1. Introduction
Aging population, obesity, previous knee injury, and overusing the knee are the main reasons that have greatly increased the incidence and prevalence of knee osteoarthritis. Knee osteoarthritis is degenerative, “wear and tear” arthritis that occurs in the knee joint. This occurs when the cartilage in the knee slowly wears away. Cartilage is the tissue that provides a cushion to the underlying bone and also helps the joint move easily. When it wears away, it roughens the bone surface. The surrounding bones react by growing thicker, which further damages the cartilage. Over a period of time, the cartilage can wear away completely, and the bone-on-bone contact can be very painful and disabling. In addition, bone spurs or extra bits of bone can form in the joint. This will limit the motion of the knee and cause further pain.
Additionally, there are many medications or methods that are available in managing knee pain from osteoarthritis: some are known to be effective and some are not. This is important because patients with knee osteoarthritis and chronic knee pain often feel there is nothing they can do and they just have to “live with it.” We will explore methods to alleviate pain and disability in patients, such as total knee replacement and medications. The Orthopaedic and Pain Practice will help identify key factors that interfere with functional improvement in patients with knee pain due to osteoarthritis and design a personal program for each individual to address these factors. This may include medical management, physical or occupational therapy.
2. The Orthopaedic and Pain Practice (TOPP)
As a practice with a special interest in pain management and knee pain Singapore, an important aspect in the management of knee pain is also the treatment of associated painful conditions such as osteoarthritis. Often, these conditions can be associated with pain at a specific joint but may also involve general widespread pain or pain referring into other areas.
For many, the option of knee arthroscopy that may only provide short-term relief or osteoarthritis that may require joint replacement are daunting prospects. At TOPP, we offer alternatives to these with specialist knowledge in the area of knee regenerative medicine. This involves minimally invasive solutions to aid in the healing and regeneration of damaged tissue. These techniques are aimed at providing long-term relief and possibly slowing the progression of arthritis with the potential to avoid or delay the need for joint replacement. This is an exciting and evolving field, and TOPP specialists are currently involved in research and clinical trials in this area.
The Orthopaedic and Pain Practice (TOPP) is a multi-disciplinary practice specializing in musculoskeletal injuries and chronic pain. This practice consists of both orthopaedic surgeons and intervention pain specialists. TOPP’s methodology involves collaboration between orthopaedic surgery and pain medicine. TOPP offers comprehensive consultation and management for all types of musculoskeletal injuries and acute and chronic pain. With respect to knee pain, TOPP specialists are highly trained in the management of knee injuries and painful knee conditions. Treatment options provided are based on the best available evidence and tailored based on the patient’s individual condition and needs.
3. Knee Pain Treatment in Singapore
Singapore is one of the few developed countries in the world with a rapidly ageing population. The population above 65 years is projected to increase from 344,800 in 2004 to 836,600 in 2030. Along with an increasing number of elderly, the incidence of knee arthritis has been rising. Knee arthritis is a major cause of functional limitation in walking, stair climbing, and rising from a chair. The quality of life is significantly affected by knee pain and reduced mobility. Orthopaedic surgeons have been trying to find the optimal treatment for knee arthritis in the elderly. Total Knee Replacement Surgery is shown to effectively improve function and eliminate pain and disability in the elderly with knee arthritis. In the past, elderly patients may not be suitable for standard total knee replacement due to concurrent illness such as heart or lung disease, diabetes, and obesity. Anesthesia and surgery may subject the patient to a higher risk of morbidity and mortality. The recent Minimally Invasive Surgery (MIS) technique provides an alternative for elderly patients with early to mid-stage knee arthritis. MIS involves a shorter incision with a smaller scar. A muscle-sparing approach is used; this means that there is no disturbance to the quadriceps muscle group, which is so important for knee function. The recent advancement in MIS is the Quadriceps sparing technique. This technique avoids trauma to the quadriceps tendon and muscle, allowing the surgeon to work through a “window” between the muscle groups. MIS can effectively achieve less pain, rapid recovery, and a short hospital stay for the elderly. However, MIS may not be suitable for all elderly patients. A proper assessment by an orthopaedic surgeon is needed to determine the best course of treatment for knee pain treatment Singapore.
4. Knee Replacement Options
With all the recent public attention on total knee replacement, many effective surgical methods that reconstruct the joint surface and joint axis have fallen into the shadows. For example, with modern technology and surgical technique, high tibial osteotomy can be hugely successful and will delay the need for a total knee replacement for years. It is likely that in the near future there will be even more effective treatment methods that will allow us to avoid or delay knee replacement. The decision to proceed with knee replacement is a decision you make with your doctor, and will be based on a variety of factors. These include your pain, level of disability, x-ray findings, and the expectation for improvement in pain and function. With total knee replacement being a very successful and durable procedure, the goal of any alternative method or treatment is still to eventually advance to knee replacement with the hope of achieving pain relief and improved functional status.
Knee replacement is not the only option for patients with knee pain. Before considering surgery, you should consult with your orthopaedic doctor for a diagnosis of your condition and recommendation for treatment. Other alternative treatments include: “biological” knee replacement (cartilage grafting), OATS procedure, partial knee replacement, and knee osteotomy. These techniques are not considered replacements, and will not adversely affect a future knee replacement.
In summary, The Orthopaedic and Pain Practice is dedicated to helping patients resolve crippling knee pain and return to an active, fulfilling life.
