Many people experience discomfort in their knees when they reach the age of sixty or seventy. Previously, one could climb six floors in one breath, but now walking a few more steps can cause knee pain, which seriously affects the quality of life of the elderly.

Many elderly people who are troubled by knee pain have heard of artificial knee replacement surgery. In recent years, the popularity of artificial knee replacement surgery has been increasing, and many people have several patients who have recovered well and moved freely after knee replacement, which has attracted the hearts of many elderly people. But a study in the United States found that currently about one-third of patients undergoing knee replacement surgery can actually try knee preservation treatment first.

Is it suitable for oneself to 'protect the knee' or 'change the knee'? We have invited the Orthopedics and Joint Department team from Shenzhen Xinfeng United Family Hospital to share relevant knowledge with everyone.
 

Knee arthritis requires a step-by-step treatment approach

Knee osteoarthritis is the main cause of knee pain in elderly people, and it has a very obvious stage development characteristic. According to the severity of the disease, it can be divided into four stages: early, early, middle, and late. Different stages correspond to different treatment plans.

 

1. Initial stageOccasional pain in the knee joint does not affect daily activities, and there is no joint swelling or deformity; X The light film shows a narrowing of the joint gap.

2. Early stageKnee joint pain often occurs, but daily activities are not significantly affected. Occasionally, joint swelling may occur without obvious deformities; X The light film shows a narrowing of the joint space and obvious small osteophyte.

3. Mid termSevere knee joint pain, affected daily activities, repeated swelling of the knee joint, and possible mild varus or valgus deformity of the knee joint; X The light film shows clear narrowing of the joint space, moderate amount of osteophyte, mild subchondral bone sclerosis, and possible knee joint bone deformity.

4. Late stageSevere knee joint pain, severely restricted daily activities, repeated swelling of the knee joint, and possible severe varus, valgus, or flexion contracture deformities; X The X-ray shows severe narrowing of the joint space, with a large amount of osteophyte formation, obvious sclerosis of subchondral bone, and significant skeletal deformities of the knee joint.

At present, the treatment of knee osteoarthritis follows the concept of "step-by-step treatment", and the difficulty and degree of trauma of treatment gradually increase from the early stage to the late stage of the disease. The general principle of treatment is to prioritize "knee preservation" treatment, and then consider "knee replacement" if "knee preservation" is ineffective.
 

 

 

Among them, artificial knee replacement surgery is the ultimate solution for treating advanced knee arthritis and belongs to large-scale surgery. Therefore, we strongly recommend that if patients consider joint replacement, they must seek consultation and evaluation from senior orthopedic specialists.
 

 

 

Shenzhen Xinfeng United Family Hospital's Department of Orthopedics and Arthrology has multiple senior specialist doctors, all of whom are chief physicians and associate chief physicians, capable of providing professional medical and health advice to patients.
 

Does taking painkillers not work? You can try injection therapy first

In the initial stage of knee protection treatment, doctors usually administer oral or topical pain relievers to patients, including common medications such as celecoxib and iricoxib.

But for some patients, the effect of these oral or topical painkillers may not be significant, and intra-articular injection of drugs can be tried for treatment. This treatment method involves injecting drugs into the joint cavity to directly target the affected area, thereby achieving the goal of reducing inflammation and relieving pain.

There are three main types of commonly used drugs for joint injection:

1. Sodium hyaluronate injectionSodium hyaluronate can help lubricate joints, reduce joint friction, and alleviate pain.

2. Corticosteroid injectionCommonly known as "closed needles", this type of medication has strong anti-inflammatory effects and can quickly alleviate joint inflammation and pain.

3. Injection of platelet enriched plasma (PRP)This is a relatively new treatment technique that uses the patient's own blood to produce a high concentration platelet solution, which can promote tissue repair and regeneration, and has a good therapeutic effect.

For elderly people in Hong Kong, the above three treatments are all covered by the Hong Kong Elderly Health Care Voucher. among which, PRP As a new technology, it not only has significant effects, but also has high cost-effectiveness. It is highly recommended that Hong Kong seniors go to Shenzhen to try this new technology.

Is injection therapy ineffective? You can try surgery

If oral medication, topical ointments, and intra-articular injections cannot alleviate knee pain, surgical treatment may be considered. However, knee joint surgery is not limited to total knee arthroplasty as an option. There are also some less invasive surgical methods, such as arthroscopic debridement, knee joint osteotomy, unicompartmental replacement, etc., which can preserve more of the knee joint tissue.

 

For patients with advanced knee arthritis who have tried multiple treatment methods but have failed, total knee arthroplasty surgery can be considered.

These surgeries have their corresponding indications, and professional orthopedic doctors need to combine clinical conditions to make judgments for patients.

Knee joint pain does not necessarily mean that the knee needs to be replaced. Through the concept of 'step therapy', we can better alleviate pain and improve knee joint function while preserving the patient's own joints as much as possible.