Orthopaedic specialists at Cleveland Clinic in Florida say you have considerable control over keeping your knees in shape now—and when you’re into your 80s and 90s. Additionally, advanced technologies offer new options to repair injured or damaged joints for athletes young and old.
That’s promising news. A recent study shows that nearly half of all adults will have painful arthritis of the knee by age 85.
“As a large, academic medical center, we have the opportunity to provide our patients with cutting-edge techniques and equipment,” says Brian M. Leo, MD, orthopaedic surgeon, researcher and sports medicine specialist at Cleveland Clinic. “Our goal with any treatment is to help people get to them back on the field or back on the job.”
The Whole Person
Cleveland Clinic’s orthopaedic surgeons discuss the following with each patient:
- Overall health
- Risk factors
- Surgical and nonsurgical treatments
- Realistic goals
- Importance of rehabilitation
“We focus on the whole person, not just on the knee joint,” Dr. Leo says.
Overweight at 45?
When people understand the causes of knee problems, they can better prevent problems now and in the future. For example, injuries sustained in high contact sports, such as soccer and football, as well as running and tennis, can lead to osteoarthritis of the knee later in life, in addition to injuries at any age.
“Also, the heavier you are, the more likely you are to develop knee problems,” adds Dr. Leo.
In fact, people who are obese at age 45 are 60 percent more likely than people at a healthy weight to have osteoarthritis of the knee in their 80s, according to a recently published study funded by the Centers for Disease Control.
Growing up, Marshall Goldstein always enjoyed playing sports, including football and running up to 30 miles a week. Now, at age 53, he considers tennis his game.
But sharp knee pain ended his doubles match one day last summer. The pain did not subside, even after weeks of rest.
“That’s when I found Dr. Brian Leo, an orthopaedic surgeon, using the Cleveland Clinic website,” Mr. Goldstein says. Tests confirmed a torn meniscus, the knee’s shock absorber. Ten days later, Dr. Leo performed surgery.
“I chose him in part because he specializes in sports medicine,” Mr. Goldstein says. “He even treated arthritis in my hip, as well.”
Today, Mr. Goldstein is on the tennis courts, playing doubles twice a week, as usual. “My knee is so much better than it was even before the injury,” says Mr. Goldstein. “And that first game back was great! I loved it.”
If you have knee problems now, you are not alone. Nationally, knee injuries bring more people into the orthopaedic surgeon’s office than any other problem.
Innovative, Targeted Treatment
Not every patient is an appropriate candidate for every procedure, Dr. Leo notes, but physicians at Cleveland Clinic offer a variety of innovative treatments, including:
“Partial” joint replacements: “Bone is like a precious metal,” Dr. Leo explains. “We use techniques that will keep as much bone in place as possible, and for as long as possible.” This includes replacing only part of the knee joint.
Two ACL options: Reconstruction of the anterior cruciate ligament (ACL) requires replacement of the torn ligament in the knee with a new one. When the ligament comes from the person’s own leg muscle, it is an autograft procedure.
Another option is an allograft, in which the new ligament has been donated by an organ donor.
“Recovery after allograft is quicker and less painful, in part because you avoid donor site morbidity (which might include pain at the site where your own tissue was taken for transplant),” Dr. Leo says. “Both procedures are very successful.”
Arthroscopy: This is one of the most common treatment procedures because it requires only a very small incision.
“Arthroscopic technology and equipment— including new implants, sutures and techniques—continue to improve,” Dr. Leo says. “We’re able to do more advanced knee surgeries this way today, because we’re taking advantage of innovations in the field.”
Nonsurgical options: Some patients simply do not want or cannot have surgery, so orthopaedic surgeons at Cleveland Clinic offer a range of nonsurgical treatments:
- Anti-inflammatory medication
- Physical therapy
- Injections, including cortisone and viscosupplementation (i.e., artificial joint fluid)
Many patients get significant benefit with these treatments. Some can return to playing football, for example, or to daily walks without pain.
“Our goal is to treat athletic types of injuries in people of all ages, from high school to octogenarian,” Dr. Leo says. “I enjoy seeing an 80-year-old athlete who gets back on the court to play doubles (tennis) with friends.
