An orthopedic doctor specializes in the musculoskeletal system, which includes bones, joints, ligaments, tendons, and muscles. When a patient experiences knee pain, an orthopedic doctor’s role is to accurately diagnose the underlying cause and develop a tailored treatment plan. This article explores the typical steps an orthopedic doctor takes, from initial assessment to ongoing care, to help patients manage and overcome knee pain.
Understanding the Diagnosis Process
An orthopedic doctor begins by gathering a comprehensive patient history, asking detailed questions about the knee pain. This includes its onset, specific nature (sharp, dull, constant, or intermittent), and factors that worsen or alleviate it. The doctor also inquires about previous knee injuries, existing medical conditions, and daily lifestyle habits, as these provide clues about the pain’s origin.
Following the history, a thorough physical examination of the knee is performed. The doctor assesses the knee’s range of motion, joint stability, swelling, tenderness, and muscle strength in the surrounding leg. Observing the patient’s gait can also reveal imbalances or issues contributing to the pain.
Diagnostic imaging tests are used to visualize internal structures. X-rays are often the first choice, effectively visualizing bone issues like fractures, bone spurs, or joint space narrowing indicative of arthritis. For detailed insights into soft tissues, a magnetic resonance imaging (MRI) scan may be ordered, revealing damage to ligaments, tendons, menisci, and cartilage.
Other imaging modalities include computed tomography (CT) scans, which offer detailed cross-sectional bone images, useful for complex fractures or assessing alignment. Ultrasound may visualize tendon or ligament inflammation and detect fluid accumulation. If infection or inflammatory conditions are suspected, blood tests may be conducted to identify specific markers.
Non-Surgical Approaches to Knee Pain
Once a diagnosis is established, orthopedic doctors often recommend non-surgical approaches. Initial conservative management involves the R.I.C.E. protocol—Rest, Ice, Compression, and Elevation—to reduce swelling and discomfort, and activity modification. Over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, alleviate pain and reduce inflammation.
Physical therapy plays a key role in non-surgical treatment, focusing on strengthening surrounding knee muscles, particularly the quadriceps and hamstrings, to improve joint support. Therapists guide patients through exercises enhancing flexibility, restoring balance, and correcting gait patterns. This approach improves knee function and reduces re-injury likelihood.
When over-the-counter options are insufficient, an orthopedic doctor might prescribe stronger medications, including higher-dose NSAIDs or other pain relievers. Injections directly into the knee joint are a common non-surgical intervention for localized relief. Corticosteroid injections reduce inflammation and pain, offering temporary relief, particularly for osteoarthritis or bursitis.
Other non-surgical interventions include:
Hyaluronic acid injections (viscosupplementation) provide lubrication and shock absorption in arthritic knees.
Platelet-rich plasma (PRP) injections, derived from the patient’s blood, promote tissue healing and regeneration, often for tendon or ligament injuries.
Bracing or custom orthotics provide external support or correct alignment issues.
Lifestyle modifications, such as weight management, reduce stress on the knee joint, improving symptoms and preventing degeneration.
Surgical Options for Knee Pain
When non-surgical treatments are insufficient, an orthopedic doctor may consider surgical interventions. Arthroscopy is a minimally invasive procedure using a small camera and instruments inserted through tiny incisions to visualize and treat internal knee problems. This technique is commonly used for repairing meniscus tears, reconstructing torn anterior cruciate ligaments (ACLs), or addressing cartilage damage.
For patients with localized arthritis, a partial knee replacement (unicompartmental arthroplasty) might be recommended. This procedure replaces only the damaged compartment of the knee joint, preserving healthy bone and cartilage in other parts. It typically results in a faster recovery compared to a total knee replacement.
Total knee replacement (total knee arthroplasty) is a more extensive procedure for severe arthritis or widespread joint damage. During this surgery, damaged cartilage and bone surfaces of the thigh bone, shin bone, and kneecap are removed and replaced with artificial metal and plastic components. This operation aims to alleviate chronic pain and restore mobility.
Other surgical procedures include osteotomy, which involves cutting and realigning bone to shift weight away from damaged knee areas. Cartilage repair or transplant techniques may also be considered for younger patients with isolated cartilage defects. The decision to recommend surgery is based on several factors: pain severity, functional limitation, and failure of conservative treatments.
Recovery and Ongoing Care
After any knee pain treatment, a structured recovery and ongoing care plan is essential. Rehabilitation, often involving physical therapy, is a key component of this phase, especially following surgery. Physical therapists guide patients through specific exercises to regain strength, flexibility, and range of motion.
Pain management strategies are implemented during recovery to ensure comfort and facilitate rehabilitation. This might involve prescribed medications or other pain relief modalities. Regular follow-up appointments with the orthopedic doctor monitor progress, assess treatment effectiveness, and make adjustments to the care plan.
Long-term strategies are important for maintaining knee health and preventing future issues. This includes continuing prescribed exercises, adopting healthy lifestyle habits like maintaining a healthy weight, and incorporating ergonomic adjustments. These efforts help preserve knee function and improve overall quality of life.