Chronic pain in the knee

Chronic pain in the knee

Very often in our practice we meat patients with the following case: the patient suffers from pain in the knee with unspecified genesis.

He consults a doctor, who recommends an X-ray. The Ro graphy could not show the pathological amendments of the soft tissue so the diagnosis most oftenly (and most oftenly wrong) is “gonarthrosis”. The treatment prescribed usually is intra-articular injections, mostly corticosteroids (Diprofos, Flosteron, Depomedrol).

These injections applied to people over 50 years of age quickly weaken the articular cartilage and connective tissue and accelerate the process of destruction. Such injections should only be applied when the joint’s reaction to the unspecified irritation is expressed in swelling and collection of liquid. The application should be made only once and very careful!!!

Multiple application of these injections in short period of time is a serious mistake. This leads to a rapid destruction of articular cartilage, not rarely affects the underlying bone.

What is chronic knee pain? This is a pain which continues more than three months, without particular reason or evidence of trauma. The pain is more or less intense but it never disappears completely.

The reasons causing this condition may be many and various. Most often it occurs in people over 50 years of age. According to our experience in approximately 80% of the cases it’s a damage of the meniscus that causes the problem.

Other possible causes of chronic knee pain are: tissue changes determined by old age, rheumatoid arthritis, gout, “Softening” of the cartilage of the knee cap, plica syndrome, tendinitis such as “jumper’s knee”.

Тhe pain can be accompanied by swelling and limitation of movement.

Patients should consult a doctor as soon as possible after the appearance of the pain. The more the consultation is delayed the more serious the problem gets. It causes chronic inflammation of the joint, leading to more rapid “abrasion of cartilage”. This is especially noticeable when the meniscus is ragged. Our experience shows that unfortunately these injuries, lead to significant damage in the joint if not treated for more than 7-8 months.

It is recommended to make a MRI to evaluate the type of damage. If necessary, additional tests can help putting the right diagnose. Usually we start with conservative treatment. It includes anti-inflammatory medications, ice, physical therapy and rehabilitation.

We strongly recommend intra-articular injections NOT to be applied without prior specifying the type of damage, because it will only disguise the symptoms. Especially when there is a mechanical damage in the joint. And not only that, but it will cause faster degeneration and destruction of the knee.
When the data from the MRI clearly shows a damaged meniscus and preserved joint, we proceed to surgery.
The procedure is called arthroscopy. It is made through two holes about 5 mm. wide. We penetrate into the joint with a very narrow camera and microinstruments.

The most common injuries we see, are lesion of the meniscus, damage of the articular cartilage, plica syndrome, chondromalatia of the knee cap.
An additional treatment can be made after the surgery, depending on the condition of the joint. It included physiotherapy and rehabilitation, application of intra-articular injections with blood plasma, hyaluronic acid, or biopolymers helping the faster postoperative recovery of the joint.

By applying the correct treatment to the knee, endoprothesis can be avoided.