Mark Franco, M.D ., Orthopaedic surgeon with
the Alegent Health Orthopaedic Institute
Find out more about Dr. Franco
Q: Both of my knees make a loud and painful
popping noise, that is so painful sometimes my knee just won't stand the
pressure of standing up. I played a lot of sports growing up and am afraid that
there was too much wear and tear on my knee. I have had x-rays that do not
indicate anything, but something is definitetly wrong. I am on Lodine, an
anti-inflamitory but it is not working. Also I have an excessive weight gain
problem that has caused me to be depressed. Now I eat because I am depressed and
I'm depressed because I eat. What should I do?
A: More than 4.1 million people
in the United States obtain medical care each year for knee problems.
The knee joint is the place where three bones, the femur (thigh bone), tibia
(shin) and patella (kneecap) meet. The ends of the three bones are covered
with cartilage, a tough, elastic material that works as a shock-absorber and
helps the knee joint to move smoothly. The knee joint also contains tendons,
tough tissue that attaches muscle to bones, and ligaments, tissue that attaches
bones to bones, and provides stability.
Knee problems can result from injury, such as a direct blow or sudden
movements that strain the knee beyond its normal range of movement.
Knee pain can also be caused by wear and tear, which can occur in
osteoarthritis. Knee inuries in earlier life, as well as obesity, as you
indicate in your question, both increase the risk of osteoarthritis.
There are several methods used to diagnose knee problems including:
- medical history
- physical examination of the knee
- x-rays of the knee
- CT, computed tomography scan, a procedure that uses
x-rays and a large scanner to produce images of the knee
- MRI, magnetic resonance imaging, a procedure that
uses a scanner, but no x-rays to provide images of the knee.
- Arthroscopy, a procedure in which an optic tube is inserted into the knee
through a small incision, to produce images of the inside of the knee
joint
If your pain is caused by osteoarthritis of the knee, which affects over 10
million Americans, treatment may include pain-reducing medications, such as
aspirin or acetaminophen; nonsteroidal anti-inflammatory drugs (NSAIDs), such as
lodine or ibuprofen; and exercises to restore joint movement and strengthen the
knee. Losing excess weight can also help people with osteoarthritis. If the knee
has been seriously damaged by osteoarthritis, replacing the knee joint might be
a future option.
If your pain is caused by an injury to the knee, the treatment would depend
on the type of injury and the extent of the damage.
To address the issues of your weight gain, see your primary care
physician.
To determine the exact cause of your knee pain, you should see an orthopaedic
surgeon for further diagnostic testing.
