Q&A Topic: Treating Osteoarthritis without Surgery

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Victor Khabie, MD, FAAOS, FACS

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Q. I live a very active lifestyle, but lately I’ve been feeling the effects of arthritis in my knee, are there non-surgical options for relief?

A. Yes. In fact, most patients with osteoarthritis will never need knee replacement surgery thanks to a variety of non-surgical treatment options available. Once you begin to experience arthritis in the knee, you can try shifting your activity to lower-impact exercises such as swimming or bicycling, or you can swap running for an elliptical trainer. Modifying, or avoiding activities that cause pain is a wise move. If you’re a singles tennis player, try switching over to doubles to eliminate excess stress on the knee. Ice the knee after any physical activity that tends to cause soreness and use ibuprofen or naproxen to help ease the pain. These types of behavior modifications can go a long way in providing relief.

Q. If behavior modification is not effective in providing relief, what is the next step?

A. When icing and activity modification doesn’t calm your osteoarthritis, I recommend physical therapy (PT) and prescription anti-inflammatories. By strengthening the muscles surrounding the knee, you will take pressure off the joint. The physical therapist will use elastic bands, rather than dumbbells or weight machines, to do low-impact muscle-building moves. These exercises allow patients to get stronger without aggravating their arthritis.

Q. Are there any other steps I can take before considering knee replacement surgery?

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A. Sure: In the case of a severe arthritic flare up, cortisone injections may tame the inflammation. A longer-term solution for many patients can be injections of hyaluronan. Also known as a viscosupplement, the gel can help replace lost cushioning and lubrication in the knee, providing patients with relief for up to a year or longer. The injections work in about 75 percent of patients who typically come in for a shot once a year.The last step before knee replacement is an arthroscopic procedure that flushes out debris in the joint and may also correct mechanical problems that are causing your knee to become stiff. This procedure works about 50 percent of the time.

Q. When should I consider surgery?

A. Have you tried non-surgical methods of relief? Are you still unable to walk upstairs or even across the room comfortably? Does the pain interfere with your sleep? These are the questions I’ll typically ask my patients. The truth is, the patient usually knows when it’s time for a knee replacement. If you’ve exhausted all other avenues of treatment and are still living with pain, surgery may be your best option. The good news is that knee surgery is safe and has good outcomes. In fact, 90% of people who have a total knee replacement have less pain and better mobility. But it’s important that you have realistic expectations about what the surgery can accomplish and what effort you’ll need to put into your recovery.

Learn More About Dr. Khabie
Chief, Department of Surgical Services
Co-Chief of Orthopedics and Sports Medicine
Co-Director, Orthopedic and Spine Institute
Director, Sports Medicine
Northern Westchester Hospital

Northern Westchester Hospital is a proud member of Northwell Health.

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Read Past Topics from Dr. Khabie:
Robot-Assisted Partial Knee Replacement
Sports-Related Knee Injuries
Shoulder Pain — When to Seek Help


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