Steroid Injections
Injections may be used to reduce joint pain and inflammation associated with knee injuries like cartilage tears, degenerative meniscus and arthritis-related issues. Steroid injection can help improve function, and for less complicated first-time injuries, can be effective as part of a nonsurgical treatment program, which may include wearing a knee brace and participating in physical therapy. Your physician may use musculoskeletal ultrasound to help guide your injection into the joint. Musculoskeletal ultrasound improves accuracy when treating you with steroid injections in the office, and it is used for deeper joints, joints with poor anatomic landmarks and joints with little to no joint space. This technique uses sound waves to create images of the joint and to identify the needle used to inject the joint helping the physician guide it to the affected area. This technique is done in the office and does not expose you to radiation.

Natural Joint Fluid Treatment
This treatment, also known as hyaluronic acid injections, uses an injectable substance made from the building blocks of cartilage to create the type of cushioning cartilage provides. It is primarily used for arthritis of the knee. Those who respond to this treatment can experience relief for up to six months or longer, and this treatment can be repeated if pain returns.

Dry needling is an alternative pain relief technique that physical therapists may administer for muscle pain. It involves the insertion of a small, solid filament into a stressed muscle’s site of spasm and pain, also known as a trigger point. By doing so, the muscle relaxes and blood flow increases into the area, alleviating pain and improving motion.

Trigger points are often the result of an injury to a different part of the body, because other muscles overcompensate for imbalances and weakness in the injured area. Because of this overcompensation, muscle spasm occurs, causing discomfort and pain in the muscle.

Once dry needling resets the tone of muscle, your physical therapist works on correcting strength and mobility deficits in the muscle, which allows healing and prevents injury.

• Results can be immediate or take up to 72 hours
• One to five treatments is the expected course
• Rehab exercises are part of the treatment

Depending upon the type of knee problem you have, we may suggest lifestyle changes to help reduce the pain and stress on your knees. Your exercise prescription might include low- or no-impact exercises such as swimming or biking, avoiding activities with running and/or twisting and adding moves to improve the strength of your quadriceps. It is also believed that strengthening your hamstrings and gluteals is important to knee health as well. This is part of a current research study at The Ohio State University Wexner Medical Center.

Lifestyle changes like losing excess weight can also reduce the risk of knee problems.

Arthroscopy involves inserting a telescopic device fitted with a camera into the affected knee area. Your physician will make the appropriate repairs, removing inflammation, loose bone or cartilage. This procedure is often used as part of anterior cruciate ligament (ACL) reconstruction. Depending on the extent of the repair, the procedure usually takes less than an hour.

Knee microfracture surgery repairs significant acute damage to small areas of knee cartilage. An arthroscope (tubular instrument with an affixed camera) is inserted into an incision made in the knee. Small holes (microfractures) are made in the bone near the damaged cartilage. Cells from your bones are released through the microfractures and create new fibrocartilage.

You will need crutches to keep the weight off your knee for six to eight weeks, which will help the new cartilage grow.

The meniscus is padding between the tibia and femur that can tear as a result of an injury and is a common complication in ACL tears. Depending on the type of tear, the meniscus may be repaired through surgery. Surgical removal of the torn section (partial meniscectomy) or the entire meniscus (total meniscectomy) may be necessary in severe cases.

A direct blow to the kneecap (patella) in contact sports or pivoting injury to the knee are often the causes of a kneecap moving out of place (dislocation). Initial dislocations can often be corrected by wearing a brace for a few weeks and following up with physical therapy. Imaging is often needed to see if a cartilage lesion occurred with the dislocation.

In repeat cases where ligament damage occurs, medial patella femoral ligament (MPFL) reconstruction may be necessary. MPFL reconstruction rebuilds the ligament, using a graft from the femur to the kneecap to help prevent further dislocations.

Osteochondral autograft replaces injured cartilage and underlying damaged bone using your own tissue. It is common for knee repair but can be used to repair other joints as well. In this procedure, the injured cartilage and underlying bone are removed. An autograft (replacement cartilage and bone from another part of the patient or knee) is then substituted.

The injured area can usually bear weight within four to six weeks. Activity is gradually increased. Athletes can typically return to sports in about six to nine months.

Autologous chondrocyte implantation (ACI) provides pain relief from larger areas of cartilage damage and cartilage injuries. ACI is a three-stage procedure:

Stage 1: Cells are taken from another part of the patient’s knee.
Stage 2: The cells are grown in vitro for about four to six weeks.
Stage 3: The cells are reintroduced into the affected area in the knee under a patch, ultimately forming new cartilage.

Crutches are needed for at least six weeks and up to three months, depending on the condition and other factors of the individual patient. Ongoing rehabilitation is required and essential for cartilage growth, patient mobility and strength.