Knee osteoarthritis is a genuine agony, with crunching sounds as you ascend stairs, constant soreness, and swelling. If you're having trouble with it, you might want to consider surgery.
One option is to get a knee replacement, but you may not need surgery, at least not immediately away. For a variety of reasons, some individuals are unable to undergo knee replacement surgery. Others with knee pain are too young for a knee replacement; the prosthetic knee will likely only last 15 to 20 years before requiring revision surgery.
According to Daniel Valaik, M.D., orthopaedic hip and knee specialist at Suburban Hospital in Bethesda, Maryland, there are numerous things you can do first, either on your own or with the guidance of a professional, to help with knee pain and even delay the need for replacement.
He explains, "Arthritis doesn't go away." "Unfortunately, I've never seen anyone's X-rays improve in terms of arthritis among the thousands and thousands of people I've treated." There are, however, things you may do to reduce pain and remain more active."
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| Alternatives to Knee Replacement to Consider |
Knee Pain Treatments You Can Do at Home
Reduce your weight to relieve stress on your knees.
Reaching and maintaining a healthy weight is number one on Valaik's list of techniques to prevent knee discomfort and delay knee replacement.
According to Valaik, more weight puts pressure on the knees and raises stress on the joint, causing pain and making it difficult to exercise. The Johns Hopkins Arthritis Center's research indicates that being overweight increases your risk of getting knee arthritis and speeds up the loss of cartilage that cushions the joint.
"I realize it's not easy," he admits, "but decreasing weight is extremely beneficial, whether you have arthritis in one or both knees." Consultation with a dietician or a bariatric specialist may be the best place to start if you are overweight or obese.
Low-impact exercises can help you gain strength and mobility.
"Strengthening the quadriceps and hamstring muscles in the leg will help lessen pain and make it easier to stay mobile," adds Valaik, who suggests doing low-impact exercises like riding a bike or walking on a treadmill on a regular basis.
Physical treatment can make a significant difference. He explains, "A physical therapist can work with you to develop a tailored regimen."
Pain medications should be used with caution.
The American Association of Hip and Knee Surgeons advises against utilizing opioid medicines for knee osteoarthritis unless in extremely rare circumstances. In addition to being addictive, opiate pain medications have not been shown to be any better at treating knee pain in the long run than nonsteroidal anti-inflammatory drugs (NSAIDs).
NSAIDs, while safer than opioids, aren't for everyone, and Valaik suggests using them with caution. “Even over-the-counter medications like naproxen and ibuprofen can have adverse effects,” he warns.
"NSAIDs can cause a rise in blood pressure. Some of these pain medicines have been associated to a slight increase in the risk of heart attack in larger studies.
He adds, "And the more you take, the more likely you are to get heartburn, stomach irritation, or even bleeding ulcers."
Inquire with your doctor about the following treatments.
Knee injections
Cortisone shots and other injections, such as hyaluronic acid (HA) injections, lubricate the inner workings of the knee and help reduce arthritic symptoms, according to Valaik.
Other injectable medicines, such as platelet-rich plasma (PRP) and concentrated bone marrow or stem cells, have less evidence supporting their benefits, according to Valaik, but more studies will disclose more about their usefulness in treating knee arthritis.
"Injections can provide temporary relief — usually a few months — that can help you stay on your feet and avoid surgery," he explains.
Cartilage Regeneration
Doctors may be able to give newer procedures that restore cartilage rather than the entire joint for knees with a limited level of arthritis and good bone alignment.
You can consider and discuss various cartilage-regeneration methods with an orthopaedic surgeon.
For example, autologous chondrocyte implantation (ACI) entails obtaining a sample of your cartilage cells, growing them in a lab, and then replanting them in your knee surgically. It isn't for everyone, but it may be appropriate for young people and sportsmen who have cartilage loss.
Radiofrequency Ablation (RFA)
There are still solutions if none of these treatments work to relieve your arthritic knee discomfort. By eliminating the sensory nerves that transport the pain signal from the knee to the brain, radiofrequency ablation reduces knee pain.
RFA is most likely only a short-term solution, as nerves will grow again in six to two years and the pain will likely return.
When Should You Have Knee Replacement Surgery?
Despite treatment, knee arthritis can worsen. If you've tried all of these options and are still in discomfort, it's time to talk to an orthopaedic surgeon about knee replacement. Although total knee replacement is a substantial treatment, it can provide increased quality of life and mobility for many years.
The end of the femur (thigh bone), the top of the tibia (the thicker of the two bones in the shin), and the inward facing surface of the patella, or kneecap, are all resurfaced in a total knee replacement. The bony surfaces are removed and replaced with metal and plastic implants by the surgeon. The plastic performs the same function as cartilage, allowing the implants to glide easily against one another.
Valaik points out that the field of knee replacement is constantly evolving. For example, more surgeons are doing the treatment under regional anaesthetic, which can result in a shorter hospital stay than when general anesthesia is utilized.
"New multimodal pain treatments, surgical procedures, and post-operative physical therapy are all improving a patient's knee replacement experience," he says.
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