Baylor, Scott & White Health has tips on caring for your knees, and advice if you think knee surgery might be in your future.
Your knees are some of the most hardworking joints in your body.
They carry your weight through every journey you take — from carrying a child upstairs to bed, to jogging with the dog on a perfect fall day, to accomplishing heavy labor, to running into action in the face of an emergency.
Humans are incredible in their abilities and resilience — and so are the joints that are at the root of it all. Yet with all the important and sometimes strenuous work our knees do throughout our lifetime, they will likely wear out or sustain injury at some point… and that could involve knee surgery.
Here are some tips to care for these incredibly important joints, and advice if you’re considering knee surgery.
Common strains on our knees
Sean G. Haslam, MD, Chief of Surgery and Department Chair for Orthopedics and Neurosurgery and an orthopedic surgeon on the medical staff at Baylor Scott & White Medical Center – Centennial, says that the two most common types of knee injuries are meniscus tears and ACL tears.
“Meniscus tears can be avoided by ensuring you’re using proper technique during weight lifting and sports,” Dr. Haslam says. “If you start to develop knee pain, double-check your technique with a trained professional.”
ACL tears, interestingly, tend to affect female athletes with greater frequency than their male counterparts. Putting athletes through a neuromuscular training program during the off season has been shown to reduce the risk of ACL tears during in-season play.
Injuries aren’t the only stressor on our knees due to activity like sports training: a disease process called osteoarthritis can be exacerbated by high impact activities as well.
“If you have osteoarthritis, consider low impact activities for exercise,” Dr. Haslam suggests. “Low impact activities include swimming, cycling and aerobics performed on a gymnastics bouncy floor.”
But perhaps the most pervasive knee ailment is that of arthritis. Arthritis is gradual, causing inflammation in joints as a result of cartilage damage, which can lead to pain, swelling and even sickness.
“If you’re experiencing arthritis pain, you might first consider nonsurgical treatments such as anti-inflammatory medication, physical therapy and injection at the site,” says Nathan F. Gilbert, MD, Chief of Orthopedic Surgery and an orthopedic surgeon on the medical staff at Baylor Scott & White Medical Center – Plano. “If this doesn’t help alleviate the pain, you should discuss surgical treatments with your orthopedic provider.”
Options before talking knee surgery
Most people don’t like to jump right into discussing surgery when it comes to their knee pain. That’s totally understandable — and often, it lends itself to doable treatments in the meantime.
The best first step for patients with knee pain is to start with very conservative treatment with RICE (Rest, Ice, Compression, and Elevation).
Sheena Black, MD, orthopedic surgeon on the medical staff of Baylor Scott & White Medical Center – McKinney and Baylor Scott & White Sports Surgery Center at the Star, says that she also always has her patients look for activities that could be aggravating the issue.
“For my athletes – Is it time for new running shoes? Are they using correct form with squats?” Dr. Black says. “For all patients I have them evaluate what started the pain. Is it worse after certain activities? Have they gained a couple pounds over the last couple months that could have contributed to the pain? In addition, anti-inflammatory medications such as Ibuprofen can help decrease pain, as long as patients can take these types of medications under the guidance of their primary care physician.”
The next step is to refer them to a physical therapist for a stretching and strengthening program to look for any muscular imbalances. Depending on the level of pain, a steroid injection into the knee may also be considered.
“If patients are still struggling with pain after conservative options, I always suggest starting with an x-ray,” Dr. Black goes on. “Ultimately an MRI may be ordered to give more information about the cartilage, meniscus, ligaments, and bone. Surgery is always the last option, however in some patients it may be the best option depending on the source of pain.”
Choosing knee surgery
When William Montgomery, MD, Orthopedic Surgeon on the medical staff of Baylor Scott & White – McKinney, is discussing knee pain with a patient, he first determines whether the pain is caused by the internal aspect of the knee or the soft tissue around the knee. If the patient’s pain is derived from the internal aspects of the knee, the most likely cause is arthritis.
Dr. Montgomery describes the treatment options as plan A, B and C.
“Plan A is medical treatment: for example, the arthritis medicines like nonsteroidal anti-inflammatories and Tylenol. This can also include options such as a brace, a cane and physical therapy. Plan B includes injections to the knee, such as steroids or viscoelastic supplementation. And plan C is surgical intervention.”
The most knee surgery intervention is knee replacement. Most patients choose joint replacement when the pain affects and limits their ability to participate in normal activities of daily living.
“The decision for knee replacement is driven by a significant and progressive knee pain that impacts a patient’s activities of daily living and quality of life,” Dr. Montgomery emphasizes. “We as surgeons can bring value to a patient’s life when we can relieve their knee pain and help them resume the activities they enjoy.”
How’s Your Knee Health?
Go to BSWHealth.com/Knee to complete a brief nine-question multiple-choice quiz to see whether you should consider seeing a doctor to talking about knee health or knee surgery – and if so, what kind of specialist.
Physicians provide clinical services as members of the medical staff at one of Baylor Scott & White Health’s subsidiary, community or affiliated medical centers and do not provide clinical services as employees or agents of those medical centers or Baylor Scott & White Health. ©2021 Baylor Scott & White Health.
This article originally appeared in our 2021 November/December issue of Local Profile magazine.
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