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Say Goodbye to Knee Pain: New Treatments and Trends

May 20, 2009 11:59 AM with Dr. Michael O'Rourke

Knee arthritis can be a real pain. It's time to get a leg up on how best to reinvigorate those ailing knees. Michael O'Rourke, MD, Director of NorthShore's Total Joint Replacement Center, discusses current trends and new treatments related to knee arthritis, including minimally-invasive surgical procedures and the use of robotic-assisted technology.

Kristin Philbin (Moderator) - 11:49 AM:
Welcome! Today’s chat: Say Goodbye to Knee Pain: New Treatments and Trends, will begin shortly. Please start submitting your questions and Dr. Michael O'Rourke will begin answering them as soon as we get started. While you are waiting for the chat to begin, feel free to visit the Total Joint Replacement Center to obtain more information.

Dr. Michael O'Rourke (NorthShore) - 11:57 AM:
Good afternoon and thank you for participating! My name is Michael O'Rourke and I am an orthopaedic surgeon with a specialty in the treatment of hip and knee disorders. I am the Director of the Total Joint Replacement Center at Glenbrook Hospital. Please ask any questions you have about arthritis of the knee and treatment options.

  Terry Tyner (Chicago, IL) - 11:58 AM:
Have Glucosamine/Chondroitin treatments been demonstrated to have any beneficial effect on knee/joint pain?
Dr. Michael O'Rourke (NorthShore)
Glucosamine and chondroitin are commonly used supplements for osteoarthrits and have been shown to have a benefit in the treatment of pain from the arthritic process. The improvement is generally partial and does not work for everyone. These are generally safe to use. Many people will ask if these supplements decrease the progression of arthritis or make new cartilage grow. There is no evidence that these change the progression of the disease process. I tell people to try the supplements for treatment of early arthritis pain; however if no effect is noticed to stop. Generally a trial of 6-12 weeks is adequate.

  Barbara Winston (Evanston,IL) - 12:05 PM:
I have arthritis in my knees. I live in a town house with three levels, and also, I would love to start jogging again. I want to keep up my activies, what kinds of things would help?
Dr. Michael O'Rourke (NorthShore)
Activity has been shown to be beneficial for arthritis. Increasing the muscle strength and flexibility around a joint is protective to the cartilage. Exercises increase the ability of your muscle reflexes to aid in the protection of the cartilage as well. On the other hand, there is some evidence that higher impact activity (such as running) can increase the rate of progression of arthritis once the cartilage has started to wear. Overall, the best activities are non-impact such as swimming, brisk walking, cycling, etc. If you choose to run you should try to cross-train with other activities. Furthermore, using the appropriate running shoes (including changing shoes every 3-4 months) is important.

  Linda (Chicago,IL) - 12:17 PM:
Can you tell me about the cartilage replacement treatment and if it is available and if so, who would be a good candidate for it?
Dr. Michael O'Rourke (NorthShore)
There have been several questions about cartilage transplants. Cartilage transplants are generally for knees with a focal (small area) of cartilage loss in an otherwise normal knee. The disease process of osteoarthritis is a more involved condition (including involvement of the cartilage and underlying bone) that does not respond well to cartilage transplantation.

  Alyssa Lawson (Chicago, Illinois) - 12:22 PM:
What are the advantages and risks of cortisone shots? And, can a cortisone shot help delay knee replacement surgery?
Dr. Michael O'Rourke (NorthShore)
Cortisone is used to decrease inflammation that can result from the degenerative process. The results of cortisone injections are variable with some people not responding and others having benefits up to 6-12 months. Repeat injections can cause weakening of tissue including cartilage. I generally will offer cortisone for a patient who has moderate arthritis and use viscosupplementation ("lubricant injections") for earlier forms of arthritis.

  Janine Starcevich (Mt. Prospect, IL) - 12:27 PM:
What would you look for (for yourself) in an institution/doctor that replaces hips & knees? How is CAS (computer assisted arthroplasty) different from CAOS (computer assisted orthopedic surgery)? Is one a subset of the other? Is one better than the other? Thanks!
Dr. Michael O'Rourke (NorthShore)
Choosing a doctor and institution is a very personal decision. Reputation, personality, bedside manner, experience, education, training all play a role in the decision. In joint replacements, the volume of the surgeon and the institution have been shown to have an impact on the quality. The Total Joint Replacement Center at Glenbrook Hospital has highly-experienced, high volume, and fellowshipped trained surgeons performing joint replacement. We are committed to optimizing outcomes and minimizing the chance for complications. CAOS and CAS are referring to the same technology - that is the use of computer information to increase the precision and reproducibility of implant placement. This technology is available and used at NorthShore University HealthSystem.

