Your knee....don't easily go for replacement

Taming tendinitis in the knee

Tendons are the bands of fibrous tissue that attach muscle to bone. Tendinitis — tendon inflammation — is often a repetitive strain injury. You get it by repeating the same motion over and over, which irritates the tendon. Joints commonly affected by tendinitis include the elbow, heel, and wrist.

Weekend warriors (folks who engage in high-intensity activities such as running or basketball on the weekend but do little to maintain conditioning during the week) often develop tendinitis in the knees. Simply being overweight can also contribute to knee tendinitis. Age is another risk factor. Over time, tendons become less flexible and the involved muscles lose strength, both of which further stress the tendons. Inflexible hamstring and quadricep muscles make you more susceptible as well.

Symptoms of tendinitis of the knee include:

•	pain above or below the kneecap
•	swelling
•	pain that recurs with particular activities and eases with rest
•	in severe cases, pain becomes constant (in spite of resting the joint) and can even disrupt sleep.

Here are some simple steps you can take to quell tendinitis pain. At the first sign of trouble:

•	limit activities that put stress on your knees
•	apply ice
•	use over-the-counter pain relievers, ideally aspirin or another nonsteroidal anti-inflammatory like ibuprofen or naproxen
•	use a knee support.

Once the pain and any swelling are gone, try easing back into your normal activities and hold off on more demanding athletic activities for a few weeks. Typically, tendinitis goes away in a few weeks or months. Your doctor may recommend extra treatments for particularly stubborn cases.

To keep tendinitis from coming back, ask your doctor about exercises to improve flexibility and address and muscle imbalances that may be placing stress on your knees.

 

4 ways to put off joint replacement

A desire to stay active and natural aversion to pain sends more than 770,000 of us to orthopedic surgeons each year for a hip or knee replacement. And we're turning to doctors for these surgeries much earlier in life. According to Dr. Scott Martin, associate professor of orthopedic surgery at Harvard Medical School, this isn't a healthy trend. "A lot of joint replacements are being done because they can be," says Dr. Martin.

Every surgical procedure carries the risk of complications — or even death. Because the average joint that's replaced only lasts 10 to 15 years, having the procedure done at age 50 instead of 70 means there's a good chance you'll need a second procedure when you're older and at higher risk for complications.

Here are four tips that can help you extend the life of your joints and keep the need for replacement in the very distant future.

Tip #1: Lose weight

One of the most important ways to care for your joints is to stay at a healthy weight. For every extra pound you carry, you put about three pounds of additional pressure on your knees and multiply the pressure on your hips by six. If you have arthritis, losing just 15 pounds can cut your knee pain in half. If you do eventually need a joint replaced, losing weight beforehand can reduce your risk of having complications from surgery. Even if you have tender joints, you can still work out — as long as you stick with exercises that are gentle on your joints, such as swimming, walking, or riding a stationary bike.

Tip #2: Take care when using your joints

Using poor posture and the wrong techniques during your daily activities adds more stress to damaged joints. By standing up straight instead of slouching you can protect the joints in your neck, hips, and knees. Also use the proper technique when lifting or carrying anything heavy. If any activity hurts, stop doing it right away.

Tip #3: Try nonsurgical approaches before turning to surgery

There are a number of ways to tackle joint pain other than replacing the joint itself. Treatment with steroids is one approach. Benefits can last anywhere from four to six months. However, this doesn't work for everyone. Viscosupplementation involves injecting a lubricating fluid into damaged knee joints to treat osteoarthritis. Studies show this therapy doesn't work any better than steroid injections. Yet it is another alternative for pain relief and mobility if other treatments haven't worked or you can't tolerate them.

Tip #4: Get pain relief

Instead of heading straight to your doctor to treat sore joints, try taking an over-the-counter pain reliever. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) or naproxen (Aleve), or the prescription medicine celecoxib (Celebrex), can relieve both joint inflammation and pain. Do talk with your doctor before deciding to use an over-the-counter NSAID. These drugs can cause side effects such as stomach upset, bleeding, and kidney and liver damage. Take them for the shortest possible time to relieve your discomfort. There is also some evidence that the dietary supplement glucosamine chondroitin can lead to subtle improvements in arthritis pain. "It doesn't rebuild joints, but it does seem to help with the pain," Dr. Martin says.

When to consider surgery

If you can't escape from joint pain even while at rest, your pain is only relieved by narcotic medications, or your function is severely compromised, it's time to consider a joint replacement. "I would stick with your own joint if you can, but if it's physically, mentally, and emotionally wearing you down, then it's time to go and have it done," Dr. Martin says.

Before you consider joint replacement surgery, find out all of your treatment alternatives. Know exactly what the surgery may do for you, what complications it might have, and what is involved in recovery and rehabilitation. And find out exactly how long you'll need to stay off the joint after your surgery.