Alternatives to Knee Replacement Surgery
Patient education focuses on understanding the disease, learning about treatment options, and working with our team 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 according to our instructions.
Chondroprotectives such as Glucosamine and Chondroitin sulfate, or Univestin, 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 can be 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 arthritis affects the joint mechanics. They can provide pain relief and reduce inflammation, with a subsequent increase in thigh muscle strength. However, these 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. 18,000/-
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.
Knee Arthritis - Update
Sprifermin Increases Cartilage Thickness in Patients With Knee Osteoarthritis
LIVERPOOL, United Kingdom -- May 2, 2018 -- Sprifermin is effective at increasing cartilage thickness in a dose-dependent manner in patients with knee osteoarthritis (OA), and has an acceptable safety profile, researchers reported here at the 2018 Osteoarthritis Research Society International (OARSI) World Congress.
Sprifermin is a novel recombinant human fibroblast growth factor-18 that is currently under investigation as a potential disease-modifying osteoarthritis drug (DMOAD) for intra-articular administration. A decrease in TFJ cartilage thickness from year 2 to 3 was observed in all treatment groups; however, the difference of 0.05 mm between the high-dose sprifermin dose group and placebo observed at year 2 was maintained at year 3.
In addition, significant differences were observed in mean cartilage thickness change from baseline to year 2 were maintained up to year 3 with sprifermin 100 mg versus placebo in both the medial and lateral TFJ compartments, and in central medial and central lateral TFJ subregions. Total Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were improved by about 50% in all treatment groups by year 2 and continued up to year 3.
When considering the safety data, the frequencies and natures of adverse events at year 3 remained similar to year 2.
Symptoms of Osteoarthritis Lessened With Simple Changes to the Diet
The researchers also found that a reduction of weight for overweight and obese patients and the introduction of exercise tailored to mobility could also help ease the symptoms of OA. Not only does obesity increase strain on joints, it can cause low-grade, systemic inflammation in the body aggravating the condition further. A calorie-restricted diet, combined with strengthening, flexibility, and aerobic exercises, was identified as an effective approach in reducing pain in overweight patients. There is no evidence that a calorie restricted diet does anything beneficial for lean patients with the condition.
An increase in foods rich in Vitamin K such as kale, spinach, and parsley was also found to deliver benefits to patients with OA. Vitamin K is needed for vitamin-K-dependent (VKD) proteins, which are found in bone and cartilage. An inadequate intake of the vitamin adversely affects the working of the protein, affecting bone growth and repair and increasing the risk of OA.