Meier Orthopedic

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Knee Arthritis


“Arthritis” is a general term that refers to the degenerative deterioration of a joint. Arthritis invariably involves the breakdown of the cartilage, the slippery, gliding tissue that cushions the ends of bones where they contact one another in the joint. As it degrades through wear-and-tear, aging, or prior injury, articular cartilage erodes from the thick, healthy, smooth tissue to a thinned and roughened surface, prone to causing irritation and inflammation within the joint. In arthritic joints, the highly sensitive joint lining or synovium becomes inflamed (synovitis), leading to swelling and pain. The loss of the cushioning, shock-absorbing capacity also leads to increased stress on the underlying bone, which can be associated with reactive changes and bone marrow lesions (BMLs), another potential source of pain. The joint capsule that envelops the joint thickens, becoming contracted and stiff. Eventually, if the cartilage wears through completely, this can result in the commonly described “bone-on-bone” contact.

Patients with arthritis may experience one or more of several symptoms, including joint pain, swelling, stiffness, catching, locking, and giving out. The symptoms may fluctuate in intensity from one day to the next, depending on the intensity of physical activities and systemic inflammation levels. While the severity of the symptoms can vary from one day to another, this chronic, underlying condition does not go away and tends to be progressive over time.

Depending on the severity of arthritis, different treatments can be helpful, all with the common goal of reducing pain and improving function.

Orthobiologic injection therapy with hyaluronic acid and bone marrow aspirate concentrate are non-surgical injection treatments that many patients find to be very helpful in relieving the symptoms of knee arthritis. The benefits of these treatments are that they are very safe and have minimal risk of adverse effects. Many people consider orthobiologic injection therapy preferable to corticosteroid injections for the knee because the therapeutic effects can last longer, and these treatments are safer to repeat. Orthobiologic injection therapy can be an excellent first-line treatment to try before more invasive surgical procedures. This injection treatment can also be preferable to other therapies often considered first-line, like oral anti-inflammatory medication. Systemic side effects involving the gastrointestinal system, kidneys, and liver can occur when commonly prescribed oral pain medications are used regularly. Many patients can manage their arthritis symptoms successfully and safely with periodic orthobiologic injection maintenance therapy, avoiding the need for more invasive surgery.

Knee replacement surgery can be an effective pain-relieving treatment for advanced arthritis. This operation involves removing a portion of bone along the joint surface of the femur, tibia, and often patella, replacing it with implants composed of highly polished metal and high-molecular-weight polyethylene (surgical-grade plastic). Essentially the roughened, damaged joint surfaces are replaced with smooth, gliding prosthetic implants. In many patients with knee arthritis, the damage is spread diffusely throughout the joint, and total knee arthroplasty is the recommended treatment to address the source of the pain thoroughly. However, in some cases where joint damage is confined to only one of the three knee compartments, a unicompartmental (“partial”) knee arthroplasty can allow successful treatment with a less invasive procedure. Determining which type of joint replacement surgery is most suitable for each patient is done by analyzing the pattern of arthritis and limb alignment on standing X-rays and other variables.

Even though knee replacement surgery can significantly improve function and quality of life in many individuals who have debilitating joint degeneration, it is not a perfect solution. Clinical follow-up studies show that as many as 25% of patients (a full one in four) are not entirely pleased with their knee replacement. Because a knee replacement prosthesis is a mechanical joint, it does not function biomechanically precisely like a natural knee. Because of this, knee replacement patients may need to modify or avoid certain activities. Like any mechanical device, knee replacements are also prone to wear and tear and breakage. So, the need for revision surgery is always a possibility. And revision surgery is always more complicated with lower success rates than the initial surgery. Because of these concerns, it is wise to exhaust all non-prosthetic treatments before resorting to knee replacement surgery.

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With outstanding precision and attention to detail, Dr. Meier provides all patients under his care the same level of attention as professional athletes receive. Read what some patients have to say about Dr. Meier’s life-changing treatments by visiting here.

I recieved Regenerative Injection Therapy on my right hip back in early March, 2018 from Dr. Meier. The result thus far have been very good - I have less pain and much better mobility. Dr. Meier and his staff are true professionals and have been great at setting expectations for the potential results of the Regenerative Injection Therapy process, making sure all my questions are answered in detail both before and after the procedure. I highly recommend Dr. Meier to anyone looking for alternatives to a hip replacement.

M. Hill

Dr. Meier is a fantastic doctor. He did a series of Prolotherapy Injections on my knees, shoulder and lower back, which saved me from having to have surgery. I trust him and his opinions on the best care for his patients.

Susan Kelber

I always have an outstanding experience when I have an appointment with Dr. Meier. Apart from being an outstanding doctor who listens to you, he has helped me so much in dealing with my pain from my accident. I highly recommend Dr. Meier. An added plus is the wonderful caring staff that he has in his office.

Terri Valencia
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