Nearly one in three people in the UK over 65 suffer from pain in one or both of their knees. However, it doesn’t just affect older people – anyone can experience knee pain, whether it’s due to injury or a medical problem.
Our renowned medical team provides a range of treatments, from the traditional to the innovative:
This is an effective and well-researched procedure that’s a potential alternative to surgery. It takes advantage of the blood’s natural healing properties to reduce pain and improve joint function. It uses a specially concentrated dosage of platelets prepared from your own blood to repair damaged cartilage, tendons, ligaments, muscle and bone. Treatment is administered via an injection and depending on the injury two to six injections may be required, performed at weekly intervals. Patients usually see their symptoms improve within four to six weeks of having the injections. PRP is a safe treatment option which, because your own blood is used, carries no risk of allergic reaction. Read more clinical evidence supporting PRP here.
This day case treatment is exclusively offered to our patients. It combines the benefits of Platelet-Rich Plasma (PRP) therapy with Lipogems®, a pioneering procedure that uses your body’s own adipose (fat) cells to treat pain and inflammation. AMPP injections are minimally invasive and are carried out under ultrasound guidance. Altogether the procedure takes about an hour to perform with a minimal recovery time of around three hours. As well as being a potential alternative to surgery, AMPP can also aid post-surgery recovery.
Depending on the cause, your knee may hurt in different places with pain ranging from mild to severe. Other warning signs include:
• stiffness and swelling
• warmth and redness
• not being able to put weight on your knee
• pain when straightening your leg
• a crunching or popping sound when you flex the joint.
Your knee is the largest joint in your body. As well as carrying your weight, it can twist and rotate as well as bend With so many moving parts – muscles, bones, tendons, ligaments and cartilage – there can be many potential issues.
One of the first steps in working out the cause is to find out if there has been an injury as this can be fairly easily diagnosed. Damage deeper inside the knee may need further tests, such as an x-ray or an MRI scan, to pinpoint the problem and how it should be treated.
Different types of knee injury include:
• Sprains and strains
If you have some tenderness, swelling or bruising around your knee, have trouble putting weight on that leg or are experiencing muscle spasms or cramps, it’s likely to be a sprain or strain.
• Ligament injury
The ACL – or anterior cruciate ligament – is one of four main ligaments in your knee, and people playing any sport that needs frequent, sudden changes in direction are particularly at risk of an ACL injury. These can vary from sprains to tearing, and when it happens you might hear a popping noise and feel your knee buckle.
Inside your knee is a pair of tough, flexible cartilage wedges between your shinbone and thighbone – this ‘shock absorber’ is your meniscus. If you suddenly twist your knee and feel a pop, it could be a torn meniscus. Unlike an ACL injury most people can still walk on their injured knee, but over a few days it will grow stiffer and more swollen.
There are three bursa – small, liquid-filled sacs – inside your knee that help the joint move smoothly. Some knee injuries can cause these sacs to become inflamed and sore, which is known as bursitis.
The patellar tendon is the tough, fibrous cord that links your kneecap – your patella – to the top of your shinbone. If it becomes inflamed, for example during repeated movements in sport or exercise, it can result in a burning sensation at the base of the kneecap, which can become worse over time if not treated.
Properly called patellofemoral syndrome, this is when your kneecap rubs against the top of your thighbone. It could be triggered by injury, too much exercise or the way you walk or run. As well as pain and tenderness around the kneecap, you might also hear a clicking or popping sound as you flex your leg.
Your hamstring is the muscle running down the back of your thigh, and when the tendons connecting it to your thighbone get injured, it can cause pain, either deep inside the hip and buttocks, or in the back of the knee. A fairly common sport-related injury, it can also cause stiffness that gets worse after resting following exercise.
There are three bones in your knee – the thighbone, shinbone and kneecap – and any of these could break in an accident or fall. If it hurts to touch, you have trouble bending that leg and the pain gets worse when you move, it could mean there’s a fracture.
If you have knee pain but haven’t suffered a recent injury, our specialist will investigate whether it could be caused by other medical problems. Finding out when the pain occurs, what brings it on, what helps ease it and if it also results in swelling, heat or redness will all help diagnose the issue.
Usually you feel pain when nerves are irritated. When tissues without nerves (such as cartilage in joints) are affected, you might only feel pain once tissues containing the nerve fibres become involved – like those surrounding your knee. This is why arthritis may show up on x-rays and MRI scan images before you actually feel pain, and your condition can be quite advanced by the time you consult a doctor.
