Arthritis is a loss of cartilage on the articular surface of any joint. It is associated with chronic pain and loss of motion leading to decreased function and increasing impairment of the knee. There are many types of arthritis affecting the knee. These include:
- Rheumatoid and Inflammatory Arthritis
- Post-traumatic arthritis
- Avascular Necrosis
- Arthritis caused by exposure (Prolonged exposure to an anesthetic, such as lidocaine)
Symptoms of arthritis are often described as a deep and achy type pain associated with the knee. The pain is usually worse with activity and increases as the day progresses.
Treatment of knee arthritis with non-surgical measures is the mainstay of management. The most important factor in the treatment of knee arthritis and prevention of progression is weight control. Every pound lost or gained accounts for 5-6 pounds of pressure across the knee joint. Therefore if 10 pounds is lost, this will decrease the pressure across the knee by 50-60 pounds. The opposite is also true if the weight is gained. Additional treatment typically involves anti-inflammatory medications. Chronic use of these medications should be discussed with the patient’s primary care physician, particularly if a patient has any cardiac or kidney disease. The patient should always consult with a physician before starting these medications. Therapeutic exercises can help to slow the loss of motion but will not change the fact that the cartilage is lost. Cortisone injections and viscosupplementation injections are also helpful in decreasing pain associated with knee arthritis. When these measures are no longer helpful surgical intervention is indicated.
The end stage of treatment for knee arthritis is a knee replacement. Occasionally, when the disease is limited in its distribution, an arthroscopy may help. However, usually a knee replacement will eventually be necessary. Dr. Lenarz does treat knee arthritis up to the point that a knee replacement is needed. Once the other treatments are no longer effective, Dr. Lenarz will suggest a referral to another physician who does perform knee replacements.