Knee arthritis non-operative management

Education

Education is the key tool in having a greater understanding of what arthritis is, and what is involved to address and manage the symptoms associated with it.

We hold regular education seminars for patients, and give access to online tools to have you better comprehend what is really going on with your knee, and how we can help you improve your quality of life.

Physiotherapy

Physiotherapy has been shown to be effective in improving the symptoms of up to 70% of patients with early osteoarthritis. The more severe your arthritis unfortunately the less effective this can be.

Physiotherapy can be beneficial even if you ultimately require surgery because pre-operative physio “Pre-hab” helps you recover faster.

Exercises focus on strength, stability, maintaining your range of motion, and pain management

If physio exacerbates your pain, tablets and injections can relieve this pain temporarily

Injections

Platelet Rich Plasma

Platelet Rich Plasma uses a fraction of your own blood (obtained by spinning your blood in a centrifuge), injected into your knee to relieve your osteoarthritic pain. It is wears off after approximately 3 months but can help to relieve your pain, allow you to do physio and recover from a recent deterioration in symptoms.

Hyaluronic acid

Hyaluronic acid (eg Synvisc® or Cingal®) (link to Synvisc and Cingal info which is currently on ‘Pain Management page’) is a manufactured version of your own knee lubricant. Similar price to PRP, though 10-20% of patients experience a significant foreign material reaction.

Steroid/cortisone injections

Steroid/cortisone injections are cheaper than PRP or hyaluronic acid but do not always last as long or provide as much pain relief. These injections can slightly raise the risk of infection if you have a knee replacement in the next 3- 6 months.

Tablets

Paracetamol

Regular paracetamol is useful due to its favourable side effect profile and no addictiveness. It is not generally considered a safe pain killer. It is to be avoided if a patient has liver problems This will be prescribed in conjunction with your General Practitioner.

Anti-inflammatories

Anti-inflammatories such as ibuprofen (nurofen), diclofenac (voltaren), celecoxib (celebrex), meloxicam (Mobic) can be used for short flare-ups. They should not be used on a long term basis, and can not be prescribed if past medical complaints such as gastric ulcers and kidney problem. This will be prescribed in conjunction with your General Practitioner.

Avoid stronger (opioid based) painkillers eg. Tramadol, Endone/Oxycodone, Palexia/Tapentadol, Norspan due to the development of tolerance/addiction. If you require opioid pain relief such as these on a regular basis to relieve your pain it may be time to consider operative management rather than opioids.

Diet

Patients with knee arthritis can often put on weight because their painful knee slows them down.
It can be difficulty losing weight through exercise given how painful your arthritic knee may be.
Lower weight can mean less force through your arthritic joint and therefore less pain.
Consider the assistance of a dietician or your GP to modify your diet to help your joint pain

Activity Modification

Low impact aerobic activity is encouraged for your joint health, general health and mental wellbeing. You may need to alter which exercise you do – switch running for swimming or cycling for example.

SURGICAL TREATMENT

Surgical treatment is considered when the above non-operative management has failed to relieve your pain and get you back to doing the things you love.

If pain is affecting your quality of life significantly despite trying the techniques above, talk to your surgeon at the Sunshine Coast Orthopaedic Group about whether we are able to improve your symptoms with surgery.