Scott Perkinson, M.D.
Orthopedic Surgery, Orthopedics
Doctor's OrdersFunction better with less pain: When to consider total joint replacement for arthritisMarch 30, 2017
Millions of Americans suffer from knee arthritis, which can cause pain, stiffness and a decrease in activity level and quality of life. Eventually, this often leads to knee replacement surgery, which remains the most effective treatment for permanent pain relief. However, knee replacement should be reserved as a last resort. There are several minimally invasive options you and your surgeon can try before committing to knee replacement surgery:
- Physical therapy — Knee arthritis typically makes the knee joint painful and stiff. Consulting with a physical therapist can increase the strength of the muscles supporting the knee and reduce pain. Therapists can use ice and heat, electrical nerve stimulation and other therapies to increase blood flow to the knee. Working with a licensed therapist can be much more effective than what you can do on your own.
- Medications — Although physicians typically try to limit the number of medications prescribed, there are several medications for knee arthritis that have been proven to help. Over-the-counter anti-inflammatory medications (NSAIDs) can be quite effective in reducing the pain, swelling and stiffness associated with knee arthritis. These are readily available and typically well-tolerated by most patients. In addition to NSAIDs, there are several supplements that have been successful in reducing knee arthritis symptoms. The two most common supplements used for knee arthritis are glucosamine sulfate and hyaluronic acid.
- Injections — If you continue to experience pain from knee arthritis after trying medications and therapy, typically, the next step is to get an injection. This process usually starts with a corticosteroid injection, which can drastically reduce the inflammation, pain and swelling associated with knee arthritis. These often are effective and can be long lasting. If cortisone does not provide long-lasting relief, then hyaluronic acid injections may be suggested. Hyaluronic acid acts to lubricate the knee, which can improve mobility and reduce pain.
- Arthroscopic surgery — Arthroscopic surgery is a minimally invasive type of knee surgery performed with a camera inserted through small incisions. The surgery can be used to repair cartilage or meniscus tears inside the knee, or to remove bone or cartilage fragments. If you have symptoms such as sharp pain, catching or locking, then arthroscopic surgery may be option for you. This type of surgery could delay or eliminate the need for knee replacement surgery.
- Osteotomy — Osteotomy is a type of surgical procedure where the surgeon makes a cut in your shin or thigh bone to shift the load away from the arthritic area of the knee. This typically is recommended for younger patients with deformity or damage only in one side of the knee. Although this is considered an alternative to knee replacement surgery, osteotomy might make it difficult for patients to undergo successful knee replacement surgery at a later time, if needed.
MAKING THE DECISION
When it comes to choosing a treatment for knee arthritis, your surgeon should consider all possible alternatives to knee replacement surgery. Deciding on the best possible treatment option is a process both you and your surgeon should determine together.