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The Phoenix Joint Ledger
What waiting costs, and what it buys

The Phoenix Joint Ledger

When to get a sore joint checked now

Phoenix covers five hundred square miles and then some. A long drive can tempt you to delay an exam. Don't delay when symptoms change quickly. Some signs need urgent help close to home.

When to get same-day help

Go now for a joint that grows hot, red, and swollen while you have fever. That can be serious. After an injury, go promptly if the hurt leg won't hold you. Get help if the joint won't bend or straighten and stays stuck.

Other warning signs matter. New numbness or weakness needs urgent help when you also lose bladder or bowel control. After joint treatment or a long spell of little movement, a warm, red, swollen calf needs quick attention because it can mean a blood clot in a deep leg vein. These problems don't belong at a regular clinic visit.

Call for help if you're unsure where to go. Urgent care or an emergency department can direct you. The important part is being checked today. Waiting at home isn't safe.

When to book a regular joint exam

Arrange an exam when soreness cuts into normal life. Broken sleep, shorter walks, swelling, and less movement are good reasons. A steady decline over weeks deserves attention. Severe pain isn't required.

For ordinary soreness, QC Kinetix offers natural pain treatments prepared from your blood and given at its clinics after a medical provider examines the joint. Staff may call the choice PRP, meaning platelet-rich plasma. They draw your blood and spin it so one portion has more platelets. That prepared portion is placed into the sore joint through a needle.

Bring useful details. Note when soreness began, what sets it off, and what eases it. Take the X-ray and medicine list if you have them. That keeps the talk on your joint.

Sources

  1. The 2023 ACR/AAHKS timing guideline conditionally recommends AGAINST delaying hip or knee arthroplasty to pursue additional non-operative treatment - physical therapy, NSAIDs, ambulatory aids or intra-articular injections - in patients with moderate-to-severe osteoarthritis for whom non-operative therapy has already been ineffective and who have chosen surgery. It conditionally recommends delay for nicotine cessation and for better glycemic control in diabetes, states that obesity by itself is not a reason for delay while weight loss should be strongly encouraged, and conditionally recommends against delay in patients with severe deformity or bone loss. Evidence for all recommendations was graded low or very low quality.

    Hannon CP, Goodman SM, Austin MS, et al. — 2023 American College of Rheumatology and American Association of Hip and Knee Surgeons Clinical Practice Guideline for the Optimal Timing of Elective Hip or Knee Arthroplasty for Patients With Symptomatic Moderate-to-Severe Osteoarthritis or Advanced Symptomatic Osteonecrosis With Secondary Arthritis for Whom Nonoperative Therapy Is Ineffective.. Arthritis & Rheumatology, 2023. DOI: 10.1002/art.42630.

  2. Pooling the OAI and MOST cohorts (8,002 participants followed up to 8 years, 3,417 classifiable knees), validated appropriateness criteria classified only 290 knees (8%) as receiving a TIMELY total knee replacement, 2,833 knees (83%) as potentially appropriate but not replaced more than 2 years after replacement became appropriate, and 294 knees (9% of all knees, 26% of the 1,114 replacements actually performed) as PREMATURE. Of the potentially-appropriate-but-not-replaced knees, 1,204 (42.5%) had severe symptoms.

    Ghomrawi HMK, Mushlin AI, Kang R, et al. — Examining Timeliness of Total Knee Replacement Among Patients with Knee Osteoarthritis in the U.S.: Results from the OAI and MOST Longitudinal Cohorts.. Journal of Bone and Joint Surgery (American), 2020. DOI: 10.2106/JBJS.19.00432.

  3. In a prospective cohort of 134 patients on an Australian public orthopedic waiting list for hip or knee replacement, 69% waited at least 6 months (median 286 days, IQR 169-375). Health-related quality of life deteriorated overall during the wait (mean AQoL change -0.04, 95% CI -0.08 to -0.01), with 53% of participants experiencing a clinically important decline.

    Ackerman IN, Bennell KL, Osborne RH. — Decline in Health-Related Quality of Life reported by more than half of those waiting for joint replacement surgery: a prospective cohort study.. BMC Musculoskeletal Disorders, 2011. DOI: 10.1186/1471-2474-12-108.

