There are many causes of knee pain. The knee joint is the most mobile joint of our body. The bending of the knee during sitting and standing up and the strains that occur over the years with the strain of sports or joint movements cause our knee to degenerate. At the same time, diseases such as rheumatism, which we know as joint disease, and joint diseases in which cartilage synthesis decreases, cause problems to the knee as the age progresses.

In a case of knee pain, in addition to pain, knee noise, especially when climbing stairs or going downhill, knee swelling or locking of the knee are among the common events we encounter. These complaints should be handled and evaluated separately. These complaints may occur separately or in the same knee of the same patient.

Most people have complained of knee pain at some stage of their lives. Especially half of women after menopause have knee pain. The cartilage structure, which is more flexible and softer than men, combined with bone resorption after menopause, causes serious knee pain problems in women. With the decrease in cartilage synthesis, the cartilage structure becomes loose, functions that force the knee such as sitting on the floor, eating on the floor, eating on the floor, toilet habits, and the working environment increase the possibility of degeneration of the knee. Degeneration progresses rapidly with the addition of excessive and sudden weight gain. Another problem is the wide hip structure of women. After menopause, the balance in the knees is disturbed and a new problem is added with the inward angulation of the knees called varus. As a result, more load is placed on the inner part of the knees and the cartilage of the inner side quickly melts. People whose parents or close relatives have knee problems are in a much higher risk group than other people. In other words, the onset of pain in the knees of a 40-45 year old woman whose one of her parents has a serious knee problem should be a serious alarm for this person. At the same time, the fact that patients in the 40-45 age group, where joint rheumatism and cartilage synthesis are not good, have knee problems that will lead to knee prosthesis in the future should be an important harbinger and precautions should be taken at this age.

Knee arthritis is diagnosed radiologically and by examination. The onset of calcification, wear of the joint surfaces, the onset of some problems under the kneecap, softening and melting of the cartilages in the joint, the development of bone deformations are all advanced stage findings. When the problem reaches advanced levels, the pain that occurs only when we stand up becomes haunting us even at rest. In other words, our knees start to ache wherever we sit or lie down. It may cause deformation that may even require knee prosthesis.

Arthrosic changes in the knee are radiologically evaluated in 4 stages, starting from the mildest. If you have reached the stage we call Grade 4, prosthesis may be recommended for you. Some new technology drugs improve the quality of life. They delay the need for knee replacement considerably.

Pain It may be aching, dull or throbbing. The pain characteristically occurs when going up and down stairs and bending the knee.

Knee friction noise: It is the sound that occurs when the knee bends as a result of decreased intra-articular fluid.

Emptying sensation in the knee: Caused by the weakness of the patellofemo above the knee, this symptom occurs when bending and unbending the knee under load (stairs, downhill). Locking: The inability to reopen the knee during bending. It occurs in case of deterioration of the joint surface or meniscus tears.

Swelling: It is a condition in which intra-articular fluid increases, making it difficult to walk painfully. It occurs especially in rheumatic knee diseases and after trauma.

Calcification: It is a painful condition that occurs with the degeneration of the articular surface as a result of degeneration of the knee articular cartilage and creates sound by bending the knee.

The first approach should be conservative. In other words, interventions such as surgery should be preferred later. Nonsteroidal anti-inflammatory drugs (NSAIDs) help to reduce pain. Ice application is helpful. Pain can be reduced by wearing knee bracelets and bandaging. If there is no reduction in pain with these measures, patients may benefit from PTR. We follow the following path in "Persistent Knee Pain" due to chronic calcification.

-If the patient's pain occurs only by stepping on the knee and does not benefit from other treatment methods

-We give OZONE into the knee joint for 5-10 sessions. It has remarkable physiological and beneficial effects on knee pain up to Grade III.

-In addition, patients get rid of their pain by giving Ozone gas around the joint, especially to the upper muscles.

If joint movements are painful and there is a decrease in intra-articular fluid, we increase the stem cell stimulation by giving the platelets we extract by taking your blood, which we call PRP method, into the joint. Thus, new cartilage formation increases. Joint pain decreases.

When both OZONE treatment and PRP treatment are used together, the results are much better. Even in patients who are recommended knee replacement but avoid surgery, the decrease in pain and increase in walking potential provide a very important benefit. After 10-12 sessions of treatment, a single session once a month or once every 2 months allows the patient to move continuously without pain.

In these patients, we also recommend glucosamine and chondroidin derivative preparations to the group up to grade 3 joint degeneration in the 45-55 age group. Very good results are obtained especially in patients where cartilage degeneration has just started. Hyaluronic acid-derived intra-knee injection preparations also give very good results when selected for the right patients to relieve joint pain.

Total knee replacement surgery should be considered in patients with severe pain and walking difficulties who cannot get results despite all these treatments, especially in case of pain that does not go away at night. Since there is no turning back, such surgeries are operations that should be performed in experienced hands by thinking well and making the right decision. Total knee replacement surgery can cause problems to the patient with results such as infection and loosening in 3-5% of patients, but it gives successful results at a rate of 95%.