Friday, February 1, 2013

Why Does My Knee Hurt? Two Common Causes: Arthritis and Meniscal Tears


Knee pain is one of the most commonly treated orthopaedic problems in our office.  Many patients struggle with balancing their goal of remaining active with confounding knee pain and difficulty with obesity.  In fact, studies predict that by 2030, there will be an over 600% increase in the demand for primary total knee replacements to relieve arthritis pain.  (Arthritis is loss of cartilage covering the end of the bone.)  But knee pain isn’t always just arthritis.  It can also be a meniscal tear or cartilage injury as well.  (A meniscus is like a shock-absorbers or padding in the knee joint that cushions the impact of activity.)




How can you tell the difference between arthritis and a meniscal tear?  Often, the pain is very similar for both conditions.  The joint can become swollen, painful and may have sharper pain at times.  Other symptoms include a sense of weakness in the knee joint.   In addition, the location of the pain is usually the same, right on the joint line.  However, one typical difference is this:  arthritis pain is typically a dull, more constant ache, while meniscal pain can be more of a sharper, catching pain that comes and goes.   A torn meniscus can flip into the joint and increase symptoms, and even cause the knee to lock in place.  Arthritis pain can also be worse after inactivity, such as sitting for long periods of time in the same position, or in the mornings. 


 A diagnosis can often be made with x-rays and physical exam.  In addition, an MRI is helpful to determine if the pain is from a meniscal injury.  The MRI is then helpful in planning for surgical intervention. 

Conservative treatment options for both problems is also quite the same:  Ice for swelling, non-steroidal anti-inflammatory medications (NSAIDs), physical therapy to get the joint moving again, and often times a knee brace for support.   A steroid injection can also be helpful in relieving arthritis pain.  A general exercise routine is good to keep an arthritic joint moving.  Low-impact activities such as an exercise bike, elliptical machines and swimming are helpful and are better tolerated by arthritic joints. 

Surgical options for each problem differ greatly.  A torn meniscus can usually be treated with an arthroscopic procedure to clip out the torn piece.  Advanced arthritis is often only resolved by joint replacement.  Knee replacement is a much more significant and involved procedure that should be discussed thoroughly with your orthopedic surgeon and primary care physician. 

Written by Lori Thomassee and Dr. Dane Glueck

 **images courtesy AAOS  (http://orthoinfo.aaos.org)

1 comment:

  1. Excellently amazing and exciting too. Can you please mention me the source of your reference... I am happy that at least somebody gave this subject an attention.
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