Surgical options for chronic knee pain: Which one is right for you?

Chronic knee pain is extremely common, with over 25% of Americans experiencing frequent, debilitating knee pain on a regular basis. While nonsurgical treatments like physical therapy often provide relief, when knee pain persists, it may be time to consider your surgical options for chronic knee pain.

What causes chronic knee pain?

One of the most common causes of chronic knee pain among adults is osteoarthritis, a condition in which the cartilage cushion that serves as the “tread on your tires” starts to thin and wear away.

This degeneration leads to pain, stiffness and swelling, particularly in weight-bearing joints like the knees, hips and spine. Osteoarthritis can make daily activities difficult, such as walking or climbing stairs, as the joint becomes less flexible and movement more painful.

Fortunately, there are several surgical and nonsurgical options available to help you get rid of knee pain and feel better again.

Is it time for knee surgery?

First, let’s talk about what we can try before jumping to surgery. When you have mild to moderate pain in your knees, but aren’t yet ready for surgery, there are several options available to you.

The foundation of treatment starts with strengthening the knee, either with a good home exercise program or a formal course of physical therapy. Whether or not you advance to surgery, strengthening your knee is helpful to maintain good knee health and reduce pain.

Another option is steroid injections directly into the knee. This can typically be provided by your orthopedic surgeon or physician’s assistant in a clinic and can help reduce pain and inflammation in and around your knee.

Steroid injections may benefit you when you have a flare up of your arthritis pain and need to quickly reduce the pain in your knee, such as before a big trip or the holiday season.

Finally, nonsteroidal anti-inflammatory drugs (NSAIDs) can be taken on a more long-term basis to help reduce pain in the knee (and other joints). Your healthcare team will check your kidney function and make sure it’s safe before starting these types of medications.

Navigating your knee replacement options

While these conservative treatments are typically the first line of defense for knee pain caused by osteoarthritis, there are cases where surgery may be the best option. If your arthritis advances to the point that none of the standard nonsurgical treatments are working for you anymore, joint replacement offers a great solution to chronic knee pain due to arthritis.

There are two basic types of knee replacement: partial replacements and total knee replacements. Let’s break down what to expect with each type of knee replacement and how to know which one is right for you.

Partial knee replacement

Partial knee replacements only replace the part of your knee joint most affected by arthritis. This is most commonly the inside part of your knee joint, but it could also be the kneecap joint or outside part of the joint.

Partial knee replacements are a great option for people whose arthritis is only in one part of the knee. Here’s what to know about the benefits and risks of partial knee replacement. Benefits of a partial knee replacement:

• Easier, faster recovery
• Improved mobility and quality of life
• Preserves more of your own knee tissue and ligaments
• Retains more natural movement

Risks of a partial knee placement:

• The implant may wear out over time and require another surgery
• Not suitable for those with widespread arthritis

Total knee replacement

A total knee replacement involves removing the worn-out end of the thigh and shin bone and replacing it with metal and plastic. The replacement is either pressed or cemented into place. This is another great option for people who are not getting pain relief with nonsurgical options.

People who have a total knee replacement are generally very satisfied with the results, with over 90-95% pain relief and a relatively low complication rate (less than 2%). Benefits of a total knee replacement:

• Significant reduction in knee pain
• Improved mobility and quality of life
• Long-lasting results (typically 20 years or longer)

Risks of a total knee replacement:

• Longer recovery time
• The knee may feel less “natural” than your own knee or a partial replacement
• It may require a bigger operation to solve a “stiff” or “unstable” knee

Get care for chronic knee pain

Don’t let knee pain keep you from living the life you want. Regardless of where you are in your knee pain journey, your orthopedic surgeon is here to meet with you and find a treatment option that makes the most sense for you.

How healthy are your knees? Take this quiz and find out.