Pain in knee might be due to hip

Dear Dr. Roach: I read your recent column about a person who had knee pain after a knee replacement. I am a retired orthopedic surgeon. I saw many patients who had this story in my career, and the first thing that comes to mind is that the patient was having referred pain to the knee from an arthritic hip joint.

Oftentimes, the surgeon who performed a painful knee replacement never X-rayed the hip or did a complete exam to look for a limited range of motion in the hip. The patient who has knee pain after a total knee replacement needs to have an examination and X-ray of the hip.

I saw more than a few patients who had surgery on their knee when it was their arthritic hip causing referred knee pain that was the real diagnosis. In this case, performing a total hip replacement may eliminate the pain completely. Gary Wolfgang, M.D., Retired Orthopedic Surgeon

Answer: I thank Dr. Wolfgang for writing. It isn’t that the knee doesn’t have any problems; it’s that there may be more than one cause for knee pain.

Dear Dr. Roach: I have just had my prostate gland surgically removed three weeks ago, and I am experiencing incontinence because of the surgery. I am worried that if I drink my usual amount of 8 glasses of water a day, like I did in the past, I will be inside the bathroom more than I am outside of it.

What is your opinion on this issue of not drinking enough water because of my fear of bathroom trips? Do you think I should just keep drinking water and not care about the trips to the bathrooms?

M.G.

Answer: Some degree of incontinence is extremely common after surgery for prostate cancer. But over time, most men regain much better control over their bladder function. The use of pelvic floor muscle training also speeds up the recovery of bladder control.

Most people don’t need 8 glasses a day; 4 is enough. Thirst remains an excellent guide of whether you need fluids or not.