Knee Arthritis: Treatment Options

Knee Arthritis: Treatment Options

Patients who have arthritis typically try some sort of treatment to help with their pain. Arthritis pain does not go away on its own, so people try at least something to improve their symptoms. It is common to begin with nonoperative treatment. Health care providers usually recommend these measures to start with.

Activity modifications throughout the day, such as taking more time going up and down stairs or even using a cane can help improve pain. Nonsteroidal anti-inflammatory medications like ibuprofen or naproxen are designed to calm down the inflammation that causes pain. Certain types of knee braces can help relieve pressure on the inside or outside of the knee. Stretching with physical therapy is a great way to keep joints loose and help prevent stiffness, and injections have also helped patients with their symptoms.

If a patient has tried nonoperative treatment and has not found anything that helps, surgery may be the next step. Different procedures can help with arthritis pain. The least invasive is arthroscopy. This can help with removing loose pieces of cartilage that may have broken off, but any improvement in symptoms usually does not last long. The worn cartilage that is really causing the pain is still there.

Sometimes, a leg that is out of alignment can cause arthritis on one side of the knee. A high tibial osteotomy corrects the alignment and relieves pressure on the compartment that has the arthritis, but this procedure is only recommended for certain patients.

If a replacement surgery is needed, also called an arthroplasty, sometimes only one compartment needs to be replaced. This is a partial knee replacement. Most surgeons will only do this if the other compartments in the knee have no arthritis at all or at least very little.

When a knee has arthritis throughout most of the joint, a total knee replacement is typically recommended as the end-all for a surgical solution. Despite any nonoperative treatment, the cartilage will not heal back to normal, it will continue to wear down over time. It is just a matter of how quickly it happens. Patients make the decision to have surgery if and when all the nonoperative treatments they have tried are not working anymore.

The number of people getting knee replacements has been increasing over the years, especially patients between the ages of 45 and 64. The age range of patients who get knee replacements is pretty large, but it is most common to get one between 65 and 84 years old. These statistics show that women tend to get them replaced at younger ages than men do.

As stated before, there is a difference between a partial and a total knee replacement. These illustrations show a partial replacement of the patellofemoral joint, the kneecap in the groove, the medial compartment or inside of the knee, and the lateral compartment or outside of the knee. There are some things to think about when it comes to getting a partial knee replacement before going all the way to a full total knee replacement.

The patient may get better and be able to put off getting a total knee replacement for a while. Patients also might be able to do more activity after their recovery with just a partial replacement. However, this would mean getting two surgeries instead of just one and having to go through two recoveries. Also, patients who are still working would have to take more time off, and getting a partial replacement would only help the symptoms of that one compartment.

If there is any arthritis pain coming from another compartment in the knee, that pain would likely still be there. If a patient gets a total knee replacement, here is what it looks like. The metal parts of the replacement are bright white on the x-ray, but the plastic piece between the metal does not show.

There are many considerations that need to be discussed between the patient and doctor when it comes to deciding on surgery. The best outcome for the patient is the number one goal and being fully informed will help the patient make the best decision. Recovering from surgery can be a long process.

Different procedures require different amounts of therapy, and each rehab plan may change from surgeon to surgeon. Most patients will require a walker for a short time following knee replacement surgery until their strength returns and their pain decreases enough to walk on their own. After that, stretching and strengthening exercises will help the patient get back to their daily activities.