Auto news on Youtube Oct 23 2018

Hi guys, Dr. Mackenzie here today, we're going to talk about one of the most common questions that we get in the office

I'd say we get this question at least once a day and that is what does bone-on-bone mean?

To put this in a little context most of our patients that come and see us have been to their doctor or surgeon

Who has taken some x-rays and told them, you're bone-on-bone

Your option is basically a knee replacement

Understandably most people don't want to go through that major surgery and the risks associated with it and the recovery.

So now we're going to look at what a normal knee looks like so we can understand what bone-on-bone means

So in a normal knee

we've got our meniscus which is the white part and that's what provides some separation between the bones and some shock absorption

Then we've got the blue part which is the cartilage which provides some lubrication and decreases the friction between the bones

To think of it in simple terms

It's kind of like the Teflon on your frying pan and allows things to slide around nice and easy. There's no friction.

So now that we know what a normal knee should look like now we're going to look at our arthritic knee.

So this is arthritic knee

So the first thing we notice is the size of that meniscus has decreased

dramatically, so there's less cushion and separation between the bones but there's still a separation and

Then the cartilage we can see the red that cartilage is worn away. So it's like someone's taken a metal

spatula and scraped off that Teflon coating on your knee joint

So now there's a lot of friction which really results inflammation and swelling. So this is what's going to be called bone on bone

Now that we know what the normal knee looks like

anatomically, we're gonna look at the x-rays and I'm gonna post this x-ray image at the end of the video so you can look at

It a little bit closer, so

The scale that we use to look at these goes from 1 through 4

1 being essentially a normal knee, four being the bone on bone idea.

so in the normal knee we will see a lot of separation on the outside and

the inside

Everything is nice and smooth and the joint is pretty straight up and down

as we move along

We're gonna get into this grade 3 and grade 4 and this is what's known as bone on bone.

Where the spacing typically on the inside part of the knee is decreased dramatically where it's almost touching but not quite.

The other thing that we'll see is some sharpening of the bone

which is called bone spurs.

now the really interesting thing and why patients ask us this all the time is I've seen anywhere from

Grade 2 through grade 4 be called bone on bone. And obviously there's a huge difference

in those grades.

The good news is even though you might be grade 4 and bone on bone

As long as you're still walking and able to walk a lot of the conservative treatments that we do can still have a positive impact

The two things that we really like for bone on bone knees are the viscosupplement injections

using a fluoroscope and that's like reapplying that Teflon

back into the knee joint and the fluoroscope is key to put it in the right spot.

Then the second thing that we really like to use in conjunction with that is class 4 laser

which is really effective at reducing the inflammation and pain

associated with this condition

I hope you found this useful

If this

sparked any questions, please get in contact with the office or send us a message through Facebook. If you have any friends

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Like I said

I'm going to post a picture of this x-ray so you can take a look at it at the end of the video.