Home https://server7.kproxy.com/servlet/redirect.srv/sruj/smyrwpoii/p2/ Health https://server7.kproxy.com/servlet/redirect.srv/sruj/smyrwpoii/p2/ Suffering from bad knees, some are looking for alternatives to surgery

Suffering from bad knees, some are looking for alternatives to surgery



Now, 10 years later, Bedard, 57, walks with his young children, climbs stairs and rides up to 60 miles on weekends, all without pain. "It's been, and all of that, a long process," said Bedard, who wrote an e-book about his successful efforts to straighten his knees without surgery. These days he added, "I still notice some burning in my knees when sitting," but for the most part, "my knees feel really good."

Knee pain is mainly caused by osteoarthritis, a chronic condition , which suffers from an estimated 30 million Americans of all ages. It is the most common form of arthritis and is caused when the cartilage that the pillows joints injure and wear off, resulting in pain, swelling and stiffness.

The cartilage is the pillow that allows the joints to move. But it has no pain receptors, so the injuries go unnoticed until much of the cartilage is worn and the joint is damaged. When knee cartilage is gone and joint pain is acute ̵

1; known as phase four or end-stage knee disease – treatment options are painkillers and complete knee replacement, the most commonly performed in-patient surgical procedure for people 45 and older in USA.

In 2014, about 680,000 knee changes were performed, according to the National Inpatient Sample, a government study of hospital patients. Knee replacement surgery exceeds 500,000 bypass coronary arteries performed annually. If trends continue, it is estimated that nearly 1.3 million Americans will undergo knee replacement by 2030.

Surgical worries

While artificial knees can rid chronic pain recipients and improve quality of life, studies indicate that the pain persists in as much as 20 percent of knee replacement patients.

The procedure costs approximately $ 15,000 to perform, requires general anesthesia and an average of three to four days of hospitalization, followed by months of physical therapy. The potential risks of knee replacement surgery range from infection to blood clots.

Chronic pain often subsides after recovery from general knee replacement, but full range of motion is often not recovered. The range of movements you "undergo surgery for is what you will go through," says Elizabeth Mackin, a Brigham orthopedic surgeon and Boston Women's Hospital and spokesman for the American Academy of Orthopedic Surgeons. "Knee replacement is done to relieve pain, not necessarily to improve range of motion."

Therefore, experts say there is a strong interest in non-surgical alternatives to reduce joint pain and provide more mobility and more better quality of life. [19659005] Non-surgical Alternatives

The first line of treatment for osteoarthritis includes the basics: strengthening of leg muscles, hip and core, engaging in low impact aerobic exercise and neuromuscular education, according to evidence-based guidelines The American Academy of Orthopedic Surgeons in 2013

Weight loss can also help, especially for those who are overweight or obese. According to every AAOS, every extra kilogram eliminates four to six pounds of knee pressure.

Medications, from ibuprofen over-the-counter to powerful prescription drugs, can help combat joint pain by reducing inflammation. But the long-term use of these medicines also comes with potential serious side effects, including the risk of gastric bleeding.

The main point is that those who have early osteoarthritis, which is described as knee pain during physical activity and joint pain, i.e. you will most likely benefit from a standard lifestyle to treat more physical activity and weight loss.

"But it takes time and effort," says Mackin, "and many patients are looking for a quick solution."

Therefore, many other treatments are already available and are often advertised for knee relief. These include acupuncture, external braces, nutritional supplements glucosamine and chondroitin sulfate, needle washing, growth factor injections, stem cells or hyaluronic acid, arthroscopy to restore meniscus rupture, use of acetaminophen, steroid opioids, steroid opioids .

"There was not enough evidence to prove that they were effective," says Mackin, who serves on the AAOS committee, which wrote the instructions.

Most of these commonly used treatments fail to address the major problems of cartilage loss and joint repair, says Mackin, noting that "after the cartilage is damaged and worn, you can treat the symptoms, but you can't actually cause Since cartilage cells do not have their own blood supply, it has long been thought that these cells cannot be grown. But some research suggests this may not be right.

Among the evidence showing that cartilage can heal is a study from 2006 of 325 people, average age 45. In a two-year study that simply follows the natural history of these patients, 37 percent of participants showed improvement in cartilage measured by MRI, compared with 33 percent whose cartilage has deteriorated.

What separates those who have improved from those who have not? Men who are younger, those with thicker cartilage on the knee, and people who have shed more pounds between the first measurement of the knee and the second two years later, are more likely to show improvement in cartilage. Those who are less likely to experience natural cartilage repair on their knee are women, older adults, people who started with thinner cartilage, and those who did not lose weight in the two years between the first MRI and the second .

