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Friday 23 March 2018
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Knee and joint pain: Advice from the Bumrungrad Orthopaedic Centre in Thailand

knee surgery

Greater longevity and more active lifestyles come with a downside - painful knee and joint problems. But new and better treatments are helping many in search of much-need pain relief.


Orthopaedic surgery and knee surgery is available at many overseas hospitals. The Orthopaedic Center at Bumrungrad International offers a complete range of diagnostic, therapeutic and surgical orthopaedic services. The Center's orthopaedic specialists bring training and experience from Thailand, the USA and Europe and offer patients a broad array of orthopaedic interventions.  


Much-needed help for the pain of aging knees

Knees play a crucial role in supporting and stabilizing your body weight. The knee is the joint where the upper and lower leg bones meet; in healthy knees the bones, cartilage, muscles, tendons and ligaments all work together. The hinge-like working of the knee joint provides flexibility and strength for standing, walking, running, crouching, jumping, and turning. The pain and reduced mobility from a knee injury or condition can have a major impact on quality of life, making simple everyday activities difficult and painful.


Osteoarthritis: leading cause of knee problems

Osteoarthritis - the most common type of arthritis, a group of conditions involving inflammation in bone joints - is also called degenerative joint disease or 'wear and tear' arthritis. It occurs when the protective surface of the bone cartilage breaks down, making it difficult for joints to fulfill their roles as 'shock absorbers' for the body. The body’s weight-bearing joints - the hips, spine and knees - are most susceptible to osteoarthritis. Just as the tread on a car tire thins and eventually starts to unravel, joints can wear out, too.


The end result is bone rubbing against bone. Knee injuries such as fractures, torn cartilage and damaged ligaments can lead to chronic knee trouble, but osteoarthritis ranks as the leading cause of serious knee and joint problems.


Causes and symptoms

Aging is among the main risk factors for developing osteoarthritis, with the highest risk for people over 50. Obesity, a family history of osteoarthritis and being in overall poor health are also risk factors.

The first noticeable symptoms are usually pain, stiffness, and reduced flexibility of the knees. The affected area may become swollen due to fluid buildup, further worsening the pain when weight is exerted on the knee.


The symptoms and severity of osteoarthritis tend to worsen over time, so early detection is especially important. If you suspect you may have osteoarthritis, there are a number of tools at your doctor’s disposal to help diagnose and assess your condition. He or she will likely begin by evaluating your medical history. Specialized testing, such as a biopsy, arthroscopy, X-rays and CAT and MRI scans help confirm the diagnosis and determine the severity of the condition.


Blood tests may also be used to help rule out the possibility of infection or rheumatoid arthritis.


Treatment options

  • Patients with mild to moderate osteoarthritis can usually be treated without surgery. Your doctor may suggest a combination of treatment options, including:

  • Weight reduction

  • Resting

  • Non-steroidal, anti-inflammatory medications

  • Analgesics

  • Physiotherapy

  • Bracing

  • Using a walking aid

  • Supplementary medicine and/or Glucosamine


Total knee replacement

In cases where non-surgical treatments prove ineffective, surgery is often the best option.


A variety of procedures are available to help repair damaged cartilage and provide pain relief.

For patients with severe cases of osteoarthritis, medical research points to total knee replacement as the most effective treatment option.

During the procedure, the damaged knee is replaced with an artificial replacement joint known as a prosthesis which consists of four parts:

  • The first part is called the femoral component. This replaces the end of the femur (thigh bone) and is usually made of metal

  • There are two tibial components a metal tray placed directly on the knee bone and a plastic spacer. These components replace the end of the shin bone, called the tibia

  • The fourth is the patellar component. This part of the knee slides up and down in the femoral groove when the leg bends or straightens


Knee replacement prostheses typically last 12 to 15 years and can be replaced quite easily when they become worn.

Other surgical options for treating painful knees include knee fusion, high tibial osteotomy and partial knee replacement. As with all surgical procedures, knee surgery involves some level of risk and potential side-effects such as thrombophlebitis, sometimes called Deep Venous Thrombosis (DVT), infection and stiffness or loosening of the joint.


Your doctor will explain the risks and treatment options for your individual situation. Once the treated knee has sufficiently healed, patients are often advised to incorporate a comprehensive exercise program into their daily lifestyle. Low-impact activities like swimming and walking are usually recommended as they can help patients improve circulation, endurance, flexibility and muscle strength, and ward off stiffness - without placing excessive pressure on the knees.


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