Patient Registration  
Knee Foot Ankle CenterKNEEFOOTANKLESelect a topic

Knee Anatomy

Common Knee Problems

Acute injury:
Chronic Problems:
Surgery at the KneeFootAnkleCenter

Arthritis Treatment

 

Treatments

Conservative (Non-surgical)
Surgical
  • Medial side erosions

 

 

<-- Erosion causes increased bowing cause increased bowing. The bowing increases medial side forces and increases accelerates the arthritic process.

Medial erosion and collapse - years after medial meniscectomy -->

Conservative Treatments
Lateral shoe wedges for medial knee pain

Lateral wedge shifts weight away from medial side erosions.

Put "fat" side of wedge outside (lateral).

Orthotics

Orthotics can be designed as a wedge. These devises can be move from shoe to shoe. Also, orthotics reduce pronation - causing less rotational stress in the knee.

Read "Orthotics for Knee Pain"

Non-impact Conditioning

Non-impact conditioning 30 min per day

Walking / jogging /treadmill is too stressful for an acute knee injury,

Start with a stationary bike. Set the seat high, low resistance. Start by rocking you feet "to and fro". Eventually, work up to spinning.

Swimming is another good choice. Swim laps, walk or "run" in chest high water. Avoid breast stroke or whip kicking at first.

Anti-inflammatory Medication

Ibuprofen - Take 3 with food three times a day

Aleve - Take two with food twice a day.

Prescription Medication- see your MD

Anti inflammatory medication reduces pain and swelling. These medicines are all quite similar. Use the one with a cost and dosage schedule that suits you.

Avoid these medications if you have a history of stomach problems or ulcers, kidney problems, allergy to aspirin, or take the medication coumadin.

Weight Loss

If appropriate - usual goal 10%

Glucosamine Sulfate

An intermediate in mucopolysacharide synthesis

3000 mg per day

These substances are key ingredients for joint lubrication. In culture, glucosamine sulfate may be rate limiting. In theory, oral intake of glucosamine sulfate could help the body build a better supply of joint lubricants.

Numerous studies show beneficial effect - similar to NSAIDs (mostly European data) The studies are treating arthritis - primarily of the knee.

Glucosamine sulfate appears to be safe. No significant side effects have been reported.

Available at health food stores - GNC, Costco

Cost - $20 - 50 / month
Good shoes

Must absorb impact - no thin soles, no high or wooden heals

"air" soles, crepe, rubber

Examples: athletic cross trainers

Dress: Easyspirit, Rockport, Bass

Medial Wedges

Shoe wedges - "fat" side in

Shifts weight inward - away from painful compartment.

Custom molded arch supports

Gait analysis and orthotics fabrication

Designed to "center" biomechanic forces and reduce pronation. 80% of patients with knee pain respond.

Hyaluronic Acid Injections

Series of three weekly injections

Hyaluronic acid is a natural lubricant within joints. Injections help arthritic surfaces to glide more smoothly. Studies suggest that 80% of patient will experience reduced pain for 6 months.

 

Surgical Treatments
Arthroscopic Debridement

Outpatient procedure, approximately 1 hr, no crutches, ice and rest for 2 days, then progressive rehabilitation.

Debridement smoothes the joint surface - relieves pain and "grinding" - allows rehabilitation.

 
Biologic Resurfacing

Outpatient procedure, approximately 1 hour, crutches or brace for one month, early swim / cycle

Several techniques, all stimulate new cartilage to form in region of damage or disease.

 


Articular cartilage is transplanted from low use area - to primary weight bearing surface.

 
Realignment

Moves forces towards healthy side of the knee

May include leg lengthening technology

 

High Tibial Osteotmoy

The correction is sometimes secured with a small plate.

Realignment using distraction. This technique uses limb lengthening methods to realign the leg.

The fixator is used for 6 weeks.

 
Hemi Knee Replacement

Minimally invasive

Outpatient or one night stay

Immediate full weight bearing

Rapid recovery

 
Total Knee Replacement

Minimally invasive

Computer assisted.
--Less traumatic
--More accurate

Read about the Stryker Triathalon Knee System

Resurfaces knee

Allows realignment and rebalancing