Knee pain in adults over 45 is most often osteoarthritis — gradual wear of the cartilage that cushions the joint. Replacement is the right answer only when the joint has worn to bone on bone and daily life is limited. Before that, ultrasound-guided injections, PRP and radiofrequency of the knee’s pain nerves relieve most patients as day-care procedures.
The knee carries the body’s weight through a thin layer of cartilage, two shock-absorbing menisci and four stabilising ligaments. Cartilage wears with age, weight and old injury; menisci fray; tendons around the knee overload; and the lining produces fluid when irritated. Pain in osteoarthritis is carried by small genicular nerves that can be identified and treated.
Examination of alignment, swelling, stability and the patellar tendon; ultrasound for fluid, cysts, tendons, menisci and to guide injections; a standing X-ray to grade arthritis; MRI when a ligament or meniscal tear needs confirmation.
Conditions treated
Cartilage wear graded mild to severe on X-ray. Mild to moderate: ultrasound-guided injection — hyaluronic acid or PRP — with strengthening and weight management; steroid for acute flares. Moderate to severe pain: genicular nerve block, then radiofrequency ablation for relief lasting many months. Regenerative injection (BMAC or SVF) is considered in selected patients. Replacement is discussed when bone-on-bone change limits walking and sleep despite these.
Degenerative tears in adults over 40 are part of arthritis and rarely need arthroscopy; they are treated with injection and rehabilitation. Traumatic tears in younger patients, with locking or a knee that will not straighten, are referred for arthroscopic repair.
Sprains and partial tears are treated with bracing, rehabilitation and ultrasound-guided PRP to support healing. A complete ACL tear in an active person usually needs reconstruction; Dr. Kiruthika refers these.
Pain at the front of the knee below the kneecap, in jumpers, runners and squatters. Loading programme first; ultrasound-guided PRP for persistent cases. Steroid is avoided in this tendon.
Aching behind or around the kneecap on stairs and after sitting, from tracking and muscle imbalance. Rehabilitation is the main treatment; injection for associated inflammation.
A fluid swelling behind the knee, usually from arthritis or a meniscal problem inside the joint. Ultrasound-guided aspiration and injection, and treatment of the underlying joint.
Pain on the inner knee below the joint line where three tendons attach, common in arthritis and in runners. Ultrasound-guided injection.
Persistent pain after a well-fixed, uninfected replacement, confirmed with the surgeon. Genicular nerve block and radiofrequency ablation help many of these patients.
Injections take fifteen to twenty minutes; PRP about forty-five including the blood draw; radiofrequency thirty to forty-five minutes under local anaesthesia with light sedation if needed. Walk out the same day.
Many patients with moderate arthritis manage well for years with injections, radiofrequency and strengthening. Bone-on-bone arthritis with disability is a surgical problem.
Both help mild to moderate arthritis. PRP tends to last longer; hyaluronic acid is quicker to act. The choice depends on grade, age and cost.
Commonly six to twelve months, sometimes longer. It can be repeated.
No. BMAC and SVF aim to reduce pain and improve function; the evidence is developing and results vary. They are offered to selected patients with clear expectations.
No. Loss of muscle worsens knee pain. Walking, cycling and swimming are encouraged within comfort.
Precise injections into joints, tendons, bursae and around nerves — no blind injections.
Your own platelets, placed precisely into the joint or tendon under ultrasound.
Bone marrow concentrate for disc degeneration and tendon tears.
Adipose-derived cells for knee osteoarthritis and ligament injury.