Research uncovers ways to improve knee weaknesses and surgical outcomes

Scientists researching conditions affecting the knees have uncovered promising approaches to help ensure that weaknesses in the knee can be managed and treated more effectively.

The two new studies, conducted by US researchers, have highlighted potential new methods of helping to prevent knee buckling, while also assisting those who undergo surgery to replace their knees in recovering more speedily. Research such as this will help to make sure future injury risks can be minimised and that patient outcomes are positive.

Addressing knee instability

The first of the studies, conducted by the University of California, San Francisco, shed light on the need to address knee instability as a means of preventing future falls and osteoarthritis-related injuries.

A total of 1,842 patients of an average age of 67 years old were assessed in this study, all of whom had or were at high risk for knee osteoarthritis. Results from a five-year monitoring period showed that 16.8 per cent of this group reported knee buckling, while at the end of seven years 14.1 per cent had recurrent falls.

According to analysis appearing in the medical journal Arthritis Care & Research, people who experienced knee buckling at year five were 1.6 to 2.5 times more likely to experience recurrent falls, fear of falling and poor balance confidence at year seven.

Meanwhile, those who fell when a knee buckled at the start of the study were 4.5 times more likely to experience recurrent falls two years later, as well as being twice as likely to experience significant fall injuries, three times more likely to suffer fall injuries that limited their activity, and four times as likely to have poor balance.

The research underlined the need to identify signs of knee instability early and prevent it with targeted exercises or joint replacement surgery.

Dr Michael Nevitt, of the University of California, San Francisco, said: "The present study has demonstrated for the first time that knee instability and knee buckling are important causes of these problems in the very large segment of the older population suffering from knee pain."

Reducing postsurgical pain

Meanwhile, the second study showed how new approaches to treatment and care could help relieve pain for those patients who do choose to undergo a total knee replacement.

A literature review led by Mount Sinai Hospital in New York City and published in the Journal of the American Academy of Orthopaedic Surgeons indicated that a team-based care approach - consisting of the patient, family members, the surgeon and other medical practitioners - can be used in conjunction with newer pain management strategies to enhance outcomes.

These newer strategies include taking a combination of pain management medications before and after surgery, using local anaesthetics in conjunction with preoperative nerve blocks, and receiving intraoperative pain injections within the knee.

Such approaches can help reduce postsurgical pain levels and the need for painkilling medications, as well as ensuring patients are better placed to take part in physical therapy sessions. A strong support system of family and friends was also shown to be very helpful in achieving the quickest recovery and return home.

Lead study author Dr Calin Moucha, chief of adult reconstruction and joint replacement surgery at the Mount Sinai Hospital in New York City, said: "Managing postsurgical pain is key to promoting early postoperative mobility, reducing medication side effects and increasing patient satisfaction."

The Arthritis Research UK view

More than eight million people in the UK are affected by osteoarthritis, which causes pain and stiffness in the joints. People with this condition may find that their joints become weaker and may give way, because the surrounding muscles have weakened or the joint has become less stable. This instability can be associated with reduced physical function, reduced independence and can prevent people from doing the things they enjoy.

It is important that people with osteoarthritis keep physically active and keep their joints moving, as this can improve muscle strength, reduce frailty and risk of falling, and is also effective at improving other symptoms such as pain. Strengthening exercises can also be effective at reducing pain and making your joints more stable.
Read more about exercise and arthritis.

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