What About My Aching Knee, by Shane Smith, M.D.

“What About My Aching Knee?”

As an orthopaedic surgeon, this is one of the most common complaints I hear from patients.

Many knee problems occur during sports or recreational activities, work-related tasks, or home projects. Knee problems may also manifest due to injury, disease, overuse, or just every day wear and tear.  Knee issues affect people of all ages from children to the elderly, and most everyone will experience knee problems at some point in their lives.

Knee problems can be caused by many factors such as injury, arthritis, disease, aging, and being overweight. Some of the most common causes of knee pain in adults include arthritis and injury.  Injury is usually in the form of overuse causing tendonitis, torn cartilage or ligament, and bone fracture.

Osteoarthritis is a disease that gradually causes the cushioning cartilage within your knee to wear away resulting in pain when bone rubs against adjacent bone.

Rheumatoid arthritis usually affects younger people and is an auto-immune disease.

Other common forms of arthritis of the knee include gout (uric acid waste crystals in the joints), lupus (another autoimmune disease), psoriatic arthritis (inflamed joints as a precursor to psoriasis), and infectious arthritis (brought on by infectious agents such as bacteria or viruses).

Treatment for arthritis is determined by the type and severity. Early stages sufferers use over-the-counter pain relievers and lifestyle modifications like weight loss and performing mild exercises that strengthen the muscles that support the knee.  If osteoarthritis has progressed, a knee resurfacing, partial knee replacement, or total knee replacement may be the solution to ending the pain.

The most common structures to be injured or damaged are the cartilages (meniscus) within the joint and the 4 ligaments which keep the two bones of the knee (femur and tibia) together and functioning properly.  The ligaments are the bands of soft tissue that act as restraints connecting the bones and providing stability in the joint.

Treatment involves applying ice packs, elevating the knee, and immobilization.  Severe injuries may require surgical repair and stabilization.

Patients who have an injured their meniscus may experience some pain when the knee is fully straightened and on weight bearing. There may also be some swelling if there was a significant injury. Symptoms of meniscal injury may sometimes disappear on their own, but frequently persist or return months or years later and require treatment, particularly if the knee is injured a second time.

Treatment of meniscal tears is usually knee arthroscopy, an outpatient, minimally-invasive procedure that takes less than 30-40 minutes in most cases.  Results for this type of procedure usually reveal a 90-95% success rate with very high level of return to activity.

Knee problems can, and are likely to occur in most people, and can be caused by many factors. Although knee problems as a result of an accident cannot be avoided, other knee problems can be lessened or avoided by:

  • Warming up your muscles before sports by walking and stretching.
  • Avoiding sudden changes in the level of exertion in exercises and activities you’re currently enjoying.
  • Wearing shoes that fit correctly and are in good condition.
  • Strengthening your leg muscles through exercise such as walking up stairs or working out with weights.
  • Maintaining a healthy weight as extra weight puts additional pressure on your knees.