Osteoarthritis of the Knee

Is your child having difficulty getting in and out of cars, and experiencing knee pain in the morning? He or she may have knee osteoarthritis. Most people associate osteoarthritis with old age, but it can affect young people, too. Knee osteoarthritis can happen due to injury, infection, and hereditary reasons. Other factors such as excess weight and repetitive stress injuries come into play as well.

Osteoarthritis is a medical condition in which the natural cushioning of the knee joints becomes weak, resulting to the knee’s bones rubbing closely together during movement. This leads to pain, swelling, stiffness, and development of bone spurs.

Treatment Plan

In order to set your child on the way to recovery, it is always best to get an early diagnosis from a San Diego orthopedic doctor. Once your child has been diagnosed with osteoarthritis, a treatment plan will be implemented that includes pain relievers, anti-inflammatory drugs, and physical therapy. Corticosteroid and hyaluronic acid may also be injected to relieve the pain.

Surgical Options

The doctor may also advise your kid to lose weight to reduce the strain on the knee and to incorporate low-impact exercise to strengthen muscles while avoiding the possibility of aggravating the injury. If these conservative treatments do not work, there are surgical options that may be considered to prevent the osteoarthritis from progressing.

Osteotomy is a procedure in which the knee bones are modified to control the damage. Arthroscopy is a minimally invasive procedure where the orthopedic surgeon will make an incision and insert a small camera that will repair the damaged parts. Arthroplasty is a last resort and will only be considered on severe cases of osteoarthritis. It involves a total bone replacement in which the bad joint is replaced by a plastic and metal device.

Treatment for a Torn Meniscus

When left to their own devices, most children run around with abandon, increasing their chances of getting a torn meniscus whenever they make sudden stops and turns or accidentally twist or rotate their knee. The risk for this type of knee injury is especially high for young athletes who participate in sports that involve plenty of pivoting motions like tennis and basketball.

A torn meniscus leads to a persistent knee pain and can even lead to osteoarthristis in the later stages. At the time of injury, a loud popping sound will be heard, followed by swelling and pain afterwards. A “locking” sensation where the knee cannot fully extend or straighten can also be felt at times. There is also the possibility that the knee will give way at times and will not be able to support your child’s weight.

Conservative Treatments

The meniscus is a cartilage that serves as a cushion between the thighbone (femur) and shinbone (tibia). If the meniscus is injured, conservative treatments such as rest, ice, anti-inflammatory medications, and physical rehabilitation can be done to give the knee plenty of time to heal on its own.

Pain and swelling will go away in a matter of days; however, full recovery requires a long-term commitment to ensure that the muscles surrounding the knee grows strong. To return the knee to its normal function, your child will need to maintain his or her ideal body weight and avoid activities that can aggravate the tear.

Surgical Intervention

If these initial treatments do not heal the tear, an arthroscopy will be done by a San Diego orthopedic doctor to repair or remove the damaged cartilage. This is a minimally invasive outpatient procedure done to repair the meniscus tear, and has a faster rehabilitation and better outcome than a traditional open surgery.

Is a Minimally Invasive Knee Surgery the Right Treatment for Your Kid?

If your child injures a knee and requires surgery, the doctor may advise you to either go for a traditionally open surgery or a minimally invasive one. Going for the traditional open surgery route means having a long vertical incision made at the center of the knee so that the surgeon can view and repair the injured joint.

The minimally invasive knee surgery is quite similar in theory, but there is less tissue cutting involved. The procedure involves smaller incision and lesser blood loss. It is less invasive than traditional open surgery, so there is less tissue disruption and reduced post-operative pain. It also means a shorter hospital stay and faster recovery times for your child so that he or she can resume everyday activities sooner than later.

Minimally Invasive Surgery Risks

A minimally invasive surgery does not mean it is not without its own set of risks. This medical procedure is done with the use of an arthroscope, a small camera that is inserted into the small incision made by the surgeon. The camera allows the surgeon to see the inside of the knee in greater detail and fix the problem using the small instruments from the arthroscope. Since the incision is much smaller than a traditional open surgery, the surgeon has a limited view of the joint which makes the procedure more challenging and can lead to a longer time on the operating table.

