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Alternatives to Knee Replacement Surgery
If you are suffering from Knee arthritis a wide range of treatment options are available, before considering Surgery. Only if these alternatives failed to relieve your symptoms you should consider knee Replacement Surgery. Please note that the effectiveness of different treatments varies from person to person and the choice of treatment should be a joint decision between you and your doctor.
Patient education focuses on understanding the disease, learning about treatment options, and working with your physician to develop exercise and pain management programs suited to your life.
Physiotherapy and exercise are often effective in reducing pain and improving function. Simple weight loss can reduce stress on the knee. Losing weight can result in reduced pain and increased function, particularly in walking and climbing.
A Knee brace can assist with stability and function. There are two types of braces that are often used. An "unloader" brace shifts load away from the affected portion of the knee. A "support" brace helps support the entire knee load.
Simple pain relievers like Dolo 650, Voveran, Etoshine and Ultracet can help if combined with a good exercise program. NSAIDs can cause side effects including indigestion leading to stomach ulceration, changes in kidney and liver function as well as a reduction in the ability of blood to clot. However these are safe for short periods of time if taken under doctors prescription
Chondroprotectives such as Glucosamine and Chondroitin sulfate may be particularly helpful in the early stages of OA Knee. Although glucosamine and chondroitin sulfate are natural substances, sometimes classified as food additives, they can cause side effects such as headaches, stomach upset, nausea, vomiting, and skin reactions. Response is unpredictable and seems to be more effective in patients with Glucosamine deficiency
Corticosteroid injections are given for moderate to severe pain. They can be very useful if there is significant swelling, but are not very helpful if the arthritis affects the joint mechanics. They can provide pain relief and reduce inflammation with a subsequent increase in thigh muscle strength. However, the effects are temporary, and no more than 3 injections should be given per joint per year.
Viscosupplementation is a way of increasing the lubrication of a joint and making it easier to move. This substance is a concentrate of hyaluronic acid. Three to five weekly injections are needed to reduce the pain, but the pain relief is not permanent. Recently Genzyme has introduced a single knee injection called SynviscOne instead of the conventional 3 injections for a price of Rs. 15,000/-
Alternative therapies include the use of acupuncture and magnetic pulse therapy. Many forms of therapy are unproven, but reasonable to try, provided you find a qualified practitioner and keep your physician informed of your decisions.
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