Treatment of Knee Osteoarthritis

The treatment of knee osteoarthritis does not necessarily require surgery for everyone. It depends on the symptoms, severity of the disease, condition of the joint surface, and other factors. Treatment options include non-drug treatments, drug treatments, and ultimately surgery. Each treatment type has specific criteria for consideration, and the doctor and patient will collaboratively plan the treatment before starting.

– Non-Drug Treatments : These include strengthening exercises (exercise), physical therapy, limited activity, and the use of orthotic devices (orthosis).
– Drug Treatments : These include anti-inflammatory drugs or pain relievers, and injections into the knee joint.
– Alternative Treatments : These include platelet-rich plasma (PRP) injections, synthetic joint fluid injections, and taking joint supplements.
– Surgery : This includes partial knee replacement or total knee replacement.

Methods of Treating Osteoarthritis

Treatment with Medication

Most commonly used oral medications are nonsteroidal anti-inflammatory drugs (NSAIDs) or pain relievers, which manage inflammation and reduce pain but do not prevent future inflammation or pain.

– Continuous long-term use of NSAIDs should be avoided as it may lead to kidney and liver dysfunction, or gastrointestinal bleeding.
– Another group of oral medications includes joint supplements, known for their high safety profile.
– Injectable medications for knee osteoarthritis come in two types: steroid injections are beneficial for severe knee inflammation and significant symptoms, with a relatively lower cost. Another type is hyaluronic acid injections, which typically require weekly injections for 3-5 weeks or a single session to improve knee lubrication. However, they are costly and may require repeating every 6-12 months.

Exercise to Strengthen Muscles

The importance of exercise lies in strengthening the muscles around the specific joint, which helps cushion direct impacts on the joint, reducing the feeling of stiffness. It also aids in controlling the joint’s weight-bearing alignment, ensuring it stays in a straighter position to lessen weight load. Additionally, dynamic exercise can help control overall body weight, which is highly beneficial for joints that bear direct weight.

Physical Therapy

Physical therapy includes various methods such as massage therapy on the sore area, applying heat packs, performing ultrasound therapy, and others. These methods help alleviate pain without posing risks to the knee joint and can be adjusted based on changes in symptoms. This approach is beneficial for individuals who prefer non-medication treatments.

Activity Limitation

Preventive measures to avoid injury or accelerate joint degeneration, based on principles, include:

– When the patient exhibits abnormal joint sensitivity, tasks involving excessive bending of the knees such as squatting deeply, kneeling, cross-legged sitting, and sitting on the heels should be avoided. These positions are unsuitable as they increase twisting forces on the knee joint.

– Avoid excessive stair climbing and descending, such as climbing more than 2 flights of stairs per day.

– For individuals with bow legs or abnormal knee alignment, it is advisable to refrain from activities like running or jumping. This is because joints with misaligned axes distribute weight unevenly, potentially accelerating joint degeneration.

Using orthotics (Orthosis)

Wearing elastic bandages or knee sleeves (with or without metal springs) helps support knees experiencing pain during movement. They promote tightness, reduce improper movements or misalignments, and distribute weight-bearing forces more evenly from the thigh bone to the shin bone, thus minimizing inflammation.

However, prolonged use of such devices may weaken the muscles around the knees. Therefore, patients should regularly engage in muscle-strengthening exercises.

Surgery

Surgery is an essential measure used to treat moderate to advanced knee osteoarthritis. Typically, doctors assess whether surgery is appropriate based on specific indications, and they must ensure that the patient’s quality of life significantly improves after the procedure, making it cost-effective.

Currently, surgical approaches for treating knee osteoarthritis vary based on the severity of joint degeneration and leg misalignment. These approaches include arthroscopic joint lavage, realignment surgery to correct leg axis, partial knee replacement, and total knee replacement. Patients opting for surgery are often older and have significant knee degeneration, contributing to an increasing rate of knee replacement surgeries annually.