Taking a Knee

The New York Knicks’ Amar’e Stoudemire is slated to be off the basketball court for about six weeks as he undergoes further knee surgery. The planned surgery is an arthroscopic debridement and usually involves cleaning out debris in the knee joint, such as loose cartilage fragments, bone chips and inflamed tissue.

Recent advances in the understanding of degenerative arthritis, which may be related to a traumatic sports injury such as those encountered in basketball, have lead to the increase use of arthroscopy for the management of the degenerative condition. Although articular cartilage injury is a common finding at the time of arthroscopy, each patient must be assessed for the appropriate treatment of the damaged articular cartilage.

Arthroscopic procedures (such as debridement) can provide symptomatic relief in patients who have acute onset of pain; mechanical symptoms, such as locking, painful clicking or buckling; normal leg alignment; and minimal radiographic evidence of osteoarthritis. However one must understand that these are temporizing treatments and at times the results are unpredictable. This is in contrast to patients who have a symptomatic torn meniscus, or the proverbial “torn cartilage,” where the outcome following arthroscopic surgery is more predictable.

Since articular cartilage has limited, if any, capacity to heal, significant injury to the knee joint is likely to progress, despite the procedures mentioned above. For symptomatic patients with more advanced isolated areas of degenerative arthritis in the knee, several other surgical treatment options that attempt to fill the cartilage defect and restore the contour of the joint may be considered. The long-term outcome of these procedures, along with their influence on the natural history of post-traumatic degenerative arthritis is currently under investigation.

With the number of weekend warriors increasing, the knee is the most commonly injured joint. If you have been experiencing severe knee pain and stiffness, talk to your doctor. There are many options available from physical therapy to surgery and a medical professional can help determine what is best for you.

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