Q&A: Why Suffer One More Day with Knee Pain?

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Joel Buchalter, MD

Q: Do I have arthritis in my knee?
A: Ask yourself: Is my knee stiff after I’ve been sitting or sleeping? Or is my knee stiff all day with occasional painful twinges? Or does it buckle from weakness, creak, and disrupt my sleep with pain? These scenarios represent different stages of osteoarthritis of the knee. 

Let’s review the basics: Your knee is a joint — two bones held together by rope-like ligaments. The end of each bone is coated with cartilage that lets the bones glide smoothly past one another. If you have arthritis of the knee, that buffering surface can wear away until bone rubs against bone. That produces swelling in the joint from inflammation of the bone, stiffness when you’re inactive, and pain from grinding bones.

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Q: What causes knee arthritis?
A: A big risk factor is being obese (BMI of 40 and above). Also, some people are predisposed, though there’s no arthritis gene. The major cause is wear and tear. That’s why it’s most common in older people.

Q: Are there non-surgical remedies?
A: Many. One may be perfect for you. If you have mild or moderate knee arthritis, lifestyle changes can relieve pain.  Switch from high-impact to lower-impact activities. Reduce the frequency of vigorous activity.  And lose weight!  A 10 percent weight loss can result in 50 percent less pain in the knee joint.

Also consider:  physical therapy; assistive devices like shock-absorbing shoes or a knee sleeve; OTC medications like Advil or Tylenol; and prescription medications. For example, alternating cortisone injections and gel injections every three to six months may buy you many relatively pain-free years.

Q: Do I need surgery?
A: Yes, if you’ve reached the bone-on-bone stage, often with pain at night, and activities severely limited by pain. You can’t put on your shoes and socks or walk more than 100 feet. Nothing will help at this stage except a total or partial knee replacement. If your arthritis isn’t quite that severe, discuss other surgical procedures with your surgeon.

Two advanced, highly effective robot-assisted surgical approaches for full and partial knee replacements called NAVIO and MAKO are available at Northern Westchester Hospital. We’re one of the few hospitals in the region, including in New York City, to offer both technologies.  Both approaches offer a new level of accurate placement customized to your unique knee anatomy. That translates into the most natural-feeling knee ever. The procedure takes about 75 to 90 minutes and a healthy motivated patient usually goes home the same day. Post-operative pain is greatly reduced through Northern Westchester Hospital’s ERAS pain management program – and you have a faster, narcotic-free recovery. Within a week, you’ll likely walk with a cane; within a month, without a cane. Many people drive in two weeks. Most people are cycling in six weeks, playing golf in three months and skiing in six months.

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Patients tell me: “You changed my life!”  “I wish I did this 10 years ago!”

Joel Buchalter, MD
Director of Joint Replacement Surgery
Orthopedic and Spine Institute
Northern Westchester Hospital

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