Short term knee pain
Note, the term “acute” means that the condition is of recent onset and short duration, it does not relate to the severity of the problem. It does not always indicate the occurrence of an injury. Acute knee pain and injuries do not always need imaging investigations immediately. Often the condition can be treated symptomatically with simple analgesics, rest, ice and perhaps a knee support or elasticised bandage. If the problem fails to improve with these measures, consult your general practitioner.
Long term knee pain
The term “chronic” means that the condition has been present for a considerable period of time (months to years), even though it may have varied in its severity during that period of time.
Some chronic knee conditions are best treated by means other than surgery, at least in the first instance. These may include:
- Bracing of the joint
- Injections into the joint
- Weight loss
In the absence of credible published supportive evidence, Dr Kennedy does not currently support the administration of “stem cell” or “PRP” treatment to the knee (or hip) joint.
The most important aspect of the assessment of joint problems by an orthopaedic surgeon is the conversation with the patient (the “history” of the problem), closely followed by a thorough physical examination of the knee. Please wear suitable clothing to the consultation to allow easy access to the knee for examination.
Further investigation of knee problems should always begin with a set of plain x-rays, please bring the x-rays themselves to your consultation, not just the written report.
Magnetic Resonance Imaging (MRI) is a useful method of imaging in the setting of a new acute injury, especially in the young person with no previous knee joint problems.
Ultra-sound examination and CT scanning of the knee are investigations which are infrequently helpful, and should not be undertaken as a first line investigation.
Most adult knee problems are of a degenerative nature (osteoarthritis), and not necessarily the result of injuries. Additionally, there are a large variety of uncommon disease processes which can affect the knee and which need to be considered by the treating doctor.
Not all knee symptoms are best treated by surgery, which should only be undertaken if there is a clear and definite indication that symptoms will improve following surgery. Knee pain is often transient, and will resolve with time, rest and simple symptomatic treatment. This is also true of many knee injuries.
The most common surgery to the knee is arthroscopic (“key-hole”) surgery. This is often effective for the treatment of acute injuries especially to the meniscal cartilages. More information about arthroscopy
It must be stressed that arthroscopic surgery of the knee is not effective for the treatment of all knee conditions, and that this is particularly true in the setting of degenerative arthritis.
Ligament injuries are sometimes (though not always) best treated by surgery. More information about ACL reconstruction
A variety of surgical procedures are available for the treatment of degenerative arthritis of the knee. More information about surgery for osteoarthritis including TKR.