Knee joint and spinal health problems can be devastating. They can interfere with your ability to walk and stay active. Furthermore, they can cause a lot of mental stress and bad moods. In this article, we will discuss one problem: knee joint pain. This pain tends to affect a lot of people and can be too severe that surgery is recommended. Knee discomfort can be treated by a professional pain management doctor. The condition is discussed as shown below as well as different surgical treatments.
Knee joint pain
If you have consistent loss of motion that is affecting your ability to bend or extend your knee fully, this is a sign that you need knee surgery. In addition, if you are unable to squat or carry your weight on your knee or knees, this is a second sign that you might need knee surgery. Still, if you try to twist a given way and your knee makes a popping sound, get in touch with a qualified knee surgeon like Dr. Michael Nguyen, M.D. But, if you only have one of the three signs described above, chances are that you can avoid a serious treatment technique like knee surgery.
For instance, your pain management expert can advise you on how to start out physical therapy and give you drugs that can get rid of pain and inflammation (NSAIDs). Furthermore, you can try to rest some more and hopefully your knee pain will disappear without an operation. On the other hand, if you have two signs out of the three shown above, knee surgery may be done. However, it should be done after all the conservative cures have completely failed. Lastly, if all the three signs are present now, knee surgery will be the right treatment approach.
What is knee Arthroscopy
Knee arthroscopy surgery is done to correct knee pain and stiffness. In this medical procedure, a knee surgeon creates a tiny incision or cut through which he or she inserts a camera (arthroscope). The camera allows a doctor to see the inner side of the joint on a screen and find out the exact problem ailing the knee. Sometimes the pain management surgeon will use tiny instruments inside the athroscope camera to treat the knee problem. It is through knee athroscopy that the surgeon discovers meniscus tears, a misaligned kneecap, torn ligaments and more. Each time a doctor receives a patient who has knee pain; he or she may do a knee arthroscopy. Following diagnosis, the doctor might recommend an arthroscopic surgery of the knee to treat:
- A tear of the ACL OR MCL
- A meniscus tear
- A knee cap(knee patella) that has dislocated or moved out of its natural position
- Bits of torn and lose cartilage inside the joint
- Knee bones fractures
- A swollen lining, also called synovium, in your knee joint
- To get rid of a Baker’s cyst
Undergoing the surgical procedure
Prior to undergoing knee arthroscopic knee surgery, your surgeon will provide special instructions that will help you prepare. They will most likely ask about the medicines you are currently taking (prescribed or OTC drugs, and supplements) so they can decide the ones you should stop using. Weeks or days prior to knee surgery, your doctor might stop you from taking any more aspirins or ibuprofen. Six to twelve hours prior to surgery, you should stop eating or drinking anything. A pain killer will be prescribed after the operation to ease your discomfort.
Prior to the arthroscopic surgical procedure, a pain management doctor must give you an anesthetic shot. A local anesthetic drug will numb only your knee; a regional anesthetic will numb your body from the waist down while a general anesthetic will put you to sleep. Hence, there is no pain felt during the operation process. A surgeon will start by creating small cuts in the knee area and pump in saline water to expand your knee joint.
This will enable the pain management doctor to see how the insides of the joint look like and to slide the arthroscope camera into a cut to improve their joint view. After inserting specific tiny tools via the cuts to correct the discovered joint issues, he or she will drain the saline solution from your knee joint. Finally, he will suture the cuts.
Two knee joint issues that might require knee arthroscopy surgery
There are two knee problems that might lead to knee arthroscopy surgery. One of these is a meniscus tear. A knee joint has two bits of cartilage with a disc shape. Their work is to pad all the bones in it. These are: medial meniscus and lateral meniscus. If one or two of them develops a tear, you may or may not end up needing a knee surgery treatment. If the meniscus tear is tiny, you will most likely continue to do daily activities because the pain will be bearable. But, if the tear is big and so uncomfortable, your pain doctor might recommend knee surgery.
The other problem that might prompt a surgeon to operate on your knee is a knee ligament sprain or tear. A knee has 4 kinds of ligaments: the lateral collateral, medial collateral, anterior cruciate and posterior cruciate ligament. The role of each of these ligaments is to stabilize your knee bones. Due to the difficult work they all do, they are prone to injuries during contact sports or sudden body twists to change directions.
As an athlete, anterior cruciate ligament (ACL) injuries and Medial collateral ligament (MCL) injuries can keep you out of the sport for a long time. To shorten this period, you should do knee surgery and still expect up to two months of recovery. In case there is a really serious ligament tear requiring a more detailed type of surgery, you might need up to six months to recover from a surgical wound.
Risks of knee arthroscopy
Each type of knee operation, including arthroscopic surgery, can pose the following risks:
- Severe bleeding
- Infection at the area where the pain management specialist operated on
- Shortness of breath triggered by the type of anesthesia drug used
- Allergic reactions to anesthesia drugs or any other drug that the pain management expert might use.
