Undergoing a knee replacement for knee arthritis can be a very effective quality-of-life decision. Patients are able to get back to recreational activities and a severely reduced painful lifestyle.
Methods of avoiding the replacement with the arthritis.
- Weight loss – Over 65% of Americans & over 30% of Indians are either overweight or obese. The problem with this is that a lot of stress goes through the joint during ambulation. This excess weight can lead to increased pain and/or increased arthritis. Losing weight allows the patient to decrease joint pain by decreasing stress over joint, and an increased ability to perform activities of daily living, along with other substantial health benefits such as lower blood sugars and lowered blood pressure.
- Benign neglect – The patient is able to do most of the things that he or she wants to do, the most appropriate answer at that point may be to simply ignore the problem. One additional aspect to consider may be to modify one’s activities. This may include switching from jogging to fast walking, or shifting from skiing to an activity that is less stressful on the joints such as swimming.
- Physical therapy – Physical therapy may have significant benefits. Therapy can strengthen up the muscles around the knee joint, which has beneficial effect of unloading the pressure from the knee joint and dissipating it into the surrounding musculature. This can reduce pain.
- Acetaminophen and NSAIDS – These medications are predominantly available without prescription and they can be extremely beneficial for alleviating the pain. They have a low risk profile, as long as patients stick to the manufacturers dosing on the box, and don’t combine those medications that can have an additive effect and lead to a bleeding ulcer.
- Knee injections – Injections into arthritic knee can help substantially relieve the pain. Presently the bulk of these injections consist of cortisone, which is a hefty anti-inflammatory substance, but not one that is going to alter the course of the disease. There are some newer medications consisting of regenerative substances, which contain components such as stem cells, hyaluronic acid, and cytokines. These may in fact alter the course of the arthritis.
- Bracing – Off-loading braces take pressure off of the arthritic area of the knee joint and promote pain relief. These braces are typically custom fit after seeing your doctor, and should be worn whenever the patient is up and about when the pain would typically be felt.
- Narcotic medications – These should not be used on a chronic basis. They should be utilized only for an acute type of situation where patients are having an exacerbation of their arthritis pain. Narcotic medication on a chronic basis has the risk of tolerance, addiction, constipation, etc. So it should be avoided. Utilizing them for exacerbations can however be very effective.
- Non-narcotic medications – Medications that are non-addictive such as Tramadol can be very effective for knee pain. In addition there are modulating medications such as gabapentin that can help a lot with decreasing the pain that is coming into the arthritic knee joint from the surrounding nerve endings.