The first alternative to knee surgery most physicians try is lifestyle modification. This may include weight loss; avoiding activities such as running and twisting, which can aggravate the knee injury; modifying exercise to no- and low-impact; and other changes in your daily routine to reduce stress on your knee.
Regenerative Stem Cell Therapy
Stem cell knee therapy is becoming a popular alternative to knee replacement surgery. Through a method known as autologous transplantation, the cells are extracted from the patient's bone marrow or fatty tissue, processed, and immediately injected into the damaged knee.
Healthy lifestyle choices - including keeping your weight within recommended limits and exercising regularly to keep muscles strong and joints mobile - will greatly reduce the chance of joint, cartilage or ligament damage.
Joint damage: If you delay surgery, the damage to your knee joint will likely worsen. This can lead to a loss of function and mobility and may even require revision surgery. Increased risk of injury: Knee pain can make it difficult to walk, climb stairs, and participate in other activities.
Severe knee cartilage loss makes walking, sitting, standing, squatting, and going up and down stairs extremely painful. People with a total loss of knee cartilage can benefit from joint injections. In many cases, surgery including a total knee replacement is needed to treat no cartilage in the knee.
There is no set age cutoff for a knee replacement, as each patient's case is different. Before surgical intervention becomes an option, other less invasive treatments such as anti-inflammatory medications, cortisone injections, and physical therapy should be explored.
The gel injections tend to be effective for about 50% of patients, but for those that it works well for those patients tend to see improvement in VAS scores for at least 4-6 months.
Losing weight, strengthening muscles, and increasing flexibility may help you stave off joint replacement. You may be putting off a doctor visit to address knee or hip osteoarthritis because you believe it will end with joint replacement surgery, but that's not always the case.
Genicular nerve radiofrequency ablation is a minimally invasive treatment for knee pain due to osteoarthritis of the knee, and can significantly reduce pain, especially for adults who are 50 and older.
There are several cartilage-regeneration techniques that you may consider and discuss with an orthopaedic surgeon. Autologous chondrocyte implantation (ACI), for example, involves taking a sample of your cartilage cells, growing them in a lab and then surgically replanting them in your knee.
NYU Langone doctors often recommend nonsurgical options as a first-line treatment for a knee cartilage injury. These include anti-inflammatory medication, physical therapy, and injections into the joint, including steroids; hyaluronic acid, also known as synthetic joint fluid; and platelet-rich plasma (PRP).
Some exercises to try include squats, wall squats, lunges, and bridges. Regular stretching and flexibility training will help to lengthen the muscles that support the knees. This will increase the range of motion of your knees and therefore protect you from injuries associated with tightness in the muscles.
Sit on a straight back chair with your feet planted firmly in front. Lift one leg until straight and hold it for three seconds then return it to the floor. Alternate legs as you do one or two sets. As you grow stronger, you can add more repetitions and sets to continue to strengthen the joint.
Just 5 to 10 Minutes of Walking a Day Could Lower Your Risk of Needing a Knee Replacement If You Have Arthritis.
Non-Invasive Treatments
Ice and over-the-counter pain medication like acetaminophen or ibuprofen can help. Sometimes physical therapy or a guided exercise program can provide bone-on-bone knee pain relief by strengthening the muscles that support the knee, particularly the quadriceps.
The majority of patients expect to be able to kneel after TKR,2,4,5 however, these expectations are frequently not met,1,6 with between 50% and 80% of patients reporting that they have difficulty kneeling or do not kneel in the months and years after TKR.
How long the effects last varies. Some patients report pain relieving effects for several months following the injections. If the injections are effective they may be repeated after a period of time, usually 6 months.
All knee injections carry a risk of infection. This risk is slightly higher with steroid injections than with other drugs because steroids weaken the immune response within the joint. Repeated steroid injections over a long time period can also weaken the joint cartilage.
Most health insurance plans don't cover PRP shots. Does Medicare cover HA shots? Yes!
Age alone is no bar to surgery. Older and younger people benefit equally, as long as they are generally healthy to start. However, people under 60 are encouraged to delay total knee replacement if they can.
Think about the basic everyday tasks you need to do and consider how you would manage if you were unable to bend your knee eg. getting in and out of a chair or even going to the toilet. And don't forget you won't be able to drive for a while. Try to put your pride aside and make sure you have help on hand.