Alternatives to Knee Replacement Surgery

Total knee replacement surgery is typically the preferred treatment option for end-stage degenerative joint disease that has progressed to a life-affecting degree. Mobility has been significantly altered in addition to the severe pain, swelling and mechanical symptoms such as popping and catching. Many times knee replacement surgery is the final treatment option; however there are alternatives that can offer relief and improved mobility in many instances.

What Else Can Be Done?

• In the milder forms of arthritis of the knee when symptoms are essentially minimal, many treatment options exist including rest, oral pain medications, anti-inflammatory agents, physical therapy and activity modification. Many times, these simple remedies can lessen symptoms and contribute to decreased discomfort levels.

Benefits of Anti-Inflammatory Drugs vs. Pain Medication.

• The main difference between pain medication (analgesics), narcotic or otherwise, and anti-inflammatory drugs is that with analgesics, the mechanism of actions is mainly to depress the brain's interpretation of pain signals sent to it. This is especially true with narcotic pain medication. Simply put, narcotic pain medications dull the brain's ability to perceive pain impulses, thus making the knee "feel better."
  In the case of anti-inflammatory agents, these drugs are typically non-narcotic, non-steroidal (NSAID's) and work on pain in an entirely different manner. Instead of working on pain receptors in the brain, these drugs are absorbed into the blood stream and literally "travel" to the site of inflammation that causes pain and battle against it, thus reducing the severity of the pain symptoms. The newer generations of NSAID's are made in such a way as to offer added protection to the stomach lining against ulcer formation.

Keep the Joint Moving

• In addition to controlling discomfort in knee arthritis, maintaining mobility through motion is paramount. Arthritic knee joints function better overall if they are kept moving and not allowed to get stiff. Various forms of therapy can provide additional relief of discomfort as well as optimize mobility. Standard, land-based therapy is therapeutic exercise performed in a gym, while aquatic therapy is done in a pool. The water in the pool is typically warmer than that found in most community pools. Aquatic therapy serves to maximize motion and mobility without the constraints of gravity.

When Oral Medications Alone Won't Do

• When pain and inflammation have progressed beyond what simple oral treatments can handle, the next line of treatment options should be considered, such as injections directly into the knee joint.
  One such medication frequently injected into the knee joint is the steroid, or more commonly known as "cortisone." There are several brands of steroid used, each with its own duration of action. Steroid injections into the knee joint offer the patient placement of potent anti-inflammation substances directly where it is needed most, and because of a slower absorption than in muscle or other injection sites, provide for extended benefit.

What About Gel Injections?

• Another product widely used by intra-articular (in the joint) injection is the relatively new "hyaluronic acid "gel injection. These products are commonly manufactured from chicken combs or synthetically. Their purpose is to coat the affected cartilage areas and offer protection, as well as to decrease friction and increase the cartilage's ability to maintain hydration. Unfortunately, these gel products work better in the milder forms of arthritis, but are well worth trying in all cases since many alternatives are more invasive.