Knee pain can be relentless. While you may first feel it when you move, knee pain can eventually affect you while at rest too.
At New Hampshire Orthopaedic Center (NHOC), we can help restore your quality of life with effective knee pain treatments. Our knee specialists offer the latest therapies and a compassionate bedside manner. They’re focused on getting you back to doing the things you love — pain-free.
Comprehensive Knee Care in New Hampshire
Our knee doctors have decades of experience helping people get rid of knee pain. We help thousands of people improve their quality of life each year.
We offer knee pain treatments in four locations across New Hampshire: Nashua, Bedford and Londonderry. Simply choose the office location most convenient for you or the provider you prefer. When you come to us for care, you experience:
- Skilled knee doctors: Our knee team includes experts who are among New Hampshire’s top doctors, as voted by New Hampshire Magazine. They specialize in some of the most complex knee surgeries available, like ACL repair or reconstruction and knee revision surgeries (surgeries that fix previous surgeries). Our knee specialists have all completed the highest level of training in their field (fellowship training). They use this expertise to deliver excellent results.
- Complete care: We care for all your orthopedic needs in one place — from MRIs and knee braces to knee injections and surgery. You receive the highest level of care without having to cross the Massachusetts border.
- Exceptional care for high school athletes: High school athletes should get care from doctors who understand their still-developing muscles and bones. Our fellowship-trained sports medicine doctors oversee the health of student-athletes across New Hampshire — both on and off the field. They work closely with school athletic trainers to ensure teens have the safest sports experiences possible. And when injuries do happen, they offer special expertise in improving outcomes for this age group.
- Team-based care: Our knee doctors regularly discuss patients and treatment plans together. This collaboration means you get care that considers every possible option and the latest advances.
- Advanced treatments: Our patients are usually among the first in New Hampshire to benefit from new technologies and therapies, such as cold laser therapy.
Understanding Your Knee
The knee is the largest joint in your body. It is made up of:
- Bones: You knee joint is located where the thighbone (femur) and shinbone (tibia) come together. The kneecap (patella) is like a shield for the knee joint.
- Cartilage: Your knee has two types of cartilage: articular cartilage and the meniscus. Articular cartilage pads the ends of the thighbone and shinbone and the back of the kneecap. It reduces the friction between these bones as you move your knee. The meniscus is a C-shaped pad of cartilage located between the thighbone and shinbone. Each knee has two menisci. They help cushion the knee and keep it stable. The meniscus is more likely to tear than articular cartilage.
- Ligaments: The ligaments are bands of tissue that connect the bones. People most often injure the anterior cruciate ligament (ACL) and medial collateral ligament (MCL).
- Tendons: Tendons connect your bones and muscles together.
Diagnosing Knee Pain
Not all knee pain comes from an injury. That’s why your doctor will carefully listen as you describe your symptoms and how they affect your activities. Your doctor will also ask follow-up questions to get to the source of the pain. Listening is one of the most important diagnostic tools we have.
Your knee doctor will also perform a physical exam and review your medical history. You’ll get an X-ray of your knee here in our office, if needed. X-rays help us narrow down the cause of the knee pain.
We also provide MRI services in both Nashua and Bedford. MRIs show detailed pictures of the inside of your knee using painless magnetic fields and radiofrequencies.
Once we understand the cause of your symptoms, we can identify the best treatment options for you. At NHOC, your preferences matter. For example, while you may benefit from surgery, you can opt for a less invasive knee treatment.
Our doctors support your decisions because you know your body best. The best outcomes happen when patients feel comfortable with their knee treatment.
Nonsurgical Knee Pain Treatments
Many people find relief through nonsurgical knee pain treatments. We make sure you understand your options, so you can choose the one that’s best for you. And if you’re not getting the results you want, we’ll change course so you can.
We provide the full range of nonsurgical knee treatments, including:
- Activity modification: Activity modification involves changing how you perform activities to give your knee time to rest and heal. It can also prevent future knee problems. Our knee doctors’ recommendations help you minimize discomfort, so you can keep doing or return to the activities you love.
- Physical therapy: Physical therapy can help with pain, performance and balance. It can also help you maintain your independence. You’ll find physical therapy services conveniently located in our Nashua and Bedford facilities. Learn more about our physical and occupational therapy services.
- Knee braces: Knee braces help stabilize your knee. They also protect your knee so it can heal.
- Medicine: Anti-inflammatory medications like ibuprofen can help reduce knee swelling and pain. We can also prescribe stronger anti-inflammatories if over-the-counter ones don’t help.
- Cold laser therapy (low level laser therapy): Cold laser therapy treats knee pain and inflammation without medication. During this therapy, your provider holds a device on or over the affected area. It takes a few minutes or less to pass the light energy into your knee. The light energy stimulates healing in your tissues and reduces inflammation. There is no pain or recovery time. Learn more about cold laser therapy.
- Injections: We offer different types of knee injections, depending on the cause of the knee pain. These injections include cortisone shots, platelet-rich plasma injections and knee gel injections (viscosupplementation).
- iovera° treatment: iovera° uses extreme cold to target the nerves and block pain (cryotherapy). It offers immediate, long-lasting nonopioid pain relief in less than an hour. Learn more about iovera° cryotherapy.
