Knee pain has many causes. The knee joint is the most mobile joint in our body. The bending of the knee during sitting and standing and the strains that occur over the years due to 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 where cartilage synthesis decreases, cause knee problems as age progresses..
In a case of knee pain, besides the pain, the sound of the knee, especially when climbing stairs or going downhill, as if the knee is emptying, swelling of the knee or locking of the knee are among the common events. 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 suffered from knee pain at some point in their lives. Knee pain is present in half of women, especially after menopause. The cartilage structure, which is more flexible and soft than men, combined with postmenopausal bone resorption, causes serious knee pain problems in women. Functions that force the knee, such as the decrease in cartilage synthesis, the loosening of the cartilage structure, the habit of sitting on the floor, eating and toilet, increase the possibility of degeneration of the knee in the working environment. Degeneration progresses rapidly with the addition of excessive and sudden weight gain. The wide hip structure of women creates another problem. After menopause, the balance in the knees deteriorates 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 inner cartilage melts quickly. Parents or close relatives with knee problems in their family are in a much higher risk group than other people. In other words, the beginning of pain in the knees of a woman aged 40-45 with 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, whose joint rheumatism and cartilage synthesis are not good, have knee problems that will lead to knee prosthesis in the future should be an important herald and precautions should be taken at these ages.
Diagnosis of knee osteoarthritis; determined radiologically and by examination. The onset of calcification, the erosion of the joint surfaces, the onset of some problems under the kneecap, the softening of the cartilage in the joint, the beginning of melting, the development of bone deformations are always advanced stage findings. When the problem reaches advanced dimensions, the pain that occurs only when standing up becomes unbearable even at rest. So, when we sit or lie down, our knees start to hurt. It can cause enough deformation to even require knee replacement.
Arthrotic changes in the knee are considered in 4 stages, starting with the mildest radiologically. If you have reached the stage we call Grade 4, you may be offered a prosthesis. Some new technology products improve the quality of life. They greatly delay the need for knee replacement.
The first approach should be conservative. In other words, interventions such as surgery should be preferred later. Nonsteroidal anti-inflammatory (NSAID) therapy helps reduce pain. Ice application is beneficial. Pain can be reduced by wearing a string bracelet and bandaging. If there is no reduction in pain with these measures, patients can benefit from FTR. We follow a path like this in "Remitting Knee Pain" due to chronic calcifications.
- If the patient's pain occurs only by pressing on the knee and does not benefit from other treatment methods
-We give OZONE into the knee joint for 5-10 sessions. It has exceptional physiological and beneficial effects on knee pain up to grade III.
In addition, by giving ozone gas around the joints, especially to the upper muscles, patients get rid of their pain.
-We offer stretching exercises and some recommendations in the pain-free period. If joint movements are painful and there is a decrease in intra-articular fluid, we increase the stem cell stimulation by giving the platelets that we remove by taking your blood, which we call the PRP method, into the joint. Thus, the formation of new cartilage increases. Joint pain is reduced.
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 reduction of pain and the increase in walking potential provide a very important benefit. After 10-12 sessions of treatment, a single session once a month or every 2 months allows the patient to move comfortably and painlessly.
In these patients, we also recommend glucosamine and chondroidin derivative preparations for the group up to grade 3 joint degeneration in the 45-55 age group. Especially in patients with new cartilage degeneration, very good results are obtained. Hyaluronic acid derivative intra-knee injection preparations give very good results when selected for the right patients in order to relieve joint pain..
Total knee replacement surgery should be considered in patients with severe pain and walking difficulties, especially in the case of pain that does not go away at night, despite all these treatments. Since such surgeries are no longer reversible, they are surgeries that should be performed in experienced hands by making the right decision with good thought. Total knee replacement surgery can cause problems for the patient with results such as infection and relaxation in 3-5% of the patients, but it gives successful results in 95%.