When it comes to a condition like chronic knee pain, there are many treatment options available to reduce pain and improve function, including chiropractic care. However, there are cases when a patient may opt for total knee arthroplasty (TKA). In some instances, they may be able to resume their everyday activities, but a segment of patients may not achieve a satisfying outcome. What can we learn from these patients that can inform us on when to and when not to consider surgery for knee pain?
In one study, researchers examined TKA patients one year after their procedure to assess their progress with respect to knee range of motion and function, as these are important for performing activities of daily living (ADLs) such as the ability to put on shoes and socks, squat down to pick things up off the floor, get up and down from sitting, climb and descend steps, etc. The research team found that patients with poor range of motion before surgery, as well as those with poor knee alignment (the tibial-femoral angle), were less likely to have a satisfactory outcome.
Several studies have demonstrated how hyperpronation of the ankle can affect the alignment of the knee, placing added stress on the joint, as can impaired hip function. These issues should be addressed before considering TKA. This is why it’s important for doctors to assess the whole patient for a musculoskeletal condition because the cause or contributing factors for the issue could be from outside the area of chief complaint. In many cases, a combination of manual therapies and specific exercises provided by a doctor of chiropractic can restore proper motion to the affected hip or ankle, which can then benefit the knee.
Manual therapies can also break up adhesions and scar tissue that may affect knee range of motion. When the knee can move as intended, the pressure from normal movement can help provide nutrients to the remaining cartilaginous tissue, reducing inflammation and pain.
The take-home message is that there may be a time when a TKA is the only option available to a patient with knee pain, but if the knee is poorly aligned or its range of motion is restricted, then TKA may not be the answer. Luckily, these are issues that can be addressed with chiropractic care, which may delay or even reduce the need for an eventual surgical procedure.