There are a wide variety of acute and chronic conditions that can affect the knee joint. The knee joint is made up of bone, tendons, ligaments, cartilage and soft tissue structures. Acute conditions range from infection to meniscal tears to fractures. Chronic conditions range from arthritis to chronic osteomyelitis, or bone infection. The treatments vary based on the condition being treated.
Oral Medications
Oral pain medications used to treat knee joint pain range from nonsteroidal anti-inflammatory medications to opiate medications to help decrease pain, according to the "AAOS Comprehensive Orthopaedic Review." Nonsteroidal anti-inflammatory medications include ibuprofen, ketorolac, diclofenac, naproxen and meloxicam. These medications decrease inflammation and help to decrease pain. Opiates include codeine, vicodin, percocet, hydromorphone and oxycodone. These medications help to decrease pain. Rheumatoid arthritis and seronegative spondyloarthropathies are often treated with medications including methotrexate, anti-malarials and other immunomodulating agents. Oral antibiotics are often used to treat superficial infections.
Intraarticular Medications
Intraarticular medications are medications that are injected directly into the joint. Two common types of joint injections include corticosteroids and hyaluronic acid. According to the Mayo Clinic, hyaluronic acid is a thick liquid that eases pain and provides lubrication to joints, possibly by reducing inflammation. Corticosteroid injections help to reduce arthritic pain symptoms.
Intravenous Medications
Intravenous medications for knee pain include medications for pain control and to treat infection. Pain control can be achieved with intravenous opiates including morphine, fentanyl and hydromorphone. Infections can be treated with intravenous vancomycin, cefazolin, gentamicin, clindamycin and ceftriaxone.
Physical Therapy
Physical therapy aims at improving range of motion, increasing strength and decreasing pain, according to the Mayo Clinic. Patients can be sent to physical therapy for primary treatment or after surgery to help regain strength. Physical therapists use a wide variety of modalities, including electric stimulation, resistance band and hydrotherapy.
Immobilization
A variety of conditions of the knee can be treated primarily with a knee brace, including minor ligament injuries and some non-displaced fractures. Some patients are placed in braces post-operatively to help keep the knee in a fixed position. An alternative method of immobilization is by using a long leg cast or splint.
Surgery
Surgery on the knee can be performed either arthroscopically or open. Arthroscopic procedures involve making small incisions in the skin to place an arthroscope or small camera into the joint, according to the American Academy of Orthopaedic Surgeons. The surgery is performed as the surgeon watches the instruments on a monitor. Open surgery utilizes a larger incision to directly visualize important structures in the knee. Arthroplasty or knee replacement surgery is often performed for arthritis, and utilizes a larger incision to allow for full exposure of the bones.
References
- American Academy of Orthopaedic Surgeons: Knee Arthroscopy
- Mayo Clinic: Knee Pain
- "AAOS Comprehensive Orthopaedic Review"; Dr. Jay Lieberman; 2008
