Knee Pain and Arthritis in Women, Part 2

knee pic

Here are 5 more frequently asked questions in regards to knee pain and arthritis in women.

  1. What if my knees are already making grinding noises when I climb or descend stairs or get out a chair?

Answer: While knee grinding noises can be present in up to 40% of women’s knees without pain, this is not the same as saying it is normal for knees to make grinding sounds.  The grinding is called crepitation (which is a sound like walking on snow). Many doctors tend to ignore its importance.  This in unfortunate, since in my experience, knees which grind often have significant joint wear on the undersurface of the kneecap.  Chondromalacia (chondro=cartilage; malacia=softening) of the patella (kneecap) is the term for this situation.  The condition is nearly synonymous with kneecap arthritis.  Excessive knee bending exercise or impact in these patients can lead to the rapid onset of crippling arthritis.  Many of these patients are younger than 40 years of age and have to give up what they would normally do daily and are told to live with their pain.

  1. Can I be born with reasons for my knee pain or arthritis?

Answer: Yes, there are significant congenital reasons for women’s knee pain and problems.  Most commonly, the kneecaps are not properly aligned.  This “maltracking” of the kneecap leads to lifelong symptoms often staring with a history of kneecap pain and dislocation in childhood and leading to premature arthritis in midlife.  Another congenital reason for pain in the female is patellofemoral dysplasia (meaning that the kneecap and its groove are not the proper shape.  Such factors lead to surface wear just like the tire on your car with improper alignment.

  1. If I have knee pain that interferes with my daily activity, work, or exercise, what should I expect my doctor to say, do or not do for me?

Answer: Knee pain that interferes with and/or prevents normal activities and exercising must be taken seriously.  You should expect a thorough history and exam by your doctor, with special attention to your overall leg alignment and knee cap movement.  X-rays should be taken of your knee and knee cap to check for wear and malalignment.  In some cases, MRI and bone scans are useful, especially when there is fluid or swelling.  Most patients have muscle weakness and leg alignment issues that can respond to physical therapy.  A proper exam should educate you and teach you how to live and remain as comfortably active as possible.

  1. What about the Internet? Why can’t I just look up knee pain and go from there?

Today, looking up the answers to medical questions on the Internet is a common practice, but be careful.  First, make sure what you are reading relates to the diagnosis you have.  The point is everyone is at least a little bit different.  As much as the Internet can provide information, you can have a hard time knowing whether the information is both accurate and really applies to your situation.  Also, remember that today, the Internet is filled with commercial motives and advertisements that either will not help you or almost always will cost you money.  Knee pain and arthritis treatment is a multi-billion dollar business.

  1. If I do decide to look for information on the Internet, are there any sites that are better than others?

Here are some of the better peer reviewed (physician approved) sites:

www.orthoinfo.com This is the official site of the American Academy of Orthopedic Surgeons

www.emedicine.medscape.com : Good discussions of medical topics and knee problems in general

www.methodistorthopedics.com : Find under the search term “chondromalacia patella”. Good illustrations.

Remember: While these sites may provide initial information, your exact diagnosis and treatment will not be determined solely by what you can read. These sites offer a good starting point for discussion with your physician or therapist.

Information Provided by Wayne B Leadbetter,MD. Dr. Leadbetter is a Board Certified Orthopedic Surgeon recognized for his interest and publications on the female knee and women’s knee complaints especially relating to the kneecap. He may be reached at the Center for Joint Surgery and Sports Medicine, Hagerstown ,Maryland. Appointments: 301-665-4575

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