  Ron Olson (Arlington Heights) - 12:35 PM:
I’ve read that joint replacement surgery may not be a good option for people with arthritis younger than 50. What treatment options are appropriate for people in their 40s?
Dr. Michael O'Rourke (NorthShore)
Age plays an important role in the decision to proceed with a joint replacement. There is no absolute age criteria and it depends on the person's circumstances. This is best determined by meeting with your orthopaedic surgeon to discuss the pros and cons based on your circumstances and level of disease.

  Tina (Oakbrook, IL) - 12:41 PM:
I recently had reconstructive knee surgery to repair my ACL and MCL. Am I more prone to develop knee arthritis?
Dr. Michael O'Rourke (NorthShore)
Having a ligament injury to the knee can increase the risk of arthritis, although it is not absolute.

  Tom (Winnetka, IL) - 12:44 PM:
What options are there for osteoarthritis? I have recently been told I am not a candidate for repair of two miniscus tears due to presence of extensive arthritis - and that it's not bad enough to consider knee replacement. I have severe pain in my right knee that limiting what was an active life style - what other options do have?? - NSAIDS are contraindicated due to prior GI bleed -
Dr. Michael O'Rourke (NorthShore)
Having arthritis in the knee does limit the potential benefit of doing arthroscopic surgery for meniscal tears. Joint replacements are best used when there is advanced arthritis on the x-ray (i.e. "bone touching bone"). There are several patients somewhere between these two places. The best way to proceed is best determined on a case by case basis taking into consideration age, health, weight, exam finding, and other information. Other treatments may include injections, therapy and bracing. I would encourage meeting with an orthopaedic surgeon to disuss further.

Kristin Philbin (Moderator) - 12:50 PM:
Thank you everyone for your great participation, the chat will be ending in approximately 10 minutes. Please submit any final questions you have.

  Greg Sweeney (Chicago, IL) - 12:51 PM:
I'm having surgery to my left knee on the 1st of June. Is there a video I can watch regarding the surgery? Can you tell me more about the surgery?
Dr. Michael O'Rourke (NorthShore)
There are some good resources for patients on the American Association for Hip and Knee Surgeons website ( and the American Academy of Orthopaedic Surgeons website ( I do not know of any live surgeries to watch. There is an education program available through our Total Joint Replacement Center called Emmi - a web-based program with animations.

  Nita Gocht (Chicago, IL) - 12:55 PM:
Do weight-bearing exercises on the knee alleviate arthritis?
Dr. Michael O'Rourke (NorthShore)
Exercise is an important part of the treatment of arthritis. I would refer you to one of my previous responses to a similar question. In general low-impact activities are good (swimming, cycling, walking).

  Sandy Hayes (Skokie, IL) - 12:58 PM:
How is this different than total knee replacements in the past?
Dr. Michael O'Rourke (NorthShore)
A total joint replacement is a procedure that places a new "cap" on the end of the femur(thigh) and tibia (shin). This usually involves a resurfacing of the patella (kneecap). All total joint replacements take away the ACL ligament and many take away the PCL ligament (ligaments in the center of the knee). This procedure is very effective and there have been advances in the materials, size options, surgical instruments, and techniques. A partial knee replacement only resurfaces the part of the knee that is involved and leaves the ACL/PCL. Not everyone is a candidate for a partial knee replacement because the arthritis may involve more than one area, there may be a joint contracture (limited motion), or a significant deformity. Your surgeon can help make those determinations. The advantages are the knee moves more like a normal knee if done in the correct patient. Robotic surgery has improved our ability to more precisely place these partial knees.

Kristin Philbin (Moderator) - 1:10 PM:
Thank you again for participating in our chat today. For more information please visit our Orthopaedics pages.

Also, a transcript of this chat will be available shortly.

Dr. Michael O'Rourke (NorthShore) - 1:11 PM:
Thanks for participating. If I did not get to your question, I apologize. For more information you can visit our Orthopaedics pages or the links I provided. For an appointment you can call 847-570-5020. Thanks again!

This chat has ended.

Thank you very much for your participation.