ср, 10/19/2011

What to do when the knee hurts?

The knee is the largest of our joints and has the toughest job in our body. It allows us to stand, walk, run and it absorbs jumps and even carries heavy loads now and again. But the knee is also vulnerable. Almost every second German has knee problems. Correspondingly great was the interest in the telephone campaign "If the knee hurts" of Berlins biggest tabloid B.Z. The most important questions which the two experts, Prof. Dr. Wolf Petersen, MD and Dr. Karl Schmoranzer, MD, both from Martin Luther Hospital Berlin, answered were:


How can a meniscus injury occur?

A fall or sudden twist, in the elderly even a deep knee bend, can make the meniscus tear. When the injured meniscus cannot function as a buffer any longer, the joint can inflame.


After a partial removal of the meniscus, the pain remained. Can this be related with my slight bow legs?

Yes, the bowed leg can be the reason for an arthritis on the inside. In this case, an arch support in your shoe can help. Is the joint heavily worn a correction of the leg axis should be discussed.


The MRI showed a meniscus injury. But now the pain is gone. Should it be operated anyway?

No, if there are no symptoms, then surgery is not necessary.


23 years ago I had a head-fracture of the tibia. Now there is a high degree of osteoarthritis. Would a cartilage transplant help?

No. A growing cartilage is only suitable for small cartilage injuries without osteoarthritis. In your case, an artificial knee joint would be more promising.


I'm almost 60. The x-ray shows osteoarthritis on the inside of the knee. Would a sledge prosthesis come into question?

A partial prosthesis is a good solution, if the outside is still good and the pain occurs only on the inside. This procedure can even be performed with minimally invasive surgery.


I have a high degree of osteoarthritis. My doctor recommends injections with hyaluronic acid, which I must pay myself. Are they helpful?

At a high-grade osteoarthritis these injections are hardly useful. They are only helpful at the onset of osteoarthritis.


Can I stop my arthritis when I eat cartilage components (eg glucosamine)?

This has not been proven scientifically yet. But watch out for a healthy diet, your weight, adequate exercise and appropriate footwear.


My knees are often swollen at night. What can I do besides applying expensive ointments?

A very effective home remedy in this case are wet packs with skimmed curd. Just put it in a cotton cloth (handkerchief, tea towel), place it on the swelling and leave it there for at least two hours.


My orthopedic surgeon has discovered that I have a so-called patellar tendinopathy. Does it have to be operated?

Pain in the knee caps are often a result of unevenly toned muscles, often combined with shortening. Here quite often a targeted physiotherapy already helps.


Four years ago I hurt my anterior cruciate ligament. Thanks to physical therapy my knee feels good again. Do I need surgery anyway?

No, if you do not have the feeling that your knee is unstable, no surgery is needed.


Which sport is particularly stressful for the knees?

Football, handball, basketball, badminton, squash, football, skiing, tennis, running in a high degree and anything where you have to jump a lot and slow down fast.


What should I watch for while running?

The best is to run on flat forest and park trails. Here the impact of each step is absorbed better. If you run on asphalt, you should select shoes that fit to your runner type.


What sports can I do with knee problems?

Knee-friendly sports include aqua gym, Nordic walking and cycling. For winter sports, you should prefer cross country skiing. Moderate exercise can actually help to alleviate the discomfort.


Can acupuncture help with knee pain?

Yes, although it can not make the arthritis reversed, it can relieve the pain.


For me, a mucosal fold was observed. Does it have to be operated?

A mucosal fold rarely leads to symptoms. But if other causes are ruled out for pain, an arthroscopy with the removal of the mucosal fold can help.


A part of my meniscus was removed. Can we replace it?

Yes, there are already implants for meniscal replacement. But they are still not standard and are not suitable for every patient.


What is an arthroscopy?

A miniature camera is inserted into the joint so the doctor can detect changes. In addition, fine instruments can be inserted to remove fabric or sew together tears or ligaments.


When do I need a new knee joint?

If it is so much damaged that with a severe osteoarthritis you can not extend it anymore or when there is severe pain and all other treatment methods do not work.


What does it mean to get a new knee joint?

When it is implanted the damaged areas are replaced, either in form of a partial prosthesis (sledge prosthesis) or a total knee replacement (TKR) which includes the replacement of all surfaces. The rear surface of the patella however is rarely replaced.


How long will it take before I can start to walk again?

You can get up on the day after the surgery when accompanied. Driving usually is possible after rehab.


My 10-year-old son complains of pain in the knee. What can that be?

In children and adolescents knee pain occur relatively frequently. Therefore, you definitely should see a doctor, so that an accurate diagnosis can be made. Often injuries caused by accidents (eg anterior cruciate ligament) will not be noticed.


My 10-year-old son has a torn ACL. Can you operate that?

Recent studies have shown that the risk of growth failure due to modern surgical techniques is low.