Do I Need Surgery For My Chronic Knee Pain?

By November 30, 2020 January 19th, 2021 Educational Videos, Knee Surgery
Woman rubbing her knee looking for kneepain relief.

Knees support much of our daily movement. There’s hardly a day we can avoid sitting, standing, lifting, or readjusting. When knees start giving you pain, it’s hard to ignore. But is surgery your next step?

Ideally, conservative methods should help. They’re not always enough, making knee surgeries a hospital staple. Thankfully, knee surgery is one of the lowest-risk surgeries out there. It’s also highly correlated with pain relief. 

There are a few prominent signs that you may need knee surgery1

You have a significant knee injury. Broken bones, torn ligaments, or tendons often need surgery to put them back in their right place. These injuries may also need debris cleared away. If you have bones around your knees breaking the skin, or joints that are significantly out of alignment, you will probably need surgery.

Your range of motion has decreased and is not improving. Range of motion is often improved with physical or occupational therapy. Muscle relaxers and pain medications can also relax the knee. However, if these strategies are not increasing your movement range, there may be more going on under the surface. Many daily activities, like sitting down on the toilet, need your optimal range of motion to prevent falls and pain.

You have new and significant popping, crunching, or clunking. If you have these symptoms, your doctor will likely assess to see if something in your knee is loose or broken. If so, you may need to have surgery to further explore what’s going on, or to fix the damage.

Your joint/knee pain treatments haven’t helped your pain. Conservative treatment is the typical first step in relieving chronic knee pain. This includes exercise, pain medication, or activity adjustment. But many knee troubles are due to physical wear or chronic inflammation. Medication, installing extra joint fluid, and easing your activity may not be enough to live comfortably with grating knees.  

What health problems often need knee surgery?

We can’t guarantee that any of your health problems will need surgery. Different doctors may develop different plans of care. However, there are several common reasons people end up needing knee surgery.

Joint exploration

Even with an x-ray, MRI, or other imaging, some health problems can’t be solved until the knee is opened up. Knee pain or limited motion that doesn’t have an obvious answer will often need a knee arthroscopy. Thankfully, if an issue is discovered, the surgeon is often able to take care of it during that exploratory surgery.2

Torn meniscus and ligaments 

Joints and ligaments are notoriously slow healers. If they are detached, they risk not healing or healing incorrectly if left alone. These torn parts of your knee will likely need to be put in the right place and sewn back together to heal appropriately.3

Broken bones 

Because the bones in and around the knees are subject to a lot of movement, they may need stabilization if they’re broken. Rods, pins, and screws can help keep broken bones in the knee from shifting as you heal. If you have broken bones in the knee that poke through the skin, you’ll likely have surgery just to put them back in their place.

Damaged synovium 

Synovium is the joint lining that protects the ends of the bones. This lets them pass each other smoothly. Inflamed synovium can create a painful pressure and burning sensation. When it’s worn away, parts of the exposed bone can rub together. This creates a very painful grating sensation. Surgery to help this can be as minimal as replacing the synovium to as involved as replacing the entire knee.4

Misaligned patella 

Your patella (kneecap bone) protects your knee joint. It also connects your front thigh bone to your leg bone. If your patella isn’t In the right place, you can have problems with the entire movement of your leg. Restoring your patella to where it’s supposed to be can solve both mobility and pain problems. A misaligned patella can often be treated by externally aligning it, but it sometimes requires surgery.5

Osteoarthritis 

This is an especially painful knee deterioration where bone rubs against bone. Overuse, old age, injury, and late-stage rheumatoid arthritis are some of the few problems that cause it. It’s one of the most common problems that need knee surgery.6 The surgery is usually a total knee replacement. Patients who undergo it often find fast and significant relief.

Replacing a previous knee replacement

Knee replacements generally last 15-20 years.7 If your replacement is older than that, or you have a replacement that’s acting up, you may need some new equipment. You may need another replacement if the original isn’t working.

What kind of surgeries can be used as knee pain treatments?

DIfferent knee procedures fix different issues. Some are very minimal and some are very involved. Common knee surgeries include:

  • Arthroscopy of the knee surgery. It’s a minimally invasive procedure—a scope is fed into the joint. It can be used for assessing a joint, cleaning up debris, or shaving down a bone.
  • Full or partial knee replacement surgery. This procedure resurfaces your knee. These surgeries have a high rate of pain relief. In one study, 90% of patients who went through a knee replacement had pain relief.
  • Nerve surgery. If your chronic knee pain is related to a long-pinched nerve, an inflammatory disease, or unknown reasons, nerve surgery may be your next step. 

Looking for relief for your chronic knee pain?

Your balance, walking and sitting down rely on your knees. If your pain isn’t being managed by your current plan, you’re at risk for more falls, limited activity, and more.

Dr. Tollestrup is one of the few surgeons in America using a surgical approach for nerve pain. Many people with chronic knee pain have had to go through pain, many medications, and several procedures for relief that didn’t last. Pain needs an effective management plan, and we would be happy to talk to you about your case. Please give us a call at 702-666-0463, or download and complete our New Patient Form.

References:

  1. https://www.webmd.com/pain-management/features/knee-pain-surgery#1
  2. https://www.healthline.com/health/knee-arthroscopy#purpose 
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4041869/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4041869/ 
  4. https://www.hss.edu/conditions_synovectomy.asp#:~:text=A%20synovectomy%20is%20a%20surgical,of%20the%20synovium%20is%20removed
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3426825/ 
  6. https://orthoinfo.aaos.org/en/diseases–conditions/arthritis-of-the-knee#:~:text=and%20posttraumatic%20arthritis.-,Osteoarthritis,in%20bone%20rubbing%20on%20bone.
  7. https://www.hss.edu/newsroom_five-reasons-why-knee-replacements-fail.asp#:~:text=The%20most%20common%20symptoms%20of,95%20percent%20of%20patients%2C%20Dr.
[This article is not meant to replace the assessment and diagnosis of a physician able to assess your case. If you are considering knee surgery or another health treatment, consult a doctor]