Understand how injections, surgeries and knee joint replacement are performed

There are several ways to deal with knee pain. From cold compresses to rest, pausing physical activities and taking medication, many things can alleviate symptoms. Persistent cases may require more invasive interventions, such as injections, surgery and even joint replacement.

Dr. Marcos Cortelazo, orthopedic specialist in knees and sports traumatology, member of the Brazilian Society of Orthopedics and Traumatology (SBOT) explains the treatments and surgeries that can help:

Injections

Corticosteroid (cortisone) injections are sometimes used by healthcare professionals to relieve pain from osteoarthritis or degenerative cartilage tears. “They provide short-term relief, but must be placed in context for the patient, who must generally also undergo physical therapy. They are generally administered punctually to alleviate symptoms in the acute phase. Additionally, because corticosteroids can weaken and potentially rupture a tendon, they should not be administered directly to these structures to treat a strain or tendonitis.†he explains.

Hyaluronic acid, a high-viscosity substance that helps lubricate an arthritic joint, can also be used to treat knee osteoarthritis.Â

Meniscectomy or Meniscal Repair

When knee pain is caused by a meniscal tear, it may need to be treated surgically if less invasive options are not successful. This type of condition is typically treated surgically by: removing the damaged portion of the meniscus (called a partial meniscectomy) or by suturing the meniscus (called a meniscal repair).

“Although meniscal repairs have better long-term results than meniscectomy surgeries and are less likely to lead to osteoarthritis, only a small portion of injuries can be repaired surgically. This is because repairs can typically only be performed on tears in the outer third of the meniscus, which has better blood flow than the rest of the structure.†, he explains.

Total knee replacement

If other conservative treatments for osteoarthritic knee pain fail to provide pain relief and improved function, a total knee replacement is usually necessary to correct the problem.

“This common surgical technique, which involves replacing the arthritic joint with prosthetic components, has been shown to be extremely successful in improving knee pain and increasing overall function. . Typically, surgery is followed by physical therapy focused on increasing the knee's range of motion and improving leg muscle strength.†, highlights the doctor.

In the case of arthroplasty, the objective is to replace the joint affected by osteoarthritis with a knee prosthesis, which can be made from different materials, such as metal and polyethylene, a type of plastic. “However, despite the high success rates of the procedure, many patients say they are dissatisfied with the result due to pain, stiffness and swelling in the region, which can even cause fear in those who are yet to undergo the procedure. procedure.

Fortunately, a new generation of completely customized knee prostheses is now available to improve the prognosis of arthroplasty.†, explains the doctor. These are custom-made prostheses for each patient using 3D printing. “Although today they are already very advanced, traditional knee prostheses are identical for everyone, with only variation in size. Therefore, for a perfect fit, it is often necessary to make large cuts in the femur and tibia.†, explains the doctor. The new prostheses are produced based on computed tomography images that allow the doctor to analyze the size, shape and position of the knee bones, thus ensuring a perfect fit. “This means the surgery is faster, there is less need for bone cuts and the prosthesis can be positioned more easily†, highlights the orthopedist.

Finally, the doctor says that many cases of knee pain can benefit from reducing body weight and practicing strengthening physical activity. “Therefore, before opting for a supplement or any homemade technique, the most important thing is to seek medical help, especially if the pain persists or is not alleviated.†, he finishes.

DR. MARCOS CORTELAZO: Orthopedist specializing in knee and sports traumatology. Graduated in Medicine and postgraduate in Orthopedics and Traumatology from Escola Paulista de Medicina/Federal University of São Paulo (UNIFESP).

Featured photo: knee pain (Photo/reproduction)