When it comes to chronic knee pain, there are several rehabilitation options available to relieve pain and improve function, including Osteopathic therapy. However, there are cases where a patient can opt for total knee arthroplasty (TKA). In certain cases, they may be able to continue their day-to-day routines, but a section of patients may not reach a successful result. How do we learn from these patients who can advise us when not to recommend surgery for knee pain?
In one study , the researchers evaluated TKA patients one year after their treatment to determine their results with respect to the range of motion and function of the knees, as these are critical for performing day-to-day tasks such as the ability to put on shoes and socks, to squat down to pick items up from the floor, to get up and down from sitting, to climb and descend down stairs, etc. The study team observed that patients with impaired range of motion before surgery, as well as those with poor coordination of the knee (tibial-femoral angle) were less likely to have a favourable outcome.
Several experiments have shown how hyperpronation of the ankle can affect the alignment of the knee, bringing extra tension to the joint, as it can affect the operation of the hip. These matters should be discussed prior to the consideration of TKA. That is why it is necessary for clinicians to examine the patient as a whole for a musculoskeletal disorder because the cause or underlying factors for the injury may be beyond the region of the main concern. In certain cases, a combination of manual treatment and precise exercises offered by an Osteopath can return proper mobility to the injured hip or ankle, which can also help the knee.
Manual treatments can also break up adhesions and scar tissue that may hinder the mobility of the knee. When the knee can function as expected, the pressure from regular activity can help to bring nutrients to the remaining cartilaginous tissue, decreasing inflammation and discomfort.
The take-home lesson is that there might be a time when TKA is the only alternative to a patient with knee pain, but if the knee is poorly balanced or the range of motion is reduced, TKA may not be the solution. Luckily, there are problems that may be treated by osteopathy therapy, which can prolong or even minimise the need for a surgical operation.