Arthritis or inflammation of the knee joint is painful and can make it difficult to do everyday activities, such as walking or climbing stairs. As prevalent as knee arthritis is, it’s one of the major causes of lost time at work and disability claims.
Osteoarthritis and rheumatoid are the most common forms of arthritis. Sometimes patients seek knee arthroscopy surgery of the meniscus and cartilage, also referred to as “clean out” surgery, as a solution to their debilitating pain. But we at Kelsey-Seybold Clinic in Houston agree with medical experts throughout the world who have determined that knee arthroscopic surgery is not useful for the treatment of knee arthritis. In fact, it may actually be harmful and lead to the arthritis becoming worse.
What Is Knee Arthroscopy?
Knee arthroscopy is a surgical procedure that is typically used to diagnose the cause of knee pain. But it can also be used to correct issues. During the procedure, a surgeon inserts an arthroscope, which is a small camera, into the knee joint through small incisions after the patient receives anesthesia. The camera displays images from inside and around the knee joint on a monitor.
During knee arthroscopy, the surgeon may decide to perform a process called lavage, which involves flushing the joint with saline solution, to clean out materials that may be causing irritation and swelling. Because tearing of the meniscus occurs in most cases of knee arthritis, the surgeon may also repair or trim the torn meniscus during the arthroscopy.
What About Hyaluronic Acid Injections?
In recent years, many patients with knee arthritis have turned to viscosupplementation, also known as hyaluronic lubricant injections.
The idea is that injecting lubricant into the knee joint can facilitate better knee movement and reduce pain. In reality, while the injections may temporarily reduce pain, they are associated with higher complication rates (such as infection, bleeding, and allergic reaction) and have no difference compared to steroid injections into the knee.
Your Kelsey-Seybold Clinic doctors do not recommend viscosupplementation.
Why Knee Arthroscopy Doesn’t Help
In most cases of knee arthritis, a tear in the meniscus probably has very little, if anything, to with knee pain. The pain is almost always caused by inflammation of the joint. The meniscus tear is the result of the arthritis, not typically the problem. Therefore, repair or removal of the meniscus and/or cartilage does not reduce pain. It may, in fact, accelerate the arthritis by removing tissue that prevents bones from rubbing against each other.
Multiple studies have shown little to no improvement in knee pain in patients who underwent knee arthroscopic surgery.
Practicing evidence-based medicine is the Kelsey-Seybold Clinic commitment to you.
In cases that have been documented in medical journals, there
Recommended Treatment of Knee Arthritis
While we do not recommend lubricant injections or arthroscopic surgery of the meniscus for treatment of knee arthritis, there are some treatment options and lifestyle changes that Kelsey-Seybold Clinic encourages for our patients.
- Weight loss to reduce impact on the knee
- Modifying activities to reduce stress on the knee
- Medications such as ibuprofen and other pain relievers
- Physical therapy
- Knee braces
- Corticosteroid injections
If you suffer from arthritis of the knee and are seeking medical relief, I can help determine what treatment options are best for you, and get you the relief you need. Request an appointment by calling 713-442-0427.
Dr. Anup Shah is a board-certified orthopedic surgeon with Kelsey-Seybold specializing in shoulder and knee injuries. He specializes in sports medicine, advanced arthroscopic surgery, cartilage repair, and shoulder reconstruction, including shoulder arthroscopy and shoulder replacements. Dr. Shah completed fellowships in sports medicine/arthroscopic surgery and shoulder reconstruction. Through education and teamwork, he forms a partnership with you to manage and treat your condition.