Doctor Statement – Dr. Naman Wahal

Dr. Naman Wahal (MBBS, MS Orthopaedics — AIIMS, MAMC)  “Knee pain should be evaluated according to its cause, severity and effect on daily activities. A structured assessment helps determine whether a patient may benefit from physiotherapy and conservative treatment or requires further investigation or surgical intervention.”

Summary

Knee pain is often caused by arthritis, sports injuries, ligament damage, meniscus, or other joint problems. An orthopedic surgeon knee specialist can help you examine the causes of your pain and find the right treatment, including physiotherapy, drugs, lifestyle changes, injections, or surgery. You can also book an Orthopedic Appointment Online to consult about your symptoms and previous medical reports before the examination.

What Does an Orthopedic Surgeon Knee Specialist Treat?

An orthopedic surgeon knee specialist deals with diseases of the knee joint and the associated parts of the body. Depending on the qualifications and areas of practice, a knee specialist treats sports-related and degenerative conditions.

The common knee problems are:

• Osteoarthritis of the knee
• Meniscus
• Degenerative diseases of the knee joint
• Ligament injury
• Patellar disorders
• Sports-related injuries of the knee
• Injuries to the knee joint cartilage
• Increased stiffness of the knee
• Swelling of the knee joints
• Tendonitis
• Injuries of the knee joint bones
• Advanced osteoarthritis

Various knee joint conditions that require knee replacement surgery

Knee osteoarthritis is a disease characterized by pain, stiffness, and reduced mobility due to cartilage and other tissues damage.

Common Causes of Knee Pain

Knee pain does not have one particular cause. The conditions under which the discomfort appeared can be significant for the diagnosis. There are several reasons for knee pain, some of which are more prevalent among middle-aged and elderly people.

1. Osteoarthritis

One of the common causes of knee pain, especially for middle-aged and elderly people, is osteoarthritis. The increased risk can be associated with age, knee injuries, weight, active lifestyle, or specific genetic traits.

The symptoms can include:

• Painful walking
• Stiffness after resting
• Challenges while climbing the stairs
• Puffiness
• Limited movements
• Difficulty walking for a long time
• Pain that grows steadily worse

2. Sports Injuries

Sportsmen and active people suffer from sports injuries. The anterior cruciate ligament, meniscus, collateral ligaments, and other knee structures can be damaged during physical activity.

A torn ligament often occurs when a person makes a wrong move while jumping or they subject the knee joint to a direct blow. Such an injury requires either conservative or surgical treatment.

3. Meniscus Injury

A meniscus is a disc between the femur and tibia; meniscus injury is one of the common causes of knee pain. It often results from twisting a knee when the foot is firmly planted on the floor. There is also a degenerative type of meniscal tear.

The symptoms can be as follows:

• Swelling
• Pain
• Nausea
• Popping and catching sensations
• Inability to fully extend or flex the knee

An orthopedic doctor can recommend a treatment that will reduce discomfort. At the same time, knee pain can be caused by other issues. A specialist must examine a patient to identify the exact cause of discomfort.

4. Ligament Injuries

The anterior, posterior, medial, and lateral cruciate ligaments keep a knee stable. Injuries of those structures can be the cause of pain, instability, and limited movements. Sports activities, sudden movements, accidents, and other events that put too much pressure on the knee joint can injure the ligaments. Some ACL injuries do not need surgery, while others require it.

5. Patellar Problems

Pain above or behind the knee can result from patellofemoral problems. It can also be caused by overuse or malfunction of the knee. The discomfort often appears when climbing stairs or squatting, while running, as well as when sitting for a long time. A specialist needs to examine the knee to determine the exact cause of discomfort and prescribe the proper treatment.

When Should You See an Orthopedic Surgeon?

Not every case of knee pain requires surgery or specialist care. However, it may be worth scheduling an appointment with an orthopedic surgeon knee specialist if:

• The pain persists despite rest
• There is recurring swelling
• The knee buckles or becomes unstable
• The knee cannot be bent or straightened properly
• There is a history of knee locking or catching
• Pain prevents walking
• There is difficulty walking up and down stairs
• There has been a serious athletic injury
• The knee pain is impacting sleep or daily activities
• The pain persists following conservative treatment

An orthopedic surgeon can help determine the cause of the knee problem, such as arthritis, injury, inflammation, cartilage issues, or other factors.

How Is a Knee Problem Diagnosed?

A diagnosis typically starts with an extensive description of your symptoms.

