Knee pain: possible osteoarthritis

Patient

Q: I had knee replacement surgery on the left leg, now I'm experiencing aching and pain behind the right knee cap, doctors have said a knee replacement needs to be done on the right knee. I however, know what knee pain from arthritis feels like, this is a deep aching pain that is not relieved by cortazone shots or the rooster comb shots. the pain starts at the hip area or buttocks area and really centers around the inner side of the right knee cap. I was wondering, since I've had L5-L4 and S1 back surgery about 4 years ago, could this knee problems be from new back problems and what do I need to ask my doctor to get in the way of an MRI or a Neurogram? The knee doctor did not suggest any other testing except that I needed knee surgery just from the x-rays. Again, the pain is not like the arthritis pain I felt with the first knee, this is totally different. Thank you, Sharon Chandler

Doctor

A:    After a knee replacement is very important have followed a proper physical therapy program, keep the weight under control and do not over stress the knee joints. If these measures are followed in most of the cases a total knee replacement can last 10 years or more before thinking in new replacement.  First of all, make sure that you are not overweight; secondly try to alternate warm with cold packs. I suggest an evaluation by a spine doctor to make sure that the pain is not caused from a lumbar nerve root compression and is radiated to the leg, once this is ruled out, proceed to confirmed by a MRI that the problem of the knee requires a replacement. Osteoarthritis is one of the main indications for a replacement; this is a degenerative disease that involves the whole joints, affecting not only the bones but ligaments, joint lining and joint cover (capsule) and also involves a progressive loss of cartilage. Osteoarthritis (OA) is the most common articular disease worldwide, affecting over 20 million individuals in the United States alone. The main symptoms are the aching pain, stiffness or difficulty moving the affected joints, for example: fingers, hips, knees and spine.

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