Dr. Cabot is an orthopedic surgeon with special dedication to knee pathology. He has been president of the Spanish Knee Society and the Spanish Arthroscopy Association. He dedicated his doctoral thesis to arthroscopy and anterior cruciate ligament. He directs the cota knee unit at Hospital Quirón Barcelona and the knee unit at Bellvitge Hospital from where numerous courses have been organized in the last 20 years, dedicated to knee pathology.
Doctor, my knee hurts, what should I do?
The first thing to do is to go to a specialist and better if it is a “knee specialist”.
Any particular details?
Yes: to reach a precise diagnosis. The most important thing is the visit and the clinical examination.
No: to be treated without diagnosis or necessary complementary tests.
What treatments can be applied?
Yes: first conservative non-surgical treatment, then arthroscopy, and finally conventional surgery.
No: “chasing flies with cannons”. Minimal risk treatments can be effective.
When is it necessary to resort to surgery in osteoarthritis of the knee?
Yes: the critical condition for surgery is the correct indication: pain and progressive functional limitation that does not improve with non-surgical treatments. The most frequent surgery is arthroplasty or prosthesis.
Is prosthetic surgery safe?
Yes: prosthetic knee surgery should provide high guarantees (more than 85%). Information from the physician to the patient is fundamental.
Who can operate on me?
Yes: the surgeon should preferably be an expert in the technique to be performed. It is recommended to come from the knee units of the hospitals.
Are there any special treatments when the previous ones fail?
Yes: Regenerative treatments with growth factors such as platelet-rich plasma or stem cells from bone marrow, best by means of ultrasound-guided infiltrations. The results are good in 60-80% of osteoarthritis of the knee.
Is there scientific evidence on the good results of these techniques?
Yes: there are recent clinical trials of evidence 1 (the highest).
Are there any problems pending solution in knee pathology?
Yes: I would highlight two: chondropathy of the patella and painful prosthesis.
Are these problems discussed at your scientific meetings?
Yes: next November we are organizing at Bellvitge hospital the X Barcelona knee pathology conference, dedicated to these issues.