What to expect from The Chandler Knee Ledger

What to know about the medical information

The medical facts come from the research listed on each page. The guide doesn't promise that one treatment will work for everyone. Results can differ, even when two knees seem much alike. The exam, X-ray, medicines, and other health concerns can change which care is safe or useful. A doctor can weigh all of that after examining the knee.

Use the guide to form questions, not to name the cause yourself.

What to know about who runs this guide

The Chandler Knee Ledger is operated by the owners of the QC Kinetix Phoenix-area clinics. That relationship is stated plainly because the site recommends one of those clinics and the owners may benefit when a reader books. This guide gives general facts about knee soreness and care without surgery. It doesn't take the place of a hands-on knee exam.

When to use a doctor instead of this site

A doctor can test knee movement and steadiness, then check for swelling or weakness. Get help promptly if a fever comes along with heat, redness, and swelling around the knee. An injury needs urgent care when the leg buckles under you as you stand. Get quick care for a locked knee, new numbness, new weakness, or a cold foot. For a routine visit, take medicine names, old records, and notes about painful tasks. The medical provider is a licensed member of the clinic staff who looks after you.

The QC Kinetix Chandler clinic offers regenerative treatments, including platelet-rich plasma, or PRP, prepared after staff take your blood and use a spinning machine to separate the platelets before knee placement.

Sources

1. A systematic review and meta-analysis of 89,996 patients (60.6% female, mean age 67.4) awaiting primary elective total hip or knee replacement found a significant deterioration in joint function (mean difference 0.0575% per additional day of waiting, 95% CI 0.0064 to 0.1086, p=0.028) and in health-related quality of life per additional day of waiting. Meta-analysis could not detect a relationship with post-operative outcomes, and patient responses to delayed surgery were unanimously negative.

   Cooper GM, Bayram JM, Clement ND. — The functional and psychological impact of delayed hip and knee arthroplasty: a systematic review and meta-analysis of 89,996 patients.. Scientific Reports, 2024. DOI: 10.1038/s41598-024-58050-6.

2. In the only randomised controlled trial to compare total knee replacement directly with non-surgical treatment in patients already eligible for surgery (n=100), the replacement group improved more at 12 months than the non-surgical group (KOOS4 32.5 vs 16.0; adjusted mean difference 15.8, 95% CI 10.0 to 21.5) but had four times the serious adverse events (24 vs 6, P=0.005). Only 13 of 50 patients (26%) assigned to non-surgical treatment alone had undergone knee replacement by 12 months.

   Skou ST, Roos EM, Laursen MB, et al. — A Randomized, Controlled Trial of Total Knee Replacement.. New England Journal of Medicine, 2015. DOI: 10.1056/NEJMoa1505467.

3. OARSI 2019 designates arthritis education plus structured land-based exercise (with or without dietary weight management) as CORE treatments for knee OA, and education plus structured land-based exercise as core for hip and polyarticular OA. Topical NSAIDs are strongly recommended for knee OA (Level 1A). Intra-articular corticosteroids and hyaluronic acid are Level 1B/2 for knee OA depending on comorbidity and are NOT recommended for hip or polyarticular OA. Oral NSAIDs are not recommended for people with cardiovascular comorbidity or frailty, and oral and transdermal opioids are strongly not recommended (Level 5).

   Bannuru RR, Osani MC, Vaysbrot EE, et al. — OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis.. Osteoarthritis and Cartilage, 2019. DOI: 10.1016/j.joca.2019.06.011.

4. A systematic search of population studies found the proportion of people with knee pain who have radiographic osteoarthritis ranges from 15% to 76%, and the proportion of people with radiographic knee OA who have pain ranges from 15% to 81%. The authors conclude that knee x-ray results 'should not be used in isolation when assessing individual patients with knee pain'.

   Bedson J, Croft PR. — The discordance between clinical and radiographic knee osteoarthritis: a systematic search and summary of the literature.. BMC Musculoskeletal Disorders, 2008. DOI: 10.1186/1471-2474-9-116.