Besides the above, blood clots might form in the affected leg and an infection might as well start within the knee joint itself. Knee stiffness can be expected, as well as an injury that could affect a ligament, cartilage, blood vessel or nerve. Knee arthroscopy is one of the less invasive knee surgeries. It takes less than an hour, generally, and most patients can be released the same day. To speed up your recovery, use an ice pack as it will reduce pain and swelling. Elevate your leg too and keep on changing your wound dressing to keep away an infection. Exercise can be so helpful too, although it should be specifically directed by your physical therapist.
Total Knee Replacement Surgery due to arthritis
Sometimes knee surgery is done to correct a bigger problem than just a meniscus tear or ligament tear. When a person has arthritis, their pain management doctor will consider replacing the whole knee joint. So they will cut the shin bone (end of tibia bone) and thighbone (femur) and cover bone with artificial components called prosthetics. Also called total knee arthroplasty, total knee replacement surgery involves the use of two prosthetic components that are often made of a high quality polyethylene plastic or metal.
The two surfaces are placed in the knee area in a way that mimics the natural ones. So they slide smoothly against one another, making a useful knee joint. You will require four to six weeks to recover partially and several months to achieve full recovery. Total knee replacement surgery offers pain relief and enhanced knee joint mobility. All the same, it cannot be compared to a healthy knee and so you should avoid strenuous or high impact sporting activities. These can increase the rate at which the newly replaced knee joint can wear down.
A joint that has been damaged by arthritis can also be replaced partially via surgery. All you require is a doctor who offers the best treatment for low back pain and knee discomfort. He or she should be able to perform a partial knee replacement surgery, also known as unicompartmental knee arthrosplasty. This surgery is all about the replacement of three knee joint compartments: medial compartment, patellofemoral compartment and lateral compartment. The medial one refers to the inner knee compartments that touch when you squeeze the legs together. The lateral compartments are the outer knees that don’t touch even if the legs are wide apart or closer together.
The patellofemoral compartment is the front section of your knee that consists of the kneecap or patella. It meets your thighbone or femur. When partial knee replacement surgery is recommended by the top pain management specialist, it will revolve around eliminating damaged knee compartment while leaving the healthier ones intact. In most situations, victims undergo lateral or medial compartment surgical removal. But if one has knock knees or rickets, it means that their knees are not well aligned and are not ideal for this type of surgery.
Others who might not be good candidates are those with severe knee stiffness, ligament damage, or rheumatoid arthritis–a kind of inflammatory arthritis. This type of surgery is not as invasive as the total knee replacement surgery, meaning that the recovery period is shorter and more manageable. If you want to achieve complete pain relief, nothing would work better than the total knee arthroplasty surgery.
Doctors offering treatment for low back pain and knee pain might choose Osteotomy
As hinted above, people with poor knee alignment are not good candidates for total knee replacement surgery. Thus, a pain management clinic might decide to operate on them differently—knee osteotomy. This kind of surgery can further be divided into femoral osteotomy or tibial osteotomy. Either of the two procedures works best for a few people who are younger than sixty years and those who stay active but their knees are misaligned.
They are best for removing unilateral knee arthritis, also called asymmetrical knee arthritis. Osteotomy entails cuts into the shin bone (tibia) or thigh bone (femur). The pain management expert will then extract a tiny wedge of bone and then replace it with a small wedge of a natural bone graft. Sometimes they use an artificial bone replacement material. The joint is, therefore, realigned to shift extra pressure onto the healthier area of the knee. This is good because it reduces damage on the ailing side of the knee.
At the same time, osteotomy is done to decelerate the development of knee osteoarthritis and prevent total knee arthroplasty surgery for up to a decade. After osteotomy recovery, patients can take part in high impact sports without the fear of deteriorating the replacement bone too soon. This is not the case when one undergoes total knee replacement surgical operation. All the same, your pain management surgeon will provide adequate tips on recovery and things you can or cannot do afterwards.
Pain management tips when cartilage is damaged
Cartilage damage is hard to heal. While your knee joint can grow afresh, the new cartilage growth will often be rough and bumpy. As a result, smooth joint movements can be tough. To try and help, your pain management surgeon, such as Dr. Michael Nguyen, can perform certain knee surgeries to try and repair your damaged cartilage.
· ACI (Autologous chondrocyte implantation) – This needs two surgical operations that will enable the surgeon to first harvest cartilage cells and grow them in a lab and then re-implant them.
· Bone marrow stimulation – It is done to arouse growth of cartilage.
· Osteochondral transplantation techniques – OATs, in short form, is also called mosaicplasty. The pain management medical doctor transplants cartilage from a given site to another.
Final word
Prior to turning to surgery of the knee, efforts should be made to heal the joint via non-surgical options. If no satisfactory pain relief is obtained, then your pain management physician might try knee arthroscopy surgery first. But, if the damage is severe due to arthritis, they might recommend the total knee replacement surgery or partial knee replacement surgery. To find out the right way to cure your knee joint, talk to well-educated and experienced doctor who provides treatment for low back pain and knee pain. Then do as they say.