If your child is going under the knife for a minimally invasive procedure, you need to go to a highly recommended and highly skilled San Diego orthopedic doctor to get this done. The doctor will weigh in all the options available and determine if an arthroscopic surgery is indeed the best choice for your child.

What is Knee Arthroscopy?

Knee arthroscopy is one of the most popular medical procedures used to diagnose and repair an injured knee. Your San Diego pediatric orthopedic doctor may recommend this type of surgery if your child is experiencing a lot of pain in the knee and no longer responds to nonsurgical treatments such as medication and physical therapy. This procedure is used to fix the following knee injuries: ACL/PCL tear, torn meniscus, Baker’s cyst, inflamed synovial tissue, patella problems, knee fracture, and knee sepsis.

What Happens During a Knee Arthroscopy?

If your child is healthy, the knee arthroscopy will be performed as an outpatient procedure. Your child will be put to sleep using local, regional, or general anesthesia. A pediatric orthopedic surgeon begins the procedure by making small incisions and pumping saline water to expand the knee, making it easier to see the injured joint.

A small camera—called an arthroscope—is placed inside the knee and will display real-time videos in the monitor inside the operating room so that the surgeon can determine where the problem lies and fix it. After the surgeon identifies and corrects the injury, he will drain the saline water and close the cuts with stitches.

Why Undergo a Knee Arthroscopy?

What’s great about a knee arthroscopy is that it is minimally invasive. The arthroscope is very small, which means the surgeon will have to make very small cuts compared to the larger ones made during an open surgery.

Depending on the extent of damage, the procedure will take less than an hour and your child can go home the very same day. Since an arthroscopy is less invasive, there is less pain involved, less complications, and faster recovery times. On the other hand, a traditional open knee surgery could place your young athlete out of commission for a considerable amount of time.

Preventing an ACL Injury

An ACL tear is a common enough injury among young athletes. This type of injury greatly impacts the anterior cruciate ligament located in the center of the knee. About 70% of ACL injuries happen in a non-contact situation, meaning the injuries happened without any contact against another person.

Most of the times, an ACL injury happens when a young athlete changes direction all too quickly while playing, or when landing awkwardly from a jump. The knee gives way to the sudden, unexpected pressure, causing trauma to the ACL.

Having an ACL tear can limit your child’s ability to compete at a high level; it can even be a career-ending injury. As a parent of a young athlete who leads an active lifestyle and plays sports, you can encourage them to do the following to nip an ACL injury in the bud:

Consult with a medical professional.

You can consult with a San Diego pediatric orthopedic doctor or a sports medicine specialist to identify and work on your child’s weak muscle areas. Sports medicine professionals can also establish a training program and teach your child proper form, such as learning to pivot properly to avoid getting injured.

Do a lot of stretching.

Balance between the left and right sides of the body is important in preventing sports injuries. The imbalance will cause the body’s center of gravity to shift when landing from a jump or a pivot, and could lead to the knee injury. Doing a lot of stretching exercise will improve your child’s sense of balance and flexibility.

Implement strengthening exercises when training.

Doing a lot of squats, lunges, and plyometric exercises will give your child a lot of strength in the hips and thighs. These exercises will also develop neuromuscular conditioning and decrease the risk of an ACL injury.

Get enough rest.

Check your child’s schedule. Is it full of practice sessions, games, training, and homework? Is there enough room for rest? If not, your child will easily get tired and exhausted, causing him or her to become sloppy during games and more susceptible to injuries. Make sure your child gets plenty of rest and recovery in between competitive performances.

If a knee injury is accompanied by a loud “pop,” pain, swelling, and difficulty in walking, it is best to have it checked by an orthopedic surgeon to begin treatment as soon as possible and prevent further damage.