Dear Doctors,
I just had a right knee replacement, am going through physical therapy and am having a lot of problems. My left knee is now starting to give me problems. I don’t want to go through another replacement with my left knee, because of the complications I have had with my right knee. I know that you work with a lot of semi professional football players and do a lot with sports injuries and knees. Is there something I could do now to prevent my left knee from going down the same road as my right knee?

Answer
There are a several things you could do in the preventive realm. Without examining you, there are some initial questions and suspicions regarding your situation. Some of the things we take into consideration regarding knee rehabilitation is the integrity of the soft tissues in the knee. This includes the cartilage, meniscus, ACL and MCL ligaments and the cruciate ligaments. Another thing we consider in the assessment is the range of motion of the joint and how much compensatory stresses are being shifted to the left knee because of the right knee not yet functioning properly. After saying all this, lets discuss some general preventative measures for the knee.

The knee is controlled by the quadriceps muscles. These are the muscles in the front of your thigh. If these muscles are weak, and not balanced, this could cause knee pain. There are certain exercises a person could do at home to build up these muscles and take pressure off the knee joint.

Joint manipulation to the knee as well as the spine could be very helpful in knee problems. All the nerves that go into the knee originate from the lower part of the spine. If there is an impingement or joint dysfunction in the pelvis or hip region, this could contribute or be a major culprit on knee
pain.

Wearing shoes with good arch supports could minimize pronation (or turning in) of the foot and will help to optimize the biomechanics of the lower extremity. In some cases we will custom make foot orthotics that will aid in foot and arch positioning. These are some basic things to consider. After examining your left knee it could be determined if going through a course of rehabilitation in our office would be beneficial, in addition to the above general guidelines.