Knee surgery can provide knee pain relief when nonsurgical options don’t help or the condition worsens. Your doctor will explain which surgery is best for your situation. Our knee surgeons perform all types of knee surgeries, including:
- ACL surgery
- Arthroscopic knee surgery
- Cartilage restoration surgery
- Patellar instability surgery
- Total or partial knee replacement surgery
You may need ACL surgery if you have a partial, near complete or complete ACL tear. Our fellowship-trained sports medicine doctors specialize in ACL surgery for teens and adults. They offer the latest techniques and advanced skill to achieve excellent results for patients, including harder-to-treat high school athletes.
We either repair or replace (ACL reconstruction) your ACL during surgery. ACL reconstruction replaces the damaged ACL with a new ligament (graft). We improve your results by choosing the best graft for you:
- Autograft: Autografts come from your own body. We offer autografts from three sources: your patellar tendon, hamstring tendon or quadriceps tendon. The quadriceps tendon — the newest option — offers a lower risk for complications and less pain than other types. Autografts often provide better outcomes for athletes under 40.
- Allograft: Allografts come from deceased donors. ACL surgery using an allograft tends to involve smaller incisions, less pain and shorter surgery times.
Our knee surgeons time your procedure to give you the best results. It’s important to wait at least four weeks after the injury before surgery. Waiting allows time for the swelling to subside so that surgery doesn’t worsen your knee injury.
P.R.O.S. Post-ACL Reconstruction Strength and Conditioning Program
Once you’ve torn your ACL, it’s more likely to tear again. Our P.R.O.S. (post-rehabilitation orthopedic services) Post-ACL Reconstruction Strength and Conditioning Program helps lower this risk. The program is conveniently located at:
P.R.O.S. is for athletes five to six months after ACL reconstruction. We tailor return-to-sport plans to help athletes safely return to sport at their previous performance levels.
For more information about P.R.O.S., please email us.
Arthroscopic Knee Surgery
Arthroscopic knee surgery allows knee surgeons to diagnose and repair knee problems through small incisions. Compared to more invasive open knee surgery, patients often experience:
- Less pain and knee stiffness
- Less scarring
- Quicker return to activities
- Shorter recovery times
To perform arthroscopic knee surgery, your surgeon:
- Makes two tiny incisions in the knee
- Inserts an arthroscope (a pencil-sized instrument equipped with a special camera) into your knee joint
- Uses the real-time images that come from the arthroscope to see inside the knee
- Fixes the knee joint with miniature surgical instruments
Meniscus surgery is one of the most common reasons people have arthroscopic knee surgery. To repair the meniscus, your surgeon either:
- Removes the damaged part of the meniscus
- Repairs the meniscus by stitching the torn edges together
The cause of the knee pain — arthritis or structural damage — helps your surgeon predict which approach will give you the best results. It’s not unusual to have both a meniscus and ACL tear. In those cases, our doctors have the expertise to fix both during one surgery.
Cartilage restoration procedures treat articular cartilage defects caused by knee injuries. Think of them like potholes that need to be repaved.
There are several kinds of cartilage restoration procedures. Surgeons repair the defects during one surgery or two surgeries several weeks apart. To heal the defect, they may use:
- Cartilage-making cells from your knee
- A piece of healthy cartilage and bone from your knee
- A piece of healthy cartilage and bone from a donor
Patellar Instability Surgery
The kneecap sits in a groove between your thighbone and shinbone. Ligaments hold it in place. The medial patellofemoral ligament (MPFL) holds the kneecap in place at the bottom of the thighbone.
When you dislocate your kneecap, it moves out of position. This movement may cause the MPFL to stretch or tear, creating patellar instability.
Trauma, such as a sports injury, can dislocate the kneecap. It can also dislocate if you have misaligned kneecaps resulting in “knock knees,” or a bone abnormality within the knee joint. If you dislocate your kneecap more than once, you may need patellar instability surgery (ligament reconstruction surgery).
During the procedure, your knee surgeon creates a new MPFL from part of your hamstring tendon (autograft) or a donor tendon (allograft). The surgeon may also perform an osteotomy to correct the alignment of your kneecap. An osteotomy involves cutting the shinbone where the patellar tendon attaches and moving it to realign the kneecap.
Total or Partial Knee Replacement Surgery
We offer multiple options for knee replacement surgery, including:
- Total knee replacement surgery: During total knee replacement surgery, your knee replacement surgeon replaces the entire joint with an artificial one. Your new joint is made of metal and plastic implants that smoothly glide against each another. This movement copies the natural motion of your knee. You might benefit from a total knee replacement if you have severe knee pain or stiffness caused by arthritis.
- Partial (unicompartmental) knee replacement surgery: During a partial knee replacement surgery, your surgeon replaces part of the joint with metal and plastic parts. You may benefit from partial knee replacement if only part of your joint is damaged. Partial knee replacements offer smaller incisions, less pain as you heal and a faster recovery. But you may eventually need another surgery if you develop arthritis in other parts of your knee.
- Robotic-assisted knee replacement surgery: During robotic-assisted surgery, your knee replacement surgeon uses advanced 3D imaging to plan your procedure ahead of time. With the help of special software, your surgeon can also position your new knee components more accurately. Patients benefit by experiencing less pain and blood loss after surgery. Learn more about Mako robotic-arm assisted knee replacement.
- Revision knee replacement surgery: At NHOC, we specialize in revision knee replacement surgery. We can repair even the most complex issues, including infections, failing knee replacements and fractures. We take extra time to explain what to expect and answer your questions so you can feel comfortable before surgery.
Contact Us About Hip Care
For questions about our hip program, or to make an appointment with one of our hip specialists, call or text 603.883.0091.