Q&A Topic: Managing Arthritis in the Knee

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Evan H. Karas, MD, FAAOS

Q. What is the most common cause of chronic knee pain?

A. Arthritis is the most common cause of long-term, persistent knee pain. What that means is the cartilage—the smooth, slippery substance that lines the joints—is wearing down. Lack of cushioning leads to inflammation. This is the primary type of arthritis, and it’s known as osteoarthritis. Another type is rheumatoid arthritis, in which an overactive immune system attacks the joint and triggers chronic inflammation.

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Q. What are the usual symptoms of arthritis in the knee?

A. The most common complaint is that the pain gets worse with activity. That’s especially true for people engaging in weight-bearing exercise like walking or running. Other symptoms include swelling, loss of flexibility, and even a grating sensation in the knee. Sometimes, you can even hear it.

Q. How do I manage the pain?

A. Start by trying to limit your weight-bearing activities. You can take over-the-counter pain relievers like ibuprofen or naproxen and ice the painful joint for 20 to 30 minutes when you’re able to. If pain persists, see your doctor who may prescribe physical therapy. You’ll learn gentle exercises and stretches that increase strength in the muscles around the joint and improve your range of motion. Your doctor may also prescribe stronger anti-inflammatory drugs and/or creams that you can rub on the joint for relief. Often, special knee braces can help provide stability to the joint and help take pressure off your knee. For short-term relief, cortisone injections may help.

Q. What is the long-term relief, if pain persists?

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A. At Northern Westchester Hospital, we treat persistent knee arthritis with an injection of viscosupplements. The injection delivers hyaluronan, which is typically found in high amounts in and around joints. The substance acts like a lubricant and a shock absorber. Viscosupplement injections can provide relief for six months to a year. The final option is surgery, and there are several types from minimally invasive procedures to a complete knee replacement.

Q. What are my options for knee replacement surgery?

A. There are two options for knee replacement: A partial or a full replacement. A partial knee replacement targets just the area affected by arthritis. Robot-assisted smart instruments deliver robotic precision to the surgeon’s hands, allowing for controlled, accurate, and predictable procedures. The device only permits movements in accordance with the plan—any deviation from the plan and the tools freeze, preventing the removal of any excess bone. Thus, robotics make partial knee replacements a viable option for patients with arthritis in only part of the knee.And then, there’s a full knee replacement if you have generalized pain throughout the knee. Replacement joints used to come in standard sizes and surgeons would choose the closest fit to the patient. Now, we’re now able to print 3-D joints to reproduce the patient’s joint. These patient-specific breakthroughs will allow your new knee to last longer and feel more natural.

Co-Chief, Orthopedic Surgery
Co-Director, Orthopedic & Spine Institute
Northern Westchester Hospital

Learn More About Dr. Karas

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Read Past Topics from Dr. Karas: 
Shoulder Pain and Advanced Shoulder Surgery
Boning Up On A Common Knee Injury

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