Q&A: Treating hip and knee pain

By Jeffrey C. Glenn, D.O.

The Orthopaedic Institute Q&A: Treating hip and knee pain
By Jeffrey C. Glenn, D.O.


 

When should I see an orthopaedic specialist?

I recommend seeing an orthopaedic physician after experiencing trauma or if you have hip or knee pain that lasts for a week to 10 days and isn’t relieved with Tylenol, ibuprofen or routine home remedies. You could be experiencing something serious, such as arthritis, or several other conditions.

What should I expect during my appointment?

My team and I will take a comprehensive history from you. We’ll also check your vitals and examine your joint in question. We then order X-rays and evaluate your case holistically. We’ll look at your medical history, consider your overall health and determine how much the problem is troubling you. Then, we’ll weigh that with the results of your X-ray. Some people have an X-ray that shows severe arthritis, but they don’t have any pain, so I always note that I treat the patient, not the X-ray.

What are the treatment options?

There are several nonoperative options, including oral medications, home exercise programs and home modification, such as elevated seats, grab bars and handrails on steps. There’s also physical therapy, braces and injections — either steroid shots or viscosupplementation, where we inject an artificial lubricant into the knee joint for patients with arthritis.

Unfortunately, there’s no way to predict how long steroid shots will last. You might get a few days of relief or a few months — or somewhere in between. But with viscosupplementation, it typically either works for around six months or doesn’t work at all.

When it comes to hip replacement, I essentially remove the arthritic ball, clean out arthritis in the socket and put in a new socket and ball that connects to a stem inside the hip bone. This eliminates painful bone-on-bone rubbing.

With knee replacement, I always tell patients how precise we are with surgical techniques. The excision of the arthritis and implant placement techniques have evolved tremendously.

What is the surgical recovery process like?

When you come in for surgery, physical therapy starts the same day, and you’ll be up walking that afternoon. Most patients will stay at the hospital for one or two nights before going home.

You’ll have physical therapy every day during your hospital stay, and then for about six weeks after going home. In some cases, hip patients require even less physical therapy.

Patients with high pain tolerance tend to recover quite quickly. Especially with knee replacements, we try to help these patients progress as rapidly as possible.

How have total hip and knee surgical techniques changed over the years?

Surgical techniques have improved drastically over the past few decades. We’re performing the same procedures, but through smaller incisions and with less tissue disruption. Pain control protocols also are more effective than before, physical therapy protocols are more advanced than ever and implants are better now than they were even 15 years ago. Everything continues to evolve and improve.

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