  4. OARSI 2019 designates arthritis education plus structured land-based exercise (with or without dietary weight management) as CORE treatments for knee OA, and education plus structured land-based exercise as core for hip and polyarticular OA. Topical NSAIDs are strongly recommended for knee OA (Level 1A). Intra-articular corticosteroids and hyaluronic acid are Level 1B/2 for knee OA depending on comorbidity and are NOT recommended for hip or polyarticular OA. Oral NSAIDs are not recommended for people with cardiovascular comorbidity or frailty, and oral and transdermal opioids are strongly not recommended (Level 5).

    Bannuru RR, Osani MC, Vaysbrot EE, et al. — OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis.. Osteoarthritis and Cartilage, 2019. DOI: 10.1016/j.joca.2019.06.011.

  5. The 2019 ACR/Arthritis Foundation guideline makes STRONG recommendations for exercise, weight loss in people with knee and/or hip OA who are overweight or obese, self-efficacy and self-management programs, tai chi, cane use, tibiofemoral bracing for tibiofemoral knee OA, topical NSAIDs for knee OA, oral NSAIDs, and intra-articular glucocorticoid injections for knee OA. Radiofrequency ablation for knee OA, acupuncture, thermal modalities, acetaminophen, duloxetine and tramadol are only CONDITIONAL recommendations.

    Kolasinski SL, Neogi T, Hochberg MC, et al. — 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee.. Arthritis & Rheumatology, 2020. DOI: 10.1002/art.41142.

  6. In 156 patients with knee osteoarthritis randomised in the US Military Health System, physical therapy produced a mean WOMAC total score of 37.0 at one year versus 55.8 for a single intra-articular glucocorticoid injection (mean between-group difference 18.8 points favouring physical therapy, 95% CI 5.0 to 32.6, on a 0-240 scale where higher is worse). Secondary outcomes moved in the same direction.

    Deyle GD, Allen CS, Allison SC, et al. — Physical Therapy versus Glucocorticoid Injection for Osteoarthritis of the Knee.. New England Journal of Medicine, 2020. DOI: 10.1056/NEJMoa1905877.

  7. At 2 years across two parallel randomised trials (200 patients, mean age 66), total knee replacement plus non-surgical treatment beat non-surgical treatment alone by 18.3 KOOS points (95% CI 11.3 to 25.3), and non-surgical treatment in turn beat written advice by 7.0 points (95% CI 0.4 to 13.5). Among patients eligible for replacement, 16 of 50 (32%) in the non-surgical group had surgery within 2 years - meaning two out of three delayed it for at least two years.

    Skou ST, Roos EM, Laursen MB, et al. — Total knee replacement and non-surgical treatment of knee osteoarthritis: 2-year outcome from two parallel randomized controlled trials.. Osteoarthritis and Cartilage, 2018. DOI: 10.1016/j.joca.2018.04.014.

  8. In the IDEA trial, 454 overweight and obese adults aged 55+ with pain and radiographic knee OA were randomised to intensive diet plus exercise, diet alone, or exercise alone for 18 months. Mean weight loss was 10.6kg (11.4%) with diet plus exercise, 8.9kg (9.5%) with diet alone and 1.8kg (2.0%) with exercise alone; knee compressive force and IL-6 were lower in the diet groups than the exercise-only group.

    Messier SP, Mihalko SL, Legault C, et al. — Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial.. JAMA, 2013. DOI: 10.1001/jama.2013.277669.

  9. A meta-analysis of seven studies (419 patients) of preoperative high-intensity strength training before total knee arthroplasty found statistically significant post-operative improvements versus control in the 6-minute walk test (pooled SMD 0.73, 95% CI 0.04 to 1.41), range-of-motion flexion (0.40, 95% CI 0.08 to 0.72), SF-36 (1.54, 95% CI 0.32 to 2.75) and WOMAC (-0.78, 95% CI -1.22 to -0.34).

    Huang ST, Yang SW. — Preoperative High-Intensity Strength Training and Outcomes After Total Knee Arthroplasty: A Systematic Review and Meta-analysis.. Sports Health, 2026. DOI: 10.1177/19417381251388638.

  10. In 63,158 hip and 54,276 knee replacement patients in the Clinical Practice Research Datalink, the lifetime risk of requiring revision surgery was about 5% for patients operated on after age 70 with no sex difference, but rose to 35% (95% CI 30.9-39.1) for men having surgery in their early 50s, with women's risk about 15% lower at the same age. Median time to revision for patients operated on younger than 60 was 4.4 years. The authors state their evidence challenges the trend toward more replacements in younger patients.

