Source: Orthopedic surgeon Kim Hoon-jae
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Recently, a woman in her 50s came to the clinic.
As soon as she came up, she asked me: Recently, her knee has been hurting, and I heard that the arthroscopic surgery wound is very small, can she do it?
It turned out that the lady had symptoms of knee discomfort a few years ago, but at that time she did not pay attention. Recently, she found that her old knee pain hurt even more after a few days of rest - her knee was sore, and she couldn't exert any energy, and climbing the stairs would also exacerbate this feeling, which was extremely painful.
It just so happened that she heard that her neighbor had undergone arthroscopic surgery because of knee pain, and the wound was very small. Therefore, she also had the idea of "going under the knife".
After examination, I found that this lady was suffering from typical senile knee osteoarthritis, which was not suitable for arthroscopic surgery at all.
Here, I think it is necessary to talk to patients and friends about arthroscopic surgery, and by the way, the small needle knife acupuncture treatment that many people ask about.
Is it necessary for patients with osteoarthritis to have "arthroscopic surgery" or "small needle knife"?
A: Actually, "arthroscopic surgery" or "small needle knife" are not suitable for patients with osteoarthritis.
Arthroscopic surgery
According to the second edition of the "Guidelines for the Treatment of Osteoarthritis" issued by the American Academy of Orthopaedic Surgeons (hereinafter referred to as the guidelines), "arthroscopic surgery is not recommended for patients with osteoarthritis".
Arthroscopic surgery is mainly performed on arthroscopic lavage and osteophyte removal, although these methods can improve the patient's condition in the short term, but it does not really improve the degenerative knee joint. Basically, patients with osteoarthritis who have undergone arthroscopic surgery will continue to proliferate due to irreversible wear and tear of cartilage, and eventually the pain symptoms of osteoarthritis will be further aggravated.
It is important to note that clinical studies have shown that repeated knee arthroscopy may also carry a risk of knee joint infection.
Small needle knife treatment
The AAOS guidelines also do not recommend any acupuncture treatment for patients with osteoarthritis.
Acupuncture and acupuncture treatment may damage the already fragile articular cartilage of patients with osteoarthritis, and interfere with the joint cavity with acupuncture and acupuncture during the onset of osteoarthritis, which will aggravate the inflammation.
The knee joint is not good, what can be used to relieve it?
A: For symptomatic osteoarthritis (such as knee pain, soft legs, joint swelling, etc.), conservative treatment, oral anti-inflammatory analgesics, topical application or intra-articular injection can be used to control the condition and relieve symptoms.
The main measures include:
1. Try to go up and down stairs as little as possible, climb mountains, stand for a long time, and lift heavy objects. These heavy activities will increase the wear and tear and burden of the articular cartilage, which is relatively harmful to the joints. If you want to exercise, I recommend choosing swimming and walking, because these two exercises do not increase the burden on the knee joint, and they also work the muscles, ligaments, etc. near the knee joint.
2. Avoid excessively cold and humid environments, and do a good job of cold and warmth, which can really protect the knee joint.
3. It is not recommended to blow the air conditioner too much.
4. Peri-articular muscle strength training: "straight leg raise to strengthen quadriceps" training method, etc. (Please refer to my previous articles)
5. Rational use of drugs. For example, oral non-steroidal anti-inflammatory drugs such as celecoxib and loxoprofen should be noted that long-term use may have risks such as gastric bleeding, so patients must take the medicine strictly according to the doctor's instructions.
Knee replacement surgery
Although arthroscopic surgery or acupuncture is not recommended for the treatment of osteoarthritis, it is not necessary for osteoarthritis to be treated surgically.
If osteoarthritis is at an advanced stage and the cartilage is worn out severely, and conservative treatment is difficult to take effect, the best way to relieve the pain is "knee replacement surgery".
Patients don't have to be afraid of knee replacement surgery. It is a relatively mature surgery, and can often be used for more than 15 years as long as there is no fall or infection. (According to the literature, the longest period of use, more than 40 years)
I have seen many elderly people who have undergone knee replacement surgery in their clinical work, and their quality of life has improved significantly, and they have become more and more energetic.
Therefore, for those elderly friends who suffer from severe osteoarthritis, the sooner this surgery is done, the less they will be tormented by illness in life, and more happiness in their old age.