Knee Pain

Knee pain is one of the most common ailment in our day to day clinical practice. All knee pain do not need a surgery . careful evaluation of joint and identifying the cause is of utmost importance. Based on clinical assessment and radiological evaluation , treatment strategy can be made and discussed with the patients.

Knee pain can arises from the joint itself say – medial joint arthritis, lateral joint arthritis, patellofemoral arthritis or tri-compartmental arthritis, and top knee replacement doctor near me. Apart from that, it can arises from the menisci, collateral ligaments. Surrounding soft tissue structures like tendons, IT band, joint synovium.

Apart from these, pain may originate from hip joint or spine which may present as knee pain and hence needs systematic evaluation.

Along with evaluation of pain , proper history taking and physical examination in the form of assessing the joint and range of movement and studying the gait of the patient is of utmost importance.

Treatment strategies

  • 1) Home based Physical Exercise , diet control and weight loss
  • 2) Injection therapy- hyaluronic acid injection , plasma rich protein injection
  • 3) Knee preservation surgery- Osteotomy, Arthroscopic ( Key-hole )surgery
  • 4) Knee replacement( unilateral knee replacement and total knee replacement)

According to AAOS ( American Academy of Orthopaedic Surgery), physical exercise , diet control and weight loss have maximum role in non-surgical management of osteoarthritis( age related degeneration of knee). Injection therapies, cartilage forming medications have limited and specific role.

Total Knee Replacement

Total Knee Replacement is actually a misnomer. It should be called- Total Knee Re-surfacing. In this surgery, patients whole knee joint is not cut and replaced by a new joint but the worn out surface of native knee are refreshed and covered with artificial metal and plastic which serves a knee joint. The ligaments on the sides of the knee called as collaterals is retained as it is. Surfaces at the distal end of the thigh bone called femur and the upper end of shin bone is resurfaced and replaced by metal implant. Natural disc ( menisci) is replaced by a highly crosslinked Polyethene( medical grade). The undersurface of the knee cap bone called patella is routinely replaced by a polyethlene button. Recovery is pretty quick. Patient can walk the next day in most cases. Knee bending and exercises can be started the next day and climbing up and down the stairs can be started as per patient comfort. Usually on 4th day the patient can be discharged. Physical exercise and few essential medications ( for a short time) is important for achieving good results.

High Tibial Osteotomy

Knee preservation surgery in which the mechanical axis of limb is corrected which is the primary cause of pain. The bone is cut and placed in a way by which the axis is corrected and the native knee joint is preserved. There are different types of HTO and weight bearing is started based on type oh HTO selected.

Uni-compartmental Knee Replacement

Knee Joint is divided into three compartments: medial , lateral and patellofemoral. Usually, patients present with medial joint line tenderness. The degenerated bone surface is replaced by metal and plastic. UKR has specific indications and can be done only if selection criteria is met.

Arthroscopy ( Key-hole surgeries)

Sports Injuries are quite common theses days. Meniscal injury and ligamentous injuries can increase the risk of early degenerative disease. Small holes are made near knee joint and camera and instruments are passed through this hole and repair or reconstruction is done according to pathology.

Computer Assisted Total Knee replacement

Its is a specialized technique for joint replacement in technology is used to map your knee intra-operatively . important parameters for successful joint replacement like mechanical axis correction , gap- balancing are adequately measured with this technique.

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