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What's Up Magazine

Living With and Treating Chronic Knee Pain

Mar 01, 2017 02:00PM ● By Cate Reynolds
They say numbers don’t lie. The number of knee replacements in older adults increased by 46 percent from 2009 to 2013.

Chalk it up to an aging population. Obesity. Sports injuries. All contribute to debilitating knee pain—and the growing demand to do something about it.

The knee joint—made up of bone, cartilage, fluid, and ligaments—is a common site for painful injuries. In fact, one in three Americans older than 45 have some form of knee pain.

Chronic knee pain is pain lasting for at least two or three months. At some point, damage has occurred in the knee joint, causing the pain. People of all ages can suffer from chronic knee pain, especially if they have had an injury in the past or have arthritis.

Cartilage is a robust cushion covering all of our joints. In the knee joint, this cushion is about 3/16 of an inch thick. It covers the entire knee joint surface. We have the same cartilage in our knuckles and finger joints. Putting weight on a damaged or arthritic joint causes pain because if the cartilage is thin or absent, the force is transmitted directly to the bone.

When it comes to treatment, specialists start with conservative measures, including anti-inflammatory medication, rest, and physical therapy. Sometimes that is enough to significantly improve the situation. If conservative measures don’t work, an MRI is usually needed to see joint surface cartilage and ligaments that help hold the knee together. Patients who have large cartilage defects in their knees—similar to craters in the joint’s surface—need advanced treatment. Partial or total knee replacements are options that provide long-term relief in relatively older patients. For younger patients, surgeons can now transplant patients’ own cartilage back into the defect.

Before a cartilage transplant can occur, surgeons perform a minor surgery so they can take a cartilage biopsy. The biopsy—the size of two small Tic-Tac candies—is from a zone in the knee that does not bear weight. Surgeons then send the biopsy to a lab, where it is cultured and eventually grows into 12 million of the patient’s own baby cartilage cells. With these new cells, surgeons open the knee again to clean out the damaged cartilage and replace it with the new. A membrane is sewn around the damaged area to keep the baby cells in place. The cells continue to grow and in about three months, will replace the damaged area.

The best candidates for cartilage transplant are patients in their 20s, 30s and early 40s who do not have arthritis. Patients who are 40s and up can benefit from partial or total knee replacement.

If you suffer from chronic knee pain, visit your health care provider and he or she will help to point you in the right direction to help alleviate your condition.

‘Living With and Treating Chronic Knee Pain’ is provided by the University of Maryland Baltimore Washington Medical Center.

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