Knees and Hips:
A troubleshooting guide to knee and hip pain

Contents

  • Knees in motion
    • Evaluating knees
    • Overuse injuries of the knee
    • Tears in supporting tissues
    • Kneecap problems
    • Osteoarthritis of the knee
  • Hips on the ball
    • Evaluating hips
    • Overuse injuries
    • Hip fracture
    • Osteoarthritis of the hip
  • Testing for knee and hip problems
    • Imaging techniques
    • Laboratory tests
  • Nonsurgical treatments for knees and hips
    • RICE
    • Heat
    • Ultrasound, phonophoresis, and iontophoresis
    • Therapeutic exercise
    • Medication
    • Alternative approaches
    • Supplements
    • Arthroscopy
  • Special section: Knee and hip replacement
  • Back on track after joint replacement
    • Guidelines for recovery from knee replacement
    • Guidelines for recovery from hip replacement
  • Living with a replacement joint
    • Revision surgery
  • Resources
  • Glossary

Excerpt

At some point in life, nearly everyone, except a lucky few, will have knee or hip pain, sometimes both. For some people, like professional athletes or dancers, the pain can start early. For the rest of us, it may take longer, but today's imaging technology shows that eventually most people experience some degree of damage to these joints even if they don't feel pain. On the other hand, as we learn more about how and why the bone, cartilage, and tendons deteriorate, we are also gaining more insight into how to protect and repair these joints.

Your knees and hips are your largest joints. They support your body's weight, and they must work in close coordination to provide the mobility most people take for granted until injury, arthritis, or other problems interfere. That's why its so important to start any new activity gradually and progress slowly over time. Avoid dramatic changes in activity level, and avoid deep squats and lunges. If you do experience pain in your hips or knees, the solution may involve physical therapy, pain-relief medication, minor surgery, or some combination of these. But for many people, knee and hip problems become so intractable that the best solution is to replace a worn-out knee or hip with a mechanical joint.

Joint replacement can help patients remain independent and active. In the United States, doctors perform about 581,000 knee replacements and 231,000 hip replacements annually. The average age for total knee replacement is 70; for total hip replacement, it's 66. Many people, young and old, gain pain relief and improved mobility from these procedures.

Medical care has changed. Doctors used to follow surgery by immobilizing the joint with a plaster cast. Today, you can wake up from surgery with your knee already being gently bent and straightened by a machine. More surgeries are performed through tiny incisions using an arthroscope, often on an outpatient basis. Pain relief has progressed to include drugs that tackle the twin problems of pain and inflammation.

These advances translate into improved lives for patients. For example, I recently performed a rotator cuff repair on a patient's shoulder. When he was ready to be discharged, I asked him to come in for a follow-up visit for his hip replacement. He looked surprised, and then admitted that he'd completely forgotten he'd had a total hip replacement four years ago. He said he had returned to an active lifestyle and the new hip had become a part of him.

This report will walk you through the most common knee and hip ailments, discuss the symptoms you're likely to experience with each, and describe how your doctor might diagnose your condition. Whether you've just started to experience pain or have been battling it for years, this report can help you make informed decisions about maintaining you rmobility and independence for years to come.