Conservative Knee Care
Arthritis is a progressive disease for which there is no cure. Not all patients with arthritis in their knees are ready to move forward with a total or partial knee replacement. There are alternatives to surgery to alleviate pain in an arthritic knee until knee replacement becomes inevitable.
Weight Loss – As we walk, 3 times our body weight is transferred through our knee joints. Running (jogging) transfers 5 times body weight. Maintaining a healthy weight can serve to reduce stress on the knee and reduce pain.
Exercise and good eating habits are not only essential to healthy living, but it is an important factor in prepping for upcoming total joint replacement surgery. Studies have shown that patients with a Body Mass Index (BMI) greater than 40 are at an increased risk for surgical complications. Compared with patients of normal weight, obese patients are at an increased risk of infection, poor wound healing, and blood clots. Obesity also increases the risk of loosening, or failure, of your components which could require another surgery to fix them.
It is in your best interest to become the best surgical candidate that you can be. Candidates for a total joint replacement should start with healthy eating habits, and low impact exercises (e.g. swimming, riding a stationary, using an elliptical machine). We want to ensure you have a pleasant experience, and are well prepared for your joint replacement rehabilitation.
Physical Therapy/Home Exercise Programs – Controlling knee pain can be complex and highly individual. Knee arthritis can be aggravated by many activities such as stair climbing, running/jogging, walking on uneven surfaces, a sudden change in activity level and new exercise programs. Physical therapy and a therapist designed home exercise program can help restore function through non-surgical, conservative means. These programs include strength and flexibility training as well as balance and mobility exercises. They strengthen the affected joint and surrounding limb and can improve pain and range of motion. Additionally, core strengthening can be highly beneficial and can indirectly help lessen knee pain. Braces can improve knee alignment, reducing pressure and pain.
Braces can also provide some support and stability for the affected knee. They may help prevent the sense of “giving way” during activities. Store bought braces can aid patients to become more active. Unloading braces, fitted by a specialist, can be effective for patients who must stand all day for work. The relief from braces is temporary but can be an effective tool to prolong the need for surgery.
Anti-inflammatory medications are the most common medication recommended for arthritis pain relief. They help reduce pain and swelling from an arthritic joint. The most common of these medications are ibuprofen and naproxen and can be found over the counter at local pharmacies. There are also a variety of prescription medications that are also indicated for arthritis pain relief. All of these medications can provide effective pain relief but they can also have serious side effects. You should consult your primary care doctor prior to starting these medications on a regular basis.
Joint Fluid Therapy (Viscosupplementation) – These injections can help improve the quality of joint fluid within an arthritic knee and act as a lubricant. While they don’t stop the arthritis from progressing forward, it can serve to alleviate pain and discomfort. These injections can last several months and can be repeated on a regular basis. nsurance approval for these injection varies by provider and are typically administered every 6 months.
Steroid (cortisone) injection – These injections into the knee joint can provide significant pain relief for patients with arthritic knees. They can be given on a regular basis, every 3 months, but eventually they will no longer control pain due to progressing arthritis.