Diagnosis / Treatment

Treatment Options for the Knee

Patients who have had a traumatic or repetitive microtraumatic injury have several treatment options. These obviously depend on the severity of the injury and the longevity of the symptoms.

Diagnosis of your problem is made by a complete history and physical examination. History of former athletic injuries, or repetitive type trauma such as incorrect or excessive weight training, history of specific type of sports injuries such as may occur with football or soccer – all may be a clue to an injury. Simple twisting injuries can cause meniscal damage. Some injuries are subtle and may not even have been noticed. The physical exam may show local pain at the joint line or swelling of the joint or soft tissues. Or, ligament instabilities can be diagnosed by abnormal laxity in certain planes of direction. In many of these cases, an MRI is often suggested to further evaluate your knee or confirm diagnostic findings.

Treatments are often classified as conservative or surgical. Conservative treatment options might include simple anti-inflammatories and physical therapy. With ongoing symptoms, steroidal medication either orally or by injection into the joint might be the next option. Sometimes, with prolonged knee symptoms, an injection of Synvisc-One is an option.

If all conservative options fail to control the problem, then a surgical option may be indicated. These are varied and should be discussed with your doctor or the doctors of the Joint Preservation Center.

Cartilage problems are the most common source of knee pain and there are several new treatment options. Were you a high school athlete? Did you play competitive sports through your early adult years? Have you had a knee injury such as a torn meniscus? Or, do you simply have long standing knee pain? Have you been told that you have “arthritis”? Have simple activities such as walking around the mall, a game of catch with your kid or getting in and out of car become painful chores? Have you been told you have no options? Finally, do you feel frustrated that your knee pain is changing the way you live?

Each year, more than 5 million Americans injure their knee and more than 2 million require a physician to evaluate cartilage damage. Whatever the cause, the result is the same: pain and swelling that makes it difficult or impossible for you to lead the active life style you enjoy.

Some of these injuries are treatable by simple conservative means but in many cases they require surgery to appropriately evaluate and treat either meniscal or articular cartilage damage. These injuries if left untreated can lead to chronic joint changes and may eventually lead to knee replacement. But, strategies are being developed to treat knee injuries earlier and aggressively. Fortunately, there are new treatment options, many of them available only in the last few years. This gives the patient the best chance of avoiding disabling knee problems in the future.

Knee Arthroscopy

The knee is a complicated joint made up of a ball sitting on shallow plateau. It is stable because of an intricate series of ligaments, capsular structures, and meniscal and articular cartilage. (see the anatomy of the knee) For many injuries or problems of the knee, a procedure called knee arthroscopy can be used.

Using small portals about the diameter of a pen, a small camera inserted into the joint allows for direct visualization of the bones, ligaments, meniscal cartilage, articular cartilage and other problems. Through accessory portals, instruments can be placed which allow for repair of injuries. Because an arthroscope uses small incisions which poke into the joint rather than cutting into the joint, recovery is often shorter and less painful than recovery from open surgery.