Omaha Knee Care Clinic FAQ – Dr. Chris Driscol

Knee Pain Care – Frequently Asked Questions

  1. Do I need a referral?

    1. You are free to just call and make an appointment anytime without a referral.
  2. Does insurance cover your treatments?

    1. We accept all major insurance as well as Medicare. We also accept Tricare, but only if it is secondary. However, be sure to bring your insurance card with you to your FREE consultation and we will do a complimentary check to see if your specific plan is covered.
  3. My doctor said that I’m bone-on-bone. Can you still help me?

    1. That depends. There are 2 things to consider:
            1. Was the diagnosis was correct? I have lost count on the number of times that we have heard that a patient was bone-on-bone only to find out after taking x-rays that they were not. MOST of the time, the patient was NOT bone-on-bone. This term is often used as a guess or because the patient’s condition was really bad, but not actually bone-on-bone, but the doctor was trying to convey the idea that there is not much “cushion” left in the joint
            2. If you are actually bone-on-bone, that still does not mean that we cannot help. We have treated many patients who were bone-on-bone and still got a lot of relief and were able to post-pone surgery. So, even if you are bone-on-bone, we still may be able to help.
  4. What do actually do to help knees?

    1. We provide several options:
            1. Corticosteroids. This is an option that we try to avoid but may be necessary if there is severe pain and inflammation
            2. PRP (Platelet Rich Plasma)
            3. Pain Meds (we also try to avoid this and reserve prescribing only to the most severe cases)
            4. Home Rehab exercises
            5. Radio wave therapy
            6. Electrotherapy
            7. Laser Therapy
            8. Hyaluronic Acid
  5. What are the benefits of Hyaluronic Acid?

    1. There is a lot of research that shows that hyaluronic acid knee injections may work several ways to reduce symptoms of osteoarthritis and improve the health of the knee. Your knee already has hyaluronic acid contained in a sack that surrounds, binds, and protects the knee. It serves as an kind of a built-in brace. But, as we age and as the knee takes on more and more traumas over the years, the cartilage that is responsible for producing the hyaluronic acid, makes less and less of this protective oil and, the oil that it does make, also decreases in quality. So, both the quantity and quality of this lubricant goes down as the years go by and we get older. The great thing about hyaluronic acid is that, when we inject it back into the knee where it is supposed to be, it stimulates the existing cartilage to actually start producing more
    2. Here are just some of the benefits of Hyaluronic Acid knee injections, according to both research and patient experience:
            1. Reduces knee pain
            2. Reduces inflammation/swelling
            3. Reduces friction
            4. Reduces stiffness
            5. Reduces/Slows degeneration
            6. Prevents loss of cartilage and bone
            7. Stimulates new cartilage, bone, and surrounding tissues
            8. Increases lubrication
            9. Increases shock absorption
            10. Works like a protective, liquid “sponge” between the thigh (femur) and leg (tibia) bones to keep the knee bones from knocking and grinding together
  6. I’ve had HA injections before, and they didn’t help. Why should I bother coming to you?

      1. They may have missed the spot. Many clinics use poor (ultrasound) or no visual aids when injecting the knee, essentially, injecting into the joint blind. The problems is, without the use of a good visual aid (fluoroscopy), it is easier to miss the sack, where the hyaluronic acid is actually stored. If the sack is missed, the hyaluronic acid cannot reach the actual area that was injured, and the body simply reabsorbs the acid. This is kind of like pouring oil over the engine of your car and not actually putting it into the hole.
      2. Each injection builds on the last. The more injections you have, the more likely the results. If there is a lot of damage to the joint, you may need more than one session. Insurance companies are aware of this and will cover new injections every 6 months.
      3. We use actual hyaluronic acid rather than artificial (aka: the chicken shot or the rooster shot), which are derived from avian products and are more likely to produce an allergic reaction.
  7. What is Fluoroscopy and why do you need it?

      1. Fluoroscopy is, basically, a high-tech video x-ray. It is, by far, the best, most advanced visual aid for this type of treatment. It helps us see clearly inside the joint in real-time and makes certain that we don’t miss the injured area and waste your visit.
  8. How long does each treatment take?

      1. Each treatment, on average, takes less than 30 minutes.
  9. Is there any downtime?

      1. You can go back to normal daily activities immediately after treatment, but we do recommend that you take it easy. This is probably not the time to hire a moving truck or take on hard labor.
  10. Are there any side-effects to hyaluronic acid?

      1. Since your body already produces hyaluronic acid, for the most part, no. You may have some mild, temporary tenderness, swelling, redness or bruising at the sight, but these are uncommon
  11. How long do the treatments last?

    1. How long treatments last varies quite a bit with each patient. We have some cases where we’ve treated them, the pain is completely gone, and we’ve never seen them again. We have others who may need treatment every 6 months. The reason why it varies so much is simply because everybody is different.
        1. Age
        2. Weight
        3. Previous Injuries
        4. Previous surgeries
        5. Previous Care
        6. How much degeneration is in the joint
        7. How long you’ve had the pain
        8. What you eat
        9. What you drink
        10. If you smoke or have a history of smoking
        11. If you have other disease processes (especially diabetes), autoimmune conditions, sicknesses, history of drugs, what drugs you are currently taking
        12. How well you take care of yourself (before and after treatment)
        13. Exercise vs no exercise, what types of exercise, how long you exercise, how aggressive you exercise
        14. Genetics

Surgery is no different

Any medical treatment you get of any kind will share these same factors- some of these factors will influence your outcome more than others, so you want to eliminate as many things as will hinder the healing process as you can

So, there are a lot of factors that can affect your results. But, in general, most patients do very well and this can easily last for several years

So, I hope that answers most, if not all of your questions, and I will see you in the office