The knee is the largest joint in the body and one of the most frequently injured. It handles enormous forces with every step, especially going up and down stairs, squatting, and getting in and out of chairs. When the knee hurts, it affects nearly everything you do.
Knee pain has many causes. Some are straightforward and respond well to simple treatments. Others indicate structural damage that may eventually require surgery. The first step is an accurate diagnosis.
Dr. Leo Zalikha specializes in evaluating and treating knee conditions in adults, with particular expertise in knee arthritis, knee replacement, and knee injections.
Knee osteoarthritis is the most common cause of chronic knee pain in adults over 50. The cartilage that cushions the joint surfaces wears down gradually, leading to bone-on-bone contact. Symptoms include pain with activity (especially stairs and prolonged walking), stiffness after sitting, swelling, and a grinding or crunching sensation. Osteoarthritis is the primary reason people undergo knee replacement surgery.
The menisci are C-shaped pads of cartilage that act as shock absorbers between the thighbone and shinbone. They can tear from an acute injury (twisting the knee) or from degenerative wear over time. Symptoms include pain along the joint line, swelling, catching or locking, and difficulty fully straightening the knee. Degenerative meniscus tears in arthritic knees are common and often managed nonsurgically.
The knee's stability depends on four major ligaments: the ACL, PCL, MCL, and LCL. Injuries to these structures typically occur during sports or trauma. Ligament injuries cause instability (the knee "giving way"), swelling, and pain. While Dr. Zalikha's practice focuses on joint replacement and arthritis care, he evaluates ligament injuries and coordinates appropriate referrals when needed.
Pain in the front of the knee, around or behind the kneecap, is common and often related to how the kneecap tracks in its groove during bending. It tends to worsen with stairs, squatting, and prolonged sitting. Physical therapy focused on quadriceps strengthening and patellar tracking is the primary treatment.
Several bursae (fluid-filled sacs) around the knee can become inflamed from overuse, kneeling, or irritation. Bursitis causes localized swelling and tenderness, typically on the front or inner side of the knee. It is usually self-limiting and responds to rest, ice, and anti-inflammatory medications.
Knee pain is not always caused by a knee problem. Hip arthritis, in particular, commonly refers pain to the knee. A careful examination of both joints is important to avoid treating the wrong problem.
You should consider an evaluation if:
Further reading: 5 signs you need to see a knee replacement surgeon
The majority of knee conditions are initially managed with non-surgical treatment options. Dr. Zalikha’s approach starts with conservative care whenever appropriate.
Strengthening the muscles around the knee (particularly the quadriceps) is one of the most effective treatments for many knee conditions. A targeted therapy program can reduce pain, improve stability, and delay or prevent the need for surgery.
NSAIDs (ibuprofen, naproxen) reduce pain and swelling. Topical anti-inflammatory creams can also be effective.
Unloader braces can shift weight away from the arthritic compartment of the knee.
Every pound of body weight translates to roughly three to five pounds of force across the knee joint. Weight loss significantly reduces knee stress.
Switching from high-impact to low-impact activities (swimming, cycling, elliptical) can reduce symptoms while maintaining fitness.
When conservative treatment has been adequately tried and the knee remains painful and limiting, surgery may be the right next step.
For knees with widespread arthritis affecting multiple compartments.
For knees with arthritis limited to one compartment, preserving healthy bone and ligaments.
Dr. Zalikha uses robotic technology for both total and partial knee replacements to optimize implant positioning.
The choice between total and partial replacement depends on the pattern of arthritis, the condition of the ligaments, and the patient's anatomy. Dr. Zalikha evaluates each knee individually and recommends the procedure that best fits the situation.
Your first visit includes a conversation about your symptoms (when they started, what makes them better or worse, what treatments you have tried), a physical examination of both knees (and often the hips), and X-rays taken in the office if you do not have recent ones.
Dr. Zalikha will explain the diagnosis, discuss the options, and develop a treatment plan with you. For many patients, that plan starts with nonsurgical care.
Don’t let knee pain keep you from the activities you enjoy. Schedule a consultation with Dr. Zalikha or call (562) 362-5024. For patients outside the area, a Virtual Second Opinion is available.
