Is Surgery for Chronic Knee Pain the Answer?

man sitting crossed legged holding knee

Chronic Knee Pain

Often senior patients who have had chronic knee pain (greater than 1 year) have come to a point where they want something done about their symptoms. It can be very frustrating to not know what’s actually causing your symptoms or having any way of controlling them.  It can then be the fear of pain that creates a protective avoidance pattern that leads to de-conditioning  and in many cases the actual worsening of symptoms. So what next?

Knee Surgery

Often patients have tried to keep active but have failed to do so due to the pain that they are experiencing. Frequently they report that therapeutic interventions such as physio have had only limited effect or short term benefit. So it appears they are led on a path that inevitably leads to surgery. However there is emerging evidence that a cohort of patient who have had knee pain for greater than one year, with signs on Xray confirming osteoarthritic changes, have poor outcomes when their meniscus is resected greater than 50%.

What can be done?

So why have these patients not responded to exercise when it has been shown to help knee osteoarthritis. The answer is usually due to a variety of reasons (i.e. it is multi-factorial) as with all persistent musculo-skeletal pain. The patient beliefs about what the pain represents, lifestyle and poor coping strategies can all lead to persistent pain. Working with the patient to address these individual areas is crucial in getting them better. And yes they can get better? And in many cases resolve their pain and return to normal daily activities.


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