Knee-Care 5 Step Protocol
As weight bearing joints, your knees take a beating throughout your life. As you age, you can be subject to a variety of sources of knee pain. In fact, knee pain has become even more common in the last two decades.
At Carolina Orthobiologics, we use a five-step process that starts with diagnosing the source of the knee pain. We’ll then make sure you know and understand your diagnosis and give you tools to help ease your symptoms. Then, we will ensure that your knee is in the correct alignment and functioning properly.
You’ll get on a program to strengthen the muscles around your knee and increase your range of motion. Finally, we can use precision-guided injections to improve the health of the knee.
Our five-step process adds up to a complete, effective knee care program. That means less knee pain for you. Here’s what you can expect from Carolina Orthobiologics’ knee care program.
The knee is a complex joint made from bone, muscle, cartilage and lots of connective tissue. When something goes wrong with even one of these types of structures, it can throw the whole joint off, causing pain, reduced range of motion, difficulty walking and other problems.
Here are some of the most common causes of knee pain:
- Knee osteoarthritis: A breakdown of the cartilage that wraps the ends of bones (called articular cartilage)
- Ligament sprains: Tears to ligaments—tissue that connects bones to each other—including the ACL, PCL, MCL and LCL
- Meniscus tears: Tears to menisci, the shock-absorbing pads of cartilage between the femur (thigh bone) and tibia (shin bone)
- Chondromalacia and patellofemoral pain syndrome: Damage to cartilage on the underside of the kneecap (patella)
- Tendon tears: Injuries to the tissue that connects muscles to bones, especially the quadriceps tendon
- Fractures: Another name for broken bones
At Carolina Orthobiologics, we’ll use a variety of imaging methods to diagnose knee pain. That’s because different scans pick up different types of injuries. X-rays, for example, are great for diagnosing fractures, but can’t detect soft tissue like ligaments or cartilage. Magnetic resonance imaging (MRI), computed tomography (CT) or ultrasound scans are used to detect problems in soft tissue.
Once you have your knee pain diagnosis in hand, we can begin to address your problem and restore your knee function. You’ll be an active partner in your own treatment, and that means getting educated on your condition and its possible treatments.
Our first step will be informing you on the risk factors for knee pain, as well as lifestyle modifications you can make that may help alleviate your symptoms or slow your condition’s progression.
Every knee pain condition has its own set of risk factors, but many are shared across the board. These can include:
- Age: Knee pain tends to increase with age due to wear and tear on the joints
- Excess weight: Being overweight or obese puts more strain on the knees
- Previous injury: Having had a knee injury can make you more prone to having another one or to developing arthritis
- Sports: Some sports, such as contact sports or those that put repetitive stress on the knees like running, increase the risk of knee injuries or conditions
When it comes to lifestyle changes, losing weight if you are overweight or obese is never a bad option. A loss of even 10 pounds is enough to relieve some of the pressure on your knees, as well as cut your risk of osteoarthritis later in life.
Another change you can make: If you lead an active lifestyle but experience knee pain, consider switching your activity. Exercises like running are known as high-impact activities because you’re sending jolts up through your knees every time your foot hits the pavement, track or treadmill. Switching to a low-impact activity without those jolts, such as cycling or swimming, can cut down on the pain.
Some forms of knee pain, such as chondromalacia or patellofemoral pain syndrome, happen because the knee does not move correctly. In such cases, it can be helpful to realign the knee.
When your knee is out of alignment, all the wrong anatomical structures are absorbing the pressure of every footfall. Cartilage gets rubbed away and strain on the ligaments and tendons are increased, creating the potential for injury.
For some conditions, such as osteoarthritis, combining a knee brace with a custom foot orthotic—a specialized shoe insert—help reduce symptoms by correcting alignment problems and reducing the force on the knee.
If you have been living with knee pain, you may have slowed down substantially in your activity. Few people want to lift weights or do cardiovascular exercise when their knees hurt. Improving your leg strength can make the treatment process easier and shorter.
Flexibility and muscle strength go hand-in-hand with healthy knees. There’s evidence to suggest that pain in the front of the knee and pain from knee osteoarthritis can be improved through leg strengthening exercises.
At Carolina Orthobiologics, we will work with you to develop a knee strengthening program that fits your needs and ability level.
Hyaluronic acid is an FDA-approved injection that replaces unhealthy joint fluid and provides lubrication and cushioning in knees with arthritis. Using the latest in ultrasound image-guided technology, Dr. Lehman administers the injection of hyaluronic acid with pinpoint precision. The precision and accuracy of the image-guided injection ensures the gel-like fluid is injected directly into the joint capsule for optimal results.
Advantages of hyaluronic acid injections include:
- Nonsurgical knee pain treatment
- Covered by Medicare and most insurance
- Combined treatment plan enhances the effects
- Exhaust all of your options
Stem cell therapy and platelet-rich plasma (PRP) injections are two treatment types that are gaining traction. They occupy the space between physical therapy and other conservative treatments on one end, and surgical procedures on the other. They can be a helpful treatment for people who’s knee pain has not improved with nonoperative treatment but who are not ready for surgery, or as ongoing treatment even after surgery.
Stem cell therapy uses special cells and growth factors harvested from the patient’s bone marrow. These stem cells can be induced to become any other type of cell. A 2014 study published in Journal of Bone and Joint Surgery suggests that stem cell therapy can reduce pain after meniscus surgery. Meniscus surgery often requires cutting away the torn part of the meniscus, so it was even more encouraging that the data suggests meniscus volume actually grew in some people treated with stem cells.
PRP, on the other hand, utilizes anti-inflammatory and reconstructive compounds found in a type of blood cell called platelets to speed healing. A 2018 study published in Current Reviews in Musculoskeletal Medicine suggests that PRP injections are on par with many more established treatments for knee osteoarthritis, carry few side effects and can be an effective complementary or alternative therapy for osteoarthritis of the knees. Another 2018 study, this one published in Journal of Translational Medicine, found that stem cell plus platelet therapy performed better than exercise, and patient quality of life remained high two years after treatment.
If your knees are in need of care, if you’re tired of living with knee pain and if you want to improve your quality of life, request an appointment with Carolina Orthobiologics. Our comprehensive knee care program may be just what you need.
18 Medical Park Drive
Asheville, North Carolina 28803