The doctor will ask you:

• When did the pain start?
• Have you had any accidents?
• Where exactly does it hurt?
• Does your knee swell?
• Does your knee lock?
• Is your knee unstable?
• Does the pain get worse when you walk or climb stairs?
• Have you taken any medications or seen a physiotherapist?
• Have you ever had a knee operation before?

The doctor will then conduct a physical examination, in which he/she evaluates mobility, stability and possible painful areas.

X-ray

An x-ray can help assess the position of bones as well as possible arthritic changes for osteoarthritis of the knee. In the case of osteoarthritis, joint space narrowing and bony outgrowths are often seen on the x-ray.

MRI

An MRI provides more detailed information about the ligaments, menisci and cartilage. An MRI may be used when there is a suspicion of damage to these tissues based on the physical examination.

Not all knee problems require an MRI. The decision to perform an MRI will depend upon the symptoms and physical examination findings.

Conservative Treatment for Knee Problems

Depending on the diagnosis, treatment options for knee problems often include non-surgical methods.

These may include:

Physiotherapy

An exercise program can aid recovery, increase strength, flexibility, balance and joint function.

Exercises are usually tailored to the individual and their needs. Possible exercises may include:

• Strengthening the quadriceps (thigh muscles)
• Stretching the hamstrings
• Building hip strength
• Improving balance
• Range of motion exercises of the knee
• Functional activities

The type of exercise will depend on the diagnosis and the person’s physical capabilities.

Activity modification

Avoiding activities making the knee painful may help. For example, a person with painful knees may need to modify or avoid high impact exercise but will likely need to remain active in other ways. Each individual’s situation will need to be assessed by their doctor or physiotherapist.

Weight management

The Australian Academy of Orthopaedic Surgeons (AAOS) highlights that increased body weight is a risk factor for developing osteoarthritis of the knee. Where weight is a factor for osteoarthritis it is appropriate for the doctor and patient to work together to establish a weight management program.

Medications

Depending on the diagnosis and individual circumstances, a doctor may prescribe medications to reduce pain or inflammation. It is not recommended that an individual routinely take medication for knee pain unless advised to do so by their doctor. Not all diagnoses will require medication, and if it is suitable, the doctor will advise how long it should be taken for.

Injections for Knee Pain

Some patients may be candidates for injections based on their diagnosis and symptoms.

Depending on the situation, the type of injection, possible benefits and risks vary. Injection treatment should be considered as a clinical option following an appropriate diagnostic work-up and not as a substitute for diagnosis. Your orthopedic specialist can advise you if an injection is right for you.

When Is Knee Surgery Considered?

Surgery is not always indicated for patients who have knee pain. An orthopedic surgeon knee specialist could recommend surgery in the presence of significant symptoms, a condition amenable to surgical treatment, and failure of non-surgical treatments or a lack of confidence that non-surgical treatment will be effective. Surgical options could include:

• Arthroscopic procedures in selected conditions
• ACL reconstruction
• Meniscus procedures
• Cartilage procedures
• Osteotomy in selected patients
• Partial knee replacement
• Total knee replacement

The surgical procedure should be dictated by the diagnosis, age, activity, degree of damage, overall health and goals of care.

Knee Replacement Surgery

Knee replacement is generally considered for advanced arthritis when pain and functional limitations are substantial.

During knee replacement, the damaged joint surfaces are substituted with prosthetic components. A total knee replacement substitutes the damaged surfaces of the knee, while a partial replacement should be considered when arthritis is limited to a particular compartment in selected patients.

A knee replacement evaluation usually considers:

• Severity of arthritis
• Pain level
• Functional limitations
• X-ray findings
• Previous treatments
• General health
• Patient expectations

The decision should be made after an individualized orthopedic assessment.

Why Early Knee Evaluation Can Matter

Persistent knee problems are not always a natural part of aging.

It is important to consider the option of joint injury as the possible cause, especially if it involves damage to the ligaments or cartilage. If a person has been diagnosed with osteoarthritis, timely assessment will help determine the most appropriate treatment and activity options. According to AAOS, early diagnosis of knee osteoarthritis ensures better understanding of the treatment by the patient.

An initial evaluation is not necessarily indicative of the need for surgical intervention. It is a way of determining the cause of discomfort and potential solutions for it.

Orthopedic Appointment Online: When Can It Help?

An Orthopedic Appointment Online can be a good option for an initial consultation, to help establish if an orthopedic visit may be right for the patient.

