'Bone on Bone' Knee Damage: What Does it Mean? (2023)

FAQs

'Bone on Bone' Knee Damage: What Does it Mean? ›

First off, what does “Bone on Bone” mean? “Bone on Bone” is reference to the increased severity of OA (osteoarthritis) in a joint. Osteoartritis is the presence of inflammation of bones in a joint due to a reduction of cartilage.

Bone-on-bone knee pain, caused by advanced arthritis, can vary from person to person depending on its severity. Generally speaking, it will feel like a dull and achy pain. However, some people get a sharp pain that can bounce back and forth between those two qualities.

Other possible options range from pain-killing drugs, injections, exercise, weight loss, and knee braces. Typically it is recommended that you combine several of these methods in order to achieve the best results. Check out the comprehensive guide to osteoarthritis treatment.

Bone-on-Bone Arthritis

Patients who have thinning of the cartilage but not bone touching bone should not undergo knee replacement surgery, except in rare circumstances.

Unfortunately, the effects of osteoarthritis of the knee can't be reversed. But treatment and self-care can help relieve your symptoms and slow your condition's progress.

The answer: a resounding yes! In fact, people with knee osteoarthritis who walk for exercise are significantly less likely to go on to develop worse pain, according to a 2022 study published in Arthritis & Rheumatology.

Knee Replacement Surgery Not a Permanent Cure

Typically, the new metal joint from a knee replacement can last between 10 and 15 years. Because of this, even with a 'perfect' procedure, many patients will need two or even more replacements in their lifetime, depending on their age at the time of the first procedure.

The idea behind these injections is that they will temporarily restore the natural function of the knee by injecting a substance which will provide cushioning and reduce bone-on-bone contact. Individual responses vary, but many patients experience months, if not potentially a year or more of relief.

Knee braces are one treatment option that can help reduce bone on bone pain so you can get back to doing what you love. Some knee braces are better for treating osteoarthritis than others.

Severe knee cartilage loss makes walking, sitting, standing, squatting, and going up and down stairs extremely painful. People with a total loss of knee cartilage can benefit from joint injections. In many cases, surgery including a total knee replacement is needed to treat no cartilage in the knee.

How bad does your knee have to be before replacement? ›

You may be offered knee replacement surgery if: you have severe pain, swelling and stiffness in your knee joint and your mobility is reduced. your knee pain is so severe that it interferes with your quality of life and sleep. everyday tasks, such as shopping or getting out of the bath, are difficult or impossible.

It may be time to have knee replacement surgery if you have: Severe knee pain that limits your everyday activities. Moderate or severe knee pain while resting, day or night. Long-lasting knee inflammation and swelling that doesn't get better with rest or medications.

Simply put, the longer you wait to get a knee replacement, the more wear and tear you put on your knees – and the longer you live with increasing pain, stiffness or mobility issues. But there are a few other things to consider, including: As your knee condition worsens, your quality of life can also decrease.

Osteoarthritis is typically treated with painkillers known as non-steroidal anti-inflammatory drugs (NSAIDs). These medications have an anti-inflammatory and pain-relieving effect. Examples of NSAIDs include diclofenac, ibuprofen and naproxen.

The gel injections tend to be effective for about 50% of patients, but for those that it works well for those patients tend to see improvement in VAS scores for at least 4-6 months.

Over-the-counter medications — such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) — may help ease knee pain. Some people find relief by rubbing the affected knee with creams containing a numbing agent, such as lidocaine, or capsaicin, the substance that makes chili peppers hot.

Do walk. Moderate walking is recommended for people with knee pain because it's a low-impact activity. If your joints are painful and stiff, start slowly and work up to 20 minutes of walking per day, recommends Stuchin.

How can I get a knee replacement without surgery? ›

Platelet-Rich Plasma (PRP) Therapy

This concentrate is then injected into the damaged knee, which can facilitate an accelerated healing response. The procedure is less aggressive and less expensive than surgery. It may heal tissue with minimal or no scarring, and may alleviate further degeneration of the tissues.

Those with any type of allergy. Even patients with allergies that are as simple as pollen or dander should avoid knee replacement surgery. People who are considered “allergic” have hyperactive immune systems and secrete antibodies inappropriately to rid their bodies of the thing that they have mistaken as harmful.

Cortisone can make bone on bone worse by thinning out the meniscus. But one injection appears okay. Cortisone injections before knee surgery lead to greater post-surgical infection risk.

Barring any complications, most patients are able to return to most normal activities and walk without the need of assistive devices between three to six weeks after surgery. Overall, it usually takes two to three months to make a complete recovery from a minimally invasive knee replacement.

Corticosteroids stimulate an immune response to control inflammation and reduce the irritation caused by bone interacting with bone. In other words, it helps relieve the symptoms caused by arthritis.

What does bone pain feel like? Bone pain usually feels dull and achy — like the pain is coming from deep inside your body. The skin near the affected area will probably feel tender to any touch. It might also hurt when you move or use that part of your body.