Medical conditions that cause knee pain include:
This is the most common form of arthritis and happens when cartilage, the rubbery padding that protects the ends of bones, wears out in your knee over time, which means it most often affects us as we get older. It can affect people differently, with some just feeling minor discomfort while others have trouble doing day-to-day tasks. As well as joint pain and stiffness, osteoarthritis can cause swelling, tenderness and a gritty, rasping feeling in your knee.
A popliteal cyst, to give it its medical name, is a fluid-filled cyst or swelling that forms behind your knee, making it feel stiff and tight. It usually develops because of another problem in your knee, for example arthritis or a cartilage tear, and treating these normally resolves the issue.
Gout can be extremely painful and affects around two per cent of people in the UK. Caused by a build-up of small crystals around your knee joint, it leads to sudden, pain and swelling with the skin around the area becoming hot to the touch.
• Septic arthritis
Septic arthritis is rare. It is caused by an infection and is often accompanied by a fever. Any joint can be affected, but it’s most common in the knee and hip. As well as pain, your knee becomes swollen and red, with the symptoms often coming on quickly. Because septic arthritis can cause permanent damage or even become life-threatening if untreated, it’s important to seek medical attention straight away if you have any of the symptoms.
Treatment for knee conditions such as osteoarthritis is usually initially aimed at relieving pain and involves anti-inflammatory medication, low-impact exercise, walking aids and weight loss, sometimes under the guidance of a physiotherapist.
If the first-step approaches don’t help, or a specialist has advised your condition requires more in-depth treatment, there are several options to treat knee pain that don’t involve surgery.
Our expert team specialises in treating knee pain using advanced non-surgical techniques including stem cell therapy, AMPP® Activated Mesenchymal Pericyte Plasma (using Lipogems® technology) and Platelet Rich Plasma (PRP) therapy.
They are minimally invasive, can decrease inflammation, stop the progression of arthritic damage and may repair joint cartilage. The recovery time is also much shorter than with surgery.
Following these treatments, patients are often encouraged to walk the same day and quickly return to normal activity without having to go through the risks associated with surgery.
Known as an arthroplasty, surgery to replace a knee with an artificial joint is most common for people between 60 to 80. It’s usually carried out when the joint is so worn or damaged it is restricting mobility and causing pain even when you are not moving. Depending on your knee’s condition, either a full or partial replacement – involving only one side of the joint – may be performed.
Less commonly, some patients are suitable for a lower impact surgery called high tibial osteotomy, which reduces pain in your knee by realigning the leg so that there is less pressure on the affected part.
Although it is common – around 100,000 knee replacements are performed each year in England and Wales – it is still a major operation that takes a long time to fully recover from. For that reason, it’s usually only recommended if alternative treatments have not worked.
The current advice is also to put off joint replacement until you’re at least 65, in order to lower the risk of the implant needing to be replaced – or at the very least only be replaced once. For most people, an artificial knee will last for around 20 years.
Our innovative range of treatments goes beyond what’s available on the NHS. As well as providing a full opinion on your condition that includes all the traditional non-surgical and surgical options, our experienced consultants will also assess your suitability for our alternative biological therapies, Platelet Rich Plasma (PRP) and Activated Mesenchymal Pericyte Plasma (AMPP).
Your consultation will be with one of our knee specialists, Professor Wilson, Mr. Sam Heaton, Mr. Jamie Arbuthnot, Mr. Arj Imbuldeniya, Mr. Rohit Jain, Mr. Ed Britton or Mr. Amit Kumar and will last approximately 30 minutes.
During the consultation, they will:
• discuss your medical history to find out more about your symptoms
• examine the joint and identify the source of the pain and any mobility issues
• arrange for a diagnostic investigation, usually an MRI scan
• discuss all the treatment options with you, along with their potential benefits and any risks.
Our expert team comprises of highly experienced surgeons, sports medicine doctors and physiotherapists who are committed to delivering a high level of care and the correct treatment option so you can quickly get back to moving around. Whether you need conventional treatment or if you are a candidate for our regenerative treatments, you can be sure that you will get the best advice.
Autologous means ‘from the same person’ rather than from a donor. Essentially, your own cells are used to encourage healing. With this type of treatment, there’s a dramatic reduction in the risks of the rejection, infection or contamination that come with using material from someone else. The innovative therapies we offer are based on this idea. If you’ve found traditional treatments aren’t helping your pain, of if you’re looking for a possible alternative to surgery, then this approach is one to consider.
Biological treatments are pioneering procedures and we’re continuously monitoring and recording its effectiveness. Patients undertaking these treatments are asked to complete pre-operative and post-operative questionnaires.
The information obtained from these questionnaires allows us to monitor your progress and it also contributes to our evidence-based database and other global studies on biological treatments. All information gathered is anonymised.