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Osteoarthritis Treatment Options – Surgery versus Non-Surgery

Osteoarthritis is a knee condition resulting in the degradation of cartilage within the joint. Whilst we all experience wear and tear on the body in extreme cases the condition sees the complete removal of cartilage within the joint resulting in bone on bone contact which is the source of pain and mobility issues.

The onset of the condition can start to have an effect on daily routines, from walking to shops and moving around the home and even getting in and out of chairs. There are 8.5 million sufferers of osteoarthritis in the UK, of which knee osteoarthritis is the most common and continues to grow, with projections showing that an estimated 17 million people will be suffering from OA by 2030.

Knee anatomy

There are 3 compartments of the knee joint, comprising of the medial, lateral and patello-femoral. The former compartments are responsible for weight bearing at either side of the knee whilst the latter works to power the quads without being directly responsible for the weight bearing itself.

Cartilage is the cushion between the femur and tibia bones which gradually wears over time as it is responsible for cushioning the weight of the body when mobile which is a huge task. There are a number of treatment options available to sufferers where the cartilage becomes worn, both from a surgical and non-surgical perspective, depending on the severity of the condition and the needs of the patient.

Surgery

Surgery is very effective in that it removes the osteoarthritis completely, though it does involve the need for a full or partial knee replacement which is no small undertaking. Following surgery rehabilitation can take up to 6 months before you are fully mobile once again which can impact on your lifestyle in the short term as this is major surgery.

Whilst the option does remove the condition it is important to consider the age at which you may consider it as they are typically only designed to last between 10 and 15 years before being replaced, resulting in another 6 months of rehabilitation following the subsequent procedure.

Surgery should only be seen as a last resort, where other treatment options have been considered in the first instance and should never be taken lightly.

Non-Surgical solutions

Non-surgical solutions include lifestyle changes, medication and the use of a specially designed osteoarthritis knee brace.

Lifestyle changes involve getting more active, ironic when being active causes more pain and further degrades the cartilage within the knee joint. Light and non-weight bearing activities such as swimming can be beneficial in helping to lose weight with exercise releasing endorphins into the body which act as natural painkillers.

Medication typically comes in the form of anti-inflammatory tablets which can help to reduce pain and keep a patient moving. Whilst this does offer some relief it is important to note that medication fails to manage the root cause of the condition and merely masks over it and should not be considered as the sole solution.

An osteoarthritis knee brace is designed to delay the need for surgery whilst still allowing you to remain active. Examples such as the Unloader One work by applying a gentle force which works to reduce the pressure on the affected side of the joint. It is this motion which offers a reduction in pain to the patient and offers them the ability to remain active for longer.

The reduction of bone on bone contact can also reduce the progression of osteoarthritis and is seen by many clinicians as a means of delaying surgery and even in some cases preventing the need for surgery altogether.

It is important to note that the use of a knee brace is dependent on the type of Osteoarthritis experienced. Unicompartmental OA allows you to off-load to the unaffected side of the knee, however where OA resides on both sides then there is nowhere to off-load the pressure to and surgery is often seen as the only remedy.