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Knee Pain

Knee pain is very common in people aged more than 40 years. Most of them are suffering from osteoarthritis knee, which is an age-related degenerative joint disorder. But sometimes pain in knee is due to other causes, which are readily treatable, if properly diagnosed. It is much more common in females as compared to males (1.7:1).

Risk factors for osteoarthritis knee:

  • Age
  • Obesity
  • Recent or past Injury to knee
  • Muscle weakness
  • Repetitive , overuse injury (Repeated or prolonged squatting, sitting cross-legged)
  • Postural causes- long hours of sitting or standing jobs
  • Previous surgical procedures : Meniscectomy
  • Knee deformities e.g. Knee varus deformity
  • Rheumatoid arthritis


Osteoarthritis is associated with destruction and loss of cartilage, remodelling of bone,  joint inflammation with narrowing of joint space and joint deformities.

Symptoms of Osteoarthritis knee:

  • Aching, throbbing pain localized to joint
  • Knee stiffness esp. in morning or after a period of rest
  • Swelling and deformity
  • Knee instability or buckling
  • Muscle weakness over front of knee joint


Investigations:

  • CBC, ESR, CRP, RF
  • X-ray of knee joint – Standing position
  • MRI knee  (If pain is not resolved with treatment, instability or feeling of giving way is present)


Treatment:

  • Medications
  • Weight loss (Loss of 10% of body weight can reduce knee forces upto 50%)
  • Exercise therapy: To maintain Range of motion, strength of muscles around knee, stretching of tight muscles
  • Physical modalities: Hot water fomentation, Ice packs, Short Wave diathermy, Interferential therapy, Ultrasound therapy,etc.
  • Life-style modification:
  1. Avoid squatting/sitting cross-legged (>10 minutes)
  2. Avoid prolonged sitting or standing (> 30 minutes)
  3. Avoid bending knee (>90 degrees) while sitting
  4. Daily brisk walk (30 minutes per day) – Avoid if having moderate-severe knee pain.
  5. Avoid pillow under knee to support it.
  6. Use cane while walking


  • Knee Braces:  For unloading affected knee joint during walking.
  • Footwear modification
  • Intra-articular Injections:
  1. Methylprednisolone or Triamcinolone injection: For patients having severe knee pain, joint inflammation or swelling. It is much more safer and effective than to have long-term medicines, as it’s effect is largely concentrated over knee joint.
  2. Dextrose Prolotherapy: For pain relief, improvement of knee stability and regeneration of knee cartilage.
  3. PRP (Platelet –Rich plasma): For regeneration of knee cartilage and retarding disease progression.
  4. Hyaluronate


  •  Arthroscopy: For removal of meniscal tears but has increased rate of knee osteoarthritis progression following this procedure. Instead, we can use intra-articular dextrose prolotherapy or PRP joint injections for healing of damaged/torn menisci.
  • Total knee Replacement: Indicated for severely damaged knee joints with deformities and knee pain not controlled by medicines, therapy and injection procedures. It should be last options after trying all the above mentioned treatments.In most of cases, surgery could be prevented, if injection procedures are given in timely fashion.


 
For more information, contact New Life centre  +91.8890003130.