If you’re on this page, chances are you’re contemplating knee surgery. Of course, that’s a pretty big, life-changing decision, so it’s usually in your best interest to exhaust EVERY other less-invasive option first. Below are my most recommended knee replacement alternatives:
This one’s the most standard of the list. You’ve probably already tried at least one type of anti-inflammatory medicine. NSAIDs (non-steroidal anti-inflammatory drugs) like Tylenol and Ibuprofen are easy enough to grab over-the-counter and a great way to manage your own pain. If/when those their effects wear off, certain types of opioids can give you years of additional pain relief (check with your doctor).
These are shots delivered straight to your knee joint. There are two popular options, corticosteroids (steroid) and hyaluronic acid. The former has been heavily studied (though the mechanism of action isn’t really known), so it’s a fairly routine treatment option. Steroid injections usually come in sets of two or three and relief can last for weeks or even several months.
Hyaluronic acid is the new kid on the block. It’s a naturally-occurring substance in the body and believed to help regulate the synovial fluid in the knee. I’ve personally had a handful of patients see remarkable results with HA; but as with most meds, your results will vary.
If you haven’t gone the non-traditional route, I highly recommend you try it. Of all the options out there, acupuncture is a great introduction to the culture. While the research on it is fairly inconclusive, some folks absolutely swear by it (it’s definitely helped me out). In this NIH study, over 500 patients were given weekly acupuncture treatments for over 6 months. A control group received either limited or sham treatments. They concluded “Acupuncture seems to provide improvement in function and pain relief as an adjunctive therapy for osteoarthritis.”
Other studies are less decisive. What we DO know is acupuncture needs to be administered by a qualified therapist, so if a study doesn’t adhere to traditional techniques, the results may not be there. At the end of the day, there’s not much to lose (other than a few bucks). Give it a try for at least a month and assess its effectiveness. You may just get hooked.
Braces and Wedges
As you know, ANY excessive use of your knee (short run, quick turn, etc) can lead to hours or days of additional knee pain. Arthritis is a very tenuous and sensitive condition, so it’s all about managing your motion. That’s where braces and wedges can help out. While you can pick these up at any pharmacy, I HIGHLY recommend you get them custom-fitted by an orthopedist. They’ll also be able to gauge whether a heel wedge and knee brace combo will provide you with synergistic benefits. Of course, when you have your equipment on, that’s not a license to run your knees ragged (I’ve seen it happen!). You may be able to do a bit more than normal, but take comfort in the fact that your arthritis will largely be kept under control during most daily activities.
Stem Cell Therapy
If you’re the high-tech or adventurous kind, stem cell therapy is a burgeoning option for osteoarthritis. Unfortunately, it’s still not commonplace in the United States and typically not covered by insurance, so it’s more of an individual choice at this point. By 2015, I expect it to be MUCH more pervasive, but for now you’ll have to travel to specialty clinics and negotiate a price. Stem cell therapy involves harvesting your own stem cells, then infusing them into your knee joint. The hope is they differentiate (morph) into healthy cartilage, dramatically improving your arthritis. Anecdotaly, over 60% of patients experience a greater than 50% improvement. A big part of the results hinge on your immune/circulatory system and how quickly it heals/regenerates new cells. If you have it in your budget, definitely consider stem cell therapy (or, at the very least, schedule a consultation, most of which are free).