Osteoarthritis symptoms range from stiffness and mild pain to persistent, severe joint pain. Common signs include swelling and tenderness, stiffness after getting out of bed, and a crunching feeling or sound of bone rubbing on bone.

The reasonable useful lifetime of custom fabricated orthosis is 3 years. Replacement during the “reasonable useful lifetime,” is covered if the item is lost or irreparably damaged.

Strength training and aerobic conditioning exercises improve symptoms of loss of cartilage in the knee. Symptom improvement occurs from lowering chronic inflammation in the body and weight loss and muscle strength gain.

NYU Langone doctors often recommend nonsurgical options as a first-line treatment for a knee cartilage injury. These include anti-inflammatory medication, physical therapy, and injections into the joint, including steroids; hyaluronic acid, also known as synthetic joint fluid; and platelet-rich plasma (PRP).

How can I lubricate my knees naturally? ›

Your joints' lubricating fluid allows your joints to move with more ease and less stress. To activate those juices, start your exercise routine with a gentle 5-10-minute warm-up and gradually increase your effort. Another good way to self-lube is drinking more water. Stretch regularly.

Activities you Cannot do After Full Recovery

You shouldn't downhill ski or play contact sports such as football and soccer. In general, avoid sports that require jerking, twisting, pulling, or running. You should be able to do lower-impact activities, such as hiking, gardening, swimming, playing tennis, and golfing.

Most people can leave hospital 1 to 3 days after the operation. Before you leave, a physiotherapist or occupational therapist will talk to you about managing daily activities and home exercise programmes. Following the exercises early on in your recovery will help with the long-term strength and movement in your knee.

A recent study found that 20% of people are unhappy with their knee replacements. Here's what can play into that dissatisfaction. Let's get one thing straight right away — knee replacements are often a smart choice. A lot of people have less knee pain and more mobility after their surgery and rehab.

There is a range of accepted weight ranges, but the current standard is that anyone obese (greater than 100 pounds over ideal weight or a BMI of roughly 40-45) should not consider joint replacement.

Hyaluronic acid injection is used to treat knee pain caused by osteoarthritis (OA) in patients who have already been treated with pain relievers (e.g., acetaminophen) and other treatments that did not work well.

When quantifying how much pain there is after surgery, it is relative to the patient. The pain after a knee replacement is typically no worse than one of your worst days before you had surgery. However, you can feel this way for the first two to three weeks after the day of surgery.

In the United States, currently, the average age to undergo knee arthroplasty is around 65 years old. Mostly knee replacement surgery is performed in elders with severe arthritis, while those under the age of 50 are considered young and are asked to wait until the age of 65.

In most cases, patients can walk without help from assistive devices like crutches or a walker within six weeks after knee replacement surgery. That said, physical therapy continues after this time to help your knee and the surrounding muscles grow stronger and more flexible.

Though routine and common, a hospital stay may be required following the procedure. But with advances in surgical procedures, it's possible to go home the same day after your knee replacement surgery.

Which knee injection is best? ›

You'll likely receive a cortisone shot, also called a steroid injection, as a first-line treatment. Cortisone shots are effective for many patients in quickly reducing inflammation and pain directly inside the joint, but they come with a few precautions.

You may get temporary relief from bone pain by using over-the-counter pain relievers such as acetaminophen, aspirin, or ibuprofen. Osteomyelitis typically requires treatment with either oral or intravenous antibiotics.

Voltaren Emulgel helps with the relief of localized traumatic inflammation and pain such as knee pain.

Knee injections are covered by Medicare and by most insurance. In fact, many insurance companies will ask you to have knee injections before considering surgery. (Insurance companies understand how effective this treatment is compared to a risky knee surgery, so they almost always provide the coverage for it.)

Administered as a series of 3 injections directly into the knee (one every 7 days), GELSYN-3 works to increase the levels of healthy hyaluronic acid in the affected joint. The hyaluronic acid in GELSYN-3 safely reduces joint pain and stiffness.

Medicare will cover knee injections once every six months if they are medically necessary. The injections are covered under Medicare Part B and subject to the annual Part B deductible. X-rays are required prior to Medicare approval. As mentioned above, there are many different injection treatments for the knees.

Osteoarthritis is typically treated with painkillers known as non-steroidal anti-inflammatory drugs (NSAIDs). These medications have an anti-inflammatory and pain-relieving effect. Examples of NSAIDs include diclofenac, ibuprofen and naproxen.

You may NOT be a good candidate if:

Your knee symptoms are not related to joint disease. Your weight is too much for the artificial joint to support. You have fragile skin or poor skin coverage over your knee. You have a severe illness or infection.

How do they fix knees without cartilage? ›

NYU Langone doctors often recommend nonsurgical options as a first-line treatment for a knee cartilage injury. These include anti-inflammatory medication, physical therapy, and injections into the joint, including steroids; hyaluronic acid, also known as synthetic joint fluid; and platelet-rich plasma (PRP).