The question is whether the pain you are experiencing in the knee is due to ongoing inflamnmation or due to severe destruction in the absence of inflammation. Since some patients may have both inflammation and destructioon at the same time, it is often difficult to figure out. If the predominant problem is destruction, then surgery may be the best option.l However, if there is ongoing inflammation (evidenced by elevated ESR, other inflammed joints or inflammation in the joint fluid on examination) then a trial of more aggressive anti-inflammatory therapy might be useful. Discuss with your rheumatologist.
About Alan Matsumoto, M.D.
Part-time Faculty, Division of Rheumatology
Johns Hopkins University