Non-Surgical Treatment Options for Knee OA
The effectiveness of certain treatments will vary from person to person and from knee to knee. Success may also depend
on lifestyle factors. That’s why your treatment plan for osteoarthritis (OA) of the knee will usually involve a
combination of approaches designed specifically to suit you.
Bracing and Supports
Technology is always advancing and today there are braces that can apply corrective forces to the leg to take
pressure off areas where the arthritis is at its worse. Originally braces were big and bulky devices, but now
there are lightweight, easy-to-use braces such as the Unloader One that are specifically designed for – and
proven to help with – knee OA.
Soft Supports can usually be bought by patients themselves at a pharmacy or sports shop. They tend to be made
of a soft, stretchy material and provide a combination of compression, warmth and gentle support. Soft Supports
do however not provide the same level of support and pain relief as the Unloader One, specifically designed
to treat the symptoms of knee OA.
Other Assistive Devices
To avoid putting too much stress on your knee, you may choose to use a walking stick/cane or other kinds of
walking aids. You can also get special inserts for your shoes, which are designed to support your foot properly
when walking, which may in turn help to lessen the pressure on your knee.
Physical or occupational therapy
If your doctor thinks massage and exercises may help, he or she may refer you to a physiotherapist, who can work with you on an exercise program tailored to your needs.
If you would benefit from things like a higher chair or toilet seat (so you don’t have to bend your knees so much), you may find it useful to talk to an occupational therapist, who will know all about special devices to make home and work life easier and less painful.
Weight management and exercising
If you can lose any surplus body weight, you will help to ease the pain because the stress on your knee is reduced.
Regular exercise can help to achieve that. It can also improve your strength and flexibility, which will help
to increase movement and potentially reduce the pain.
It’s important to include joint and muscle exercises, but to AVOID as much as possible the high-impact activities
that increase the load on your knee, such as climbing lots of stairs. Avoid activities that involve twisting
or rapid stop/start movements. Try not to bend or kneel down too much, or lift heavy objects. Don’t sit down
too often on low chairs or sofas. And if you do have to do any of these things, remember to take a break and
give your joints a rest.
Medication and injections
Medication is used primarily to control the symptoms of knee OA, especially the pain. There are a number of prescription drugs and common over-the-counter-medicines that can help. These include aspirin-free pain relievers (paracetamol), anti-inflammatory drugs and creams, corticosteroids (steroids to help control inflammation) and sleeping pills.
Pain can gradually get worse as the OA progresses, so sometimes stronger drugs are prescribed. However, the long-term nature of OA means that taking stronger medication over a long period of time may lead to unwanted side-effects, which have to be taken into consideration when treating the condition.
Injections of hyaluronic acid (found naturally in healthy joints) can also be used to provide temporary relief, while anesthetics with an anti-inflammatory ingredient (commonly cortisone) may help to relieve the pain by numbing the knee. These kinds of injections are well-established treatments, but the results can vary from patient to patient.
Wellbeing and mental health
Chronic or ongoing pain can be a real drain on your emotional wellbeing, as much as your physical health. Try to stay positive by talking things through with your family or friends or maybe finding new ways to relax, like meditation.
In some regions there are local support groups for arthritis, with people who understand what it’s like to live with this pain.
Some people prefer to replace or complement their treatment with certain foodstuffs, dietary supplements or herbal
remedies. While these can work well for some, these treatments are not widely regulated and their effectiveness
is often not proven, so always talk to your doctor if you are planning to use alternative or complementary medicines/therapies.
You may find that you can get some relief from the pain and stiffness of knee OA by using heat or cold over your joints. Inflammation and swelling can often be reduced with ice-packs, while heat or a hot compress can help to relax your muscles and increase blood circulation.
Surgical Treatments for Knee OA
When all non-surgical treatment interventions have been exhausted and no longer help to alleviate the pain, and mobility is severely compromised, your doctor might suggest a knee replacement surgery. The best time and type of surgery can be determined with the help of an orthopaedic surgeon.
Total knee replacement
This procedure is only considered when there is clearly significant damage to the surfaces on both sides of the bones and the patient is in severe pain that cannot be alleviated by means of other treatment options. During surgery, the damaged joint surface of the knee is replaced with metal and plastic components shaped to allow continued motion of the knee.
Knee replacement is a major surgery that involves general anesthesia. It typically involves substantial post-operative pain and includes vigorous physical rehabilitation. Patients may need to use mobility aids (e.g. walking frames, canes, crutches) during recovery time. It usually takes a patient between 3 and 6 months to recover after total knee replacement surgery.
The life span of an artificial knee joint is around 10-15 years, on average, after which a second knee replacement surgery might be needed.
Partial knee replacement
If the damage from knee OA is restricted to one side of the joint only, the surgeon may consider an operation that will safeguard the healthy side. The procedure involves resurfacing only the diseased or affected side of the knee with metal and plastic, and it is usually called 'unicompartmental knee replacement'.
Partial knee replacement involves smaller incisions, quicker recovery time and less blood loss than total knee replacement. It does however still require anesthesia, either regional or general. The disadvantages of partial knee replacement compared with total knee replacement include less predictable pain relief, and the potential need for more surgery in the future if arthritis develops in the parts of the knee that have not been replaced.
Post-operative physical therapy is needed after surgery and patients may need to use mobility aids (e.g. walking frames, canes, crutches) for the first days or weeks until they become comfortable enough to walk without assistance. Patients can usually resume their regular activities of daily living 6 weeks after a partial knee replacement surgery.
Used to realign arthritic damage on one side of the knee.
When your surgeon restructures the bones, as happens in this kind of surgery, the stresses on the affected cartilage are shifted to more healthy tissue.
The surgery requires general anesthesia and due to the nature of the procedure, recovery may be extensive. A period of partial weight bearing only is usually needed for at least six weeks, often achieved through use of crutches. Putting too much weight on the knee too early may damage the bone surface and prolong healing time.
Swelling in the leg usually decreases over a span of 3 to 6 months after osteotomy surgery. Patients must exercise caution during all activities, including walking, until healing is complete. Between 6 weeks and 6 months' time might be needed off from work, depending on how much patients rely on their knee to perform their job.
A less common surgical treatment for knee OA symptoms is arthroscopy, which usually involves the insertion of a small camera into the knee to get a clearer picture of what is happening and how best to treat it.