In October, Duke University reported new evidence showing that cartilage in the thighs, knees, and ankles of a person can regenerate independently – in the laboratory, anyway.

"These new findings suggest the potential for" regeneration that can be used to improve joint repair and create the basis for regeneration of human limbs, "reports the team at Science Advances.

Cartilage versus Time

The challenge is that cartilage repair takes a long time, since the only way to nourish cartilage cells is through being bathed in joint fluid.

"Cartilage has no direct blood supply, so its ability to use self-healing energy is very, very slow," said Austin Physical Therapist Doug Kelsey, who wrote "The 90 D ay Treatment for Knee Arthritis. "Therefore, it takes a long time, many repetitions, and perseverance [knee exercise]. "

Finding the" sweet spot "for injured knees can also be complicated and vary widely from person to person. It takes exactly the right amount of movement and pressure on the cartilage to accumulate cartilage cells in the joint fluid, allowing them to nourish and recover without causing further damage to the joints. This means gently moving joints that can be stiff, swollen and painful.

What makes the recovery even more complicated is that knee pain usually does not manifest itself within hours of activity.

"It may be difficult for someone to figure out what activities to stop doing because knee pain usually does not occur during the activity," says Lori Kertz Kelly, a physical therapist and certified orthopedic clinical specialist in Austin. "The pain happens later that day or the next day."

For example, Kelly refers to a client who lives in a three-story townhouse. She would take the stairs several times a day without pain, but then she would suffer later. Kelly advises her to take one step at a time with her strong knee so that her arthritic knee can recover. This strategy plus a weight training scheme that Kelly created to build the muscles that support the injured knee allowed the woman to recover after about six months. "In the end, she was able to take the stairs the usual way," Kelly said, and did not need a knee replacement surgery.

Richard Sparks, a 69-year-old retired music teacher at the University of North Texas, also avoided knee replacement. surgery after years of trying various other therapies unsuccessfully. The sparks first hurt his knee as he rode down on a motorcycle in an attempt to adjust. He developed the Runner's Knee, an edema also known as patellar thigh syndrome, which makes the knee caps feel very painful. Physical therapy did not help. Neither have they made injections with hyaluronic acid, surgery to repair a ruptured meniscus in the knee, or more physical therapy.

In 2015, Sparks read Kelsey's book and then consulted Kelly, who had been working with him on a leg-strengthening program for several months. which slowly increased the load on his knees. That made a change.

"It's only worth it to be pain-free so I can go and do the things I want to do, and of course, as long as I avoid changing my knee joint," says Sparks, who recently dropped 25 pounds. He now travels regularly without pain or discomfort. He no longer takes over-the-counter or over-the-counter medications for knee pain.

"I have friends who have had knee replacements and there are some things they can't do," he says. "I walk the way I went. ,,, The longer I can avoid knee replacement surgery, the better. "

Is this approach appropriate for everyone?

" All patients who undergo knee replacement therapy failed without surgery, "says Mackin, who adds that" I'm not sure these people are really they are restoring their cartilage, but they have improved the symptoms and this can be absolutely through diet and exercise. "

Sally Squires is a former Washington Post health and nutrition writer who now blogs at leanplateclub.com.

Why I always "listen" to my knees

Bad knees run in my family, but I still never thought they would set me aside. I sat cross-legged with ease. The knee was something I didn't think about.

Then, when I was 60, my knees began to "talk" to me.

First, there was the burning and the discomfort of long flights sitting in tight business seats. The stairs began to pause. Even the curbs were sometimes painful.

So began my knee odyssey, which was marked by physical therapy, x-rays and MRI, multiple doctors, an expensive bracket so difficult to place, many non-steroidal anti-inflammatory drugs, numerous ice packs, cortisone shots in both knees, various nutritional supplements, ointments for topical application and a folding cane.

The low point comes when one of my knees explodes like a balloon, requiring fluid to remove a long needle without anesthesia. This was followed by nearly a week of sleepless nights because of a knee that felt like it was on fire.

If I could remove my knee cup, I would do it with a pulse.

I also cut a few pounds and plan to lose weight, went to yoga and bought a device that keeps my legs moving under my desk.

Are your knees better? Yes, an improvement measured by my physiotherapist and how folding cane collects dust. But if I get out of the program, I soon pay the price with firmer knees, less flexibility and more pain.

My hope is that as a Bedard I can get my knees back for better health and avoid future invasive procedures. [19659002] But I also know that knee improvement will happen slowly during cartilage – not on my schedule – and that it will be crucial to listen carefully to my knees so as not to cause more damage to precious cartilage or joints .


Source link