    Bayliss LE, Culliford D, Monk AP, et al. — The effect of patient age at intervention on risk of implant revision after total replacement of the hip or knee: a population-based cohort study.. The Lancet, 2017. DOI: 10.1016/S0140-6736(17)30059-4.

  11. Acute bacterial septic arthritis of the knee is an orthopaedic emergency that can cause substantial joint destruction if untreated. Diagnosis rests primarily on history and the clinical presentation of a red, warm, swollen, painful joint with limited range of motion. Risk factors include age over 60, recent bacteremia, diabetes, cancer, cirrhosis, renal disease, drug or alcohol abuse, a HISTORY OF CORTICOSTEROID INJECTION, recent injury or surgery, a prosthetic joint, and rheumatoid arthritis.

    Elsissy JG, Liu JN, Wilton PJ, et al. — Bacterial Septic Arthritis of the Adult Native Knee Joint: A Review.. JBJS Reviews, 2020. DOI: 10.2106/JBJS.RVW.19.00059.

  12. FDA states directly that regenerative medicine therapies - including stem cells, stromal vascular fraction, umbilical cord blood, amniotic fluid, Wharton's jelly, ortho-biologics and exosomes - have NOT been approved for the treatment of any orthopedic condition, naming osteoarthritis, tendonitis, disc disease, tennis elbow, back pain, hip pain, knee pain, neck pain and shoulder pain. FDA further states that being charged for these products, or being offered them outside an FDA-overseen clinical trial, means a patient is likely being deceived and offered a product illegally, and that a product's presence on clinicaltrials.gov or a firm's FDA registration does not mean the product is legally marketed. Reported harms include blindness, tumor formation, neurological events and life-threatening bacterial infections.

    US Food and Drug Administration, Center for Biologics Evaluation and Research — Important Patient and Consumer Information About Regenerative Medicine Therapies. FDA.gov, 2021.

  13. The RESTORE trial randomised 288 community-based participants aged 50+ with symptomatic medial knee OA (Kellgren-Lawrence grade 2 or 3) to three weekly intra-articular injections of leukocyte-poor PRP or saline placebo, with participants, injectors and assessors all blinded. 93% completed the 12-month follow-up. PRP did not produce a clinically meaningful improvement in knee pain over placebo, and did not slow medial tibial cartilage volume loss on MRI.

    Bennell KL, Paterson KL, Metcalf BR, et al. — Effect of Intra-articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis: The RESTORE Randomized Clinical Trial.. JAMA, 2021. DOI: 10.1001/jama.2021.19415.

  14. A meta-analysis of 16 randomised trials (807 participants) of intra-articular mesenchymal stem cells for chronic knee pain from osteoarthritis found that at 3-6 months MSC therapy probably produces little to no difference in pain (WMD -0.74cm on a 10cm VAS, 95% CI -1.16 to -0.33, against a minimally important difference of 1.5cm) or physical function, both moderate certainty; at 12 months, probably little to no difference in pain. MSC therapy may increase the risk of any adverse event (RR 2.67, 95% CI 1.19 to 5.99) and of knee pain and swelling (RR 1.58, 95% CI 1.04 to 2.38).

    Sadeghirad B, Rehman Y, Khosravirad A, et al. — Mesenchymal stem cells for chronic knee pain secondary to osteoarthritis: A systematic review and meta-analysis of randomized trials.. Osteoarthritis and Cartilage, 2024. DOI: 10.1016/j.joca.2024.04.021.

What to do next

Start with a talk. QC Kinetix lets you arrange a consultation for joint soreness. After examining you, the medical provider can discuss regenerative care prepared from your own blood and given at the clinic. One name for it is platelet-rich plasma, or PRP; staff take some blood from you, spin it to collect more platelets, then use a needle to place that portion in the aching joint.

Choose the office that fits your drive. Peoria serves the north I-17 corridor. Banner Estrella is at 91st Avenue and Thomas Road, find Scottsdale on E. Mountain View Road, and Chandler is on Dobson. Call (602) 837-PAIN for help choosing.

You won't get a promise of a result. You'll get an exam and advice about what to do next. That may mean clinic care, physical therapy, home care, or a visit with a doctor who handles bones and joints. The answer needs to fit your joint.

Book a free consultation