What do I know about my knee?

By: Dr. Manuel J. Sanchez, from the Knee Pain Clinic

The knee pain clinic consist of identifying patients with degenerative arthritis of the knee, also known as osteoarthritis, that have been treated with anti-inflammatories and are still in pain and bring them into our facility for viscosupplementation treatment. Of special interest are those who may have been considered for possible surgical intervention (total knee replacement) in the near future because in many instances we can achieve significant improvement that will push back the surgery for years.

During their initial visit we supply the patient with information on the procedure and discuss alternatives as they may apply, because not all people are the same and most require individualized treatment. If we see that the knee will improve with conservative therapy then this is usually the treatment of choice. Physicians always want to do conservative therapy first and then advance in a stepwise fashion depending on the progress, or lack of progress, achieved with the treatment. Most doctors will start by prescribing non-steroidal anti-inflammatories and advance from there as needed.

Our approach is basically simple but effective. Once we have a clinical diagnosis and confirmatory x-rays we them put them on a series of virtually painless knee injections of a naturals substance that is made in Italy which was originally isolated from the rooster’s comb. This substance contains a highly purified Sodium Hyaluronate and provides natural pain management of the knee. We also use some physical medicine treatments to enhance the knee function and improve the muscle strength and motion.

Over 100 million Americans suffer from knee and joint pains, in fact pain accounts for about 25% of all visits to primary care doctor’s offices.

Some of the symptoms of knee arthritis are:

  • pain in a part or all the knee
  • limited or decreased range of motion
  • stiffness of the knee joint, specially in the morning
  • swelling of the knee
  • deformity of the knee joint as time progresses
  • difficult walking
  • marked disability

The causes of Osteoarthritis are:

  • the aging process
  • some hereditary influence
  • bad posture and misalignment of the joint
  • repetitive trauma of the knee
  • work related overuse injuries

Now you may ask then, what is the treatment for my knee pain? This is a good question and the answer is multifaceted. In other words, just as there are more than one cause for the problem, there is more than one way to treat it. First we start with analgesics to relief the pain. We may then add a Non-steroidal Anti-inflammatory medication, such as ibuprofen or naproxen, which most of you are familiar with. If this alone does the job then this should continued for some time as needed, as long as there are no contra-indications.

Most people that come to our clinic for evaluation and treatment already have tried various forms of these treatments and no longer derive benefit from them so they are ready to try something different, such as a cortisone shot or a series of Hyalgan injections. Physical medicine treatments or physical therapy may also be tried initially and has a role in the management of knee pain treatments. The ultimate and last treatment that is offered, if the severity is there and hasn’t responded to the above therapy modalities, then surgical intervention is contemplated. But as is a mention above, I believe it should be reserved only for those few selected patients that have a clear indication and have tried the other treatments mentioned.

Because it is a product that has been around for many years, developed by an Italian company that purifies the sodium Hyaluronate in such a way that makes it the ideal viscosupplementation material for the knee.
Our bodies naturally create a solution to keep our knees and other joints lubricated. However, the degenerative process of osteoarthritis reduces the ability of this natural lubricant to protect your knees. Consequently you may experience reduced mobility and increasing pain.

Our injectors use the FDA approved treatment called Hyalgan and thus it is covered (or paid for) by Medicare and most insurances.
When injected into the knee the Hyalgan solution helps to cushion and lubricate the knee joint, nourishing the cartilage cells for natural pain relieve, as it decrease the inflammation process. The solution helps restore normal function to the joint, including its natural lubrication, thus patients experience less pain and are able to enjoy a more active lifestyle

For one thing our program includes various forms of treatment that we adapt to the individual patient. Everything is explained on the first visit and the special x-rays we take are reviewed with the patient an they feel very comfortable with the informed decision they make.

We use a combination of treatments that help decrease the pain and improve the function of the tissues of the knee joint and helps feed the chondrocytes, which are the live cells of our cartilage. This helps improve the nutrition of these cells which in turn helps them work better and produce good lubrication of the joint.
Also, we use special technology that allows us to inject in the exact place where the solution needs to go. We do not guess and inject blindly to see if we introduce the Hyalgan in the right space (the synovial space), we put the solution were it needs to be and produces the most good.

Though results may vary, most patients feel and immediate reduction in the amount of pain and keep improving and return to normal activities in weeks. Of course, as you well know, results can not be guaranteed in medicine.

Call our office at 956-687-8531