Mercy Health shares tips on maintaining knee health over time

Maintaining an active lifestyle and a healthy body mass index are two critical factors for preserving the knees.

Each year in the United States, surgeons perform more than 700,000 total knee replacements, according to the American Academy of Orthopaedic Surgeons. That’s more than all the knees in Cincinnati. 

Knee replacements can offer relief for patients living with pain, stiffness or loss of mobility, and the rehabilitative and recovery processes are shorter.

But surgeons can also recommend plenty of knee preservation techniques, treatments and procedures before considering surgery, said Mercy Health’s Brian Chilelli, MD, a board-certified orthopedic surgeon, sports medicine specialist and team orthopedic physician at Miami University.

“The goals are to try to prevent or at least delay wearing out of the knee or prevent osteoarthritis of the knees so that the patient can either avoid or push off knee replacement surgery for later on in life,” said Dr. Chilelli.  

Osteoarthritis is the most common cause of knee pain and disability that leads to a joint replacement. While it usually occurs in older adults due to age-related wear and tear, it can also happen because of injury, genetics or other issues.

“Any sort of deficiencies of normal tissue and structures within the knee can lead to pain, weakness and stiffness,” he said.

What to expect with knee preservation

When a patient goes to Dr. Chilelli with symptoms like pain and dysfunction, the plan usually starts with more conservative measures such as physical therapy, braces, activity modification, anti-inflammatory medications and various types of injections. If those don’t work, then surgical options are considered.

The approach is individual and highly tailored to each patient. Dr. Chilelli considers a person’s age, occupation, current fitness level, desired goals and more when working on a treatment and recovery plan. From lifelong athletes to sedentary individuals, he works with patients to find what’s best for their lifestyle and goals.

When is knee pain more than normal wear and tear

Slight changes in fitness level and ability are normal with age, but Dr. Chilelli said there are signs and symptoms to watch for.  

“Something more serious usually presents as sudden onset or with a higher level of severity, which usually causes acute significant changes in activity levels or lifestyle and quality of life,” he said. When this happens, it’s important to check in with a healthcare provider – either a primary care provider or an orthopedic specialist.

“I tell patients to let their body be their guide to maintain their fitness,” he said. “It’s important to notice when your body is trying to tell you it’s time to change something or seek help.”

How to care for knees now and in the future

Dr. Chilelli has two pieces of advice for anyone who wants to prioritize knee health now and as they age.

“While there are lots of factors involved in poor knee health, I think that maintaining a low BMI (body mass index) and an active lifestyle are the two most important things,” he said. “Maintaining a healthy body weight decreases the amount of force on the internal structures of the knee.”

A study in the journal Arthritis &  Rheumatism found that each pound of body weight places four pounds of pressure on the knee joint. If a person lost 10 pounds, they would reduce the pressure on their knees by 40 pounds.  

Dr. Chilelli added that many factors that impact knee health are out of a person’s control, including injuries or accidents.

Advancements in knee preservation

While Dr. Chilelli commonly performs knee replacements, he also performs procedures designed to preserve the knee. Surgeons continue to fine-tune their techniques based on the latest research and data, which often leads to less-invasive procedures with shorter recovery times.

“All the exciting stuff is along the lines of making further improvements upon existing techniques and technologies to benefit patients,” he said.

For example, replacing and reconstructing the anterior cruciate ligament (ACL) was the standard for a long time. Now, surgeons can repair the ACL, the most frequently injured ligament of the knee. Additionally, surgeons do orthobiologic injections, using the body’s cells or platelets to assist with healing.  

“We’re always learning more and more about these sorts of things based on the data and information available,” he said.

Dr. Chilelli recently took part in conducting a study that involved microfragmented fat injections, which are used to treat mild to moderate arthritis of the knee.

“We’re able to currently, and moving forward, be more confident in our offerings that preserve the knees,” he said.

To learn more or take a joint risk assessment go to mercy.com/Cincinnati. Call 513-347-9999 for a same-day or next-day appointment. Visit the walk-in after-hours orthopedic clinics in Anderson and Fairfield (no appointment needed) Monday through Friday from 5 to 9 p.m. and Saturday 9 a.m. to 12 p.m.

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