During an online appointment, patients can discuss:

• Current symptoms
• How long have they been experiencing knee pain
• Any previous injuries
• Any current diagnosis
• X-rays or MRI results
• Any treatments tried
• Physiotherapy
• Any questions about surgery
• Whether an in-person examination is necessary

If the online service allows, a patient can also upload any reports or images for the doctor to review.

An online appointment, however, cannot replace a physical examination of the knee. If the doctor feels that they need to check the joints for stability, range of motion, or if there is swelling or other signs of injury, the patient may be asked to come in for an in-person examination.

What to Prepare for an Orthopedic Appointment Online

Before Orthopedic Appointment Online, prepare necessary information.

You might want to bring the following information with you to the appointment:

• Description of your symptoms.
• When did your pain start?
• What happened that caused your injury?
• X-ray or MRI results, if any.
• List of current medications.
• Treatments received for your injury.
• Medical and orthopedic history.
• Questions you want to ask an orthopedic specialist.

This will make the examination more productive and enable the orthopedic specialist to get to know you better.

After an Injury, How to Take Care of My Knee?

If you start experiencing pain following an injury, do not try to resume intense workouts.

Depending on the severity of the condition, you might have to stop exercising and see an orthopedic specialist.

If you have severe pain, along with knee swelling, knee deformity, inability to walk or your knee is locked, seek medical attention right away.

Once your condition has been diagnosed and treated, you may need to go through a rehabilitation process to help your knee recover.

How to take care of my knees as part of day-to-day life?

A knee injury often calls for a long-term recovery process.

Aside from the recommended medications and treatments, here are a few things you can do for long-term knee health:

• Maintain a healthy weight
• Develop lower limb strength
• Improve flexibility
• Adopt safe exercise practices
• Avoid overexertion
• Buy supportive footwear
• Prevent further injuries
• Go through knee rehabilitation, if required.

If you already suffer from knee conditions, consult your doctor regarding the exercises suitable for your knees.

Why Choose Dr. Naman Wahal for Knee Evaluation?

Dr. Naman Wahal is an MBBS, MS Orthopaedics — AIIMS, MAMC trained orthopaedic specialist. He has a special interest in shoulder and sports orthopaedics as well as assessment and management of musculoskeletal conditions.

An orthopedic consultation can help patients with lingering knee symptoms to understand if their condition may be amenable to conservative management, rehabilitation, advanced imaging or require surgical evaluation.

Conclusion

Knee pain may be caused by various factors, from short-term overuse or injury to osteoarthritis, ligament damage and severe degenerative conditions. A thorough orthopedic evaluation is essential to determine the underlying cause and an appropriate course of treatment.

An orthopedic surgeon knee specialist can help you understand your symptoms, perform a physical examination, review diagnostic imaging and recommend further treatment options according to your diagnosis. Treatment may include physiotherapy, lifestyle modifications, medication, intra-articular injections, rehabilitation or surgical intervention, depending on the severity and nature of the condition.

For patients who are unable to arrive at the clinic, an Orthopedic Appointment Online is an excellent opportunity to discuss symptoms and review any relevant clinical reports prior to scheduling a physical examination.

When knee pain persists, recurs frequently or begins to affect your daily life, an orthopedic evaluation can help you understand the nature of your condition and guide you towards the most suitable treatment option.

Frequently Asked Questions

1. When should I see an orthopedic surgeon for knee pain?

You should consider seeing an orthopedic surgeon if knee pain is persistent, keeps returning, or interferes with walking, climbing stairs, exercise, sleep, or daily activities. An evaluation is also advisable after a significant knee injury, especially if there is swelling, instability, locking, difficulty bearing weight, or reduced knee movement.

2. When is knee pain treated without surgery?

Knee pain can often be treated without surgery when the condition does not require an operation and symptoms can be managed with conservative care. Depending on the diagnosis, treatment may include physiotherapy, activity modification, weight management, medication, exercises, or other non-surgical approaches. Your orthopedic specialist can recommend the appropriate treatment after evaluating the cause and severity of the knee problem.

3. What does an orthopedic surgeon knee specialist treat?

An orthopedic surgeon knee specialist evaluates conditions involving the knee joint, including osteoarthritis, ligament injuries, meniscus injuries, cartilage problems, sports injuries and conditions that may require knee surgery or replacement.

4. Does knee pain always require surgery?

No. Many knee conditions can initially be managed through rehabilitation, activity modification, medication or other non-surgical approaches. Surgery is considered when clinically appropriate.