Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.
Tags: knee | surgery | pain

Do I Need Knee Surgery?

Wednesday, 14 November 2012 10:56 AM

Question: I am a 74-year-old man with very sore left knee that swells at times. I’m trying to delay having joint replacement surgery. What do you recommend for the pain and to keep swelling down?

Dr. Hibberd’s answer:

I would expect you be screened for other causes of mono-articular arthritis, and to be sure you do not have gout, crystalline, or infectious disease of your left knee, hip or foot/ankles.

Knee pain from loss of cartilage loss — a shock-absorbing tissue — often comes with age and overuse with advanced degenerative changes. It is best treated conservatively with Tylenol, weight loss, and physical therapy. Anti-inflammatories (such as ibuprofen) may be used, but be aware that they can cause gastrointestinal problems.

Recurrent pain can be relieved by joint injection of cortisone mixed with some local anesthetic for flare-ups of pain. Avoid oral cortisone use. There are agents we can inject into a knee that has lost protective cartilage that will stimulate new cartilage growth and even delay knee surgery. The newer stem cell treatments also appear to be very successful at regenerating cartilage growth. These treatments are worth your discussing with an orthopedic specialist before you agree to a knee replacement.

Total knee replacement should be considered a last choice. There is no going back after surgery, and operative and anesthesia risks need to be considered carefully.

© HealthDay

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Knee pain from loss of cartilage loss often comes with age, but surgery isn't always necessary.
Wednesday, 14 November 2012 10:56 AM
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