra-articular steroids and hyaluronate gel injections may be recommended.
Physiotherapy plays a significant role in improving knee movements and strengthening the surrounding muscles, which can be particularly helpful for patients experiencing stiffness and pain.
Surgery is a viable option when conservative treatments prove ineffective. My firm belief is that the patient should only turn to surgery only as a last resort.
I am passionate not simply about performing operations but seeing the resulting impact on the patient's quality of life. Should I deem that the surgery will improve the patient's quality of life only marginally, I will not recommend it.
SURGERY FOR KNEE PAIN
Surgical interventions may include:
Arthroscopic or keyhole surgery: The knee joint is well-suited for arthroscopic procedures, allowing for the treatment of loose bodies, torn meniscus, cartilage defects, and ulcerations with minimal risks and complications.
Corrective osteotomy: This procedure involves making bony cuts (osteotomy surgery) in the femur or tibia to correct knee deformities such as bow legs or knock knees. It is particularly beneficial for younger patients below the age of 50, delaying the need for joint replacement surgery.
Knee replacements: Severe osteoarthritis that does not respond to medical treatment and significantly impairs daily activities may necessitate knee replacement surgery. Depending on the extent and type of joint involvement, partial or total knee replacements can provide long-lasting pain relief and improved function, typically lasting 20 years or more for most patients.
By understanding the causes, exploring treatment options, and considering surgical interventions when necessary, individuals suffering from knee pain can find effective ways to alleviate their symptoms and enhance their quality of life.