arthroscopy – where fluid is flushed into the knee joint to clear out any loose bone and cartilage. osteotomy – where the shape of your shin bone is changed to reduce pressure on the worn or damaged part of your knee. microfracture – where small holes are made in the surface of the bone to help new cartilage grow.
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.
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.
Bone-on-Bone Arthritis
Patients who have thinning of the cartilage but not bone touching bone should not undergo knee replacement surgery, except in rare circumstances.
The idea behind these injections is that they will temporarily restore the natural function of the knee by injecting a substance which will provide cushioning and reduce bone-on-bone contact. Individual responses vary, but many patients experience months, if not potentially a year or more of relief.
When you put off surgery for too long, you can experience a continued loss of mobility and function in your joint. Plus, your body continues to age and your risk increases for developing other health conditions such as diabetes or high blood pressure.
The answer: a resounding yes! In fact, people with knee osteoarthritis who walk for exercise are significantly less likely to go on to develop worse pain, according to a 2022 study published in Arthritis & Rheumatology.
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.
Braces. An offloading brace can be effective when cartilage loss in the knee s confined to only one area of the knee. These offloading braces push the knee away from the side of no cartilage, reducing pressure and inflammation in that part of the knee.
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.
Hyaluronic acid injection is used to treat knee pain caused by osteoarthritis (OA) in patients who have already been treated with pain relievers (e.g., acetaminophen) and other treatments that did not work well.
You may be offered knee replacement surgery if: you have severe pain, swelling and stiffness in your knee joint and your mobility is reduced. your knee pain is so severe that it interferes with your quality of life and sleep. everyday tasks, such as shopping or getting out of the bath, are difficult or impossible.
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).
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.
Because cartilage does not have a blood supply, it has limited ability to repair itself. Cartilage regeneration, along with strengthening muscles around the joint, can help some patients delay joint replacement surgery for damaged joints.
Cartilage damage is repaired using arthroscopic (or keyhole) surgery, which means minimal impact on healthy parts of your knee, less scarring and quicker recovery times. The cartilage may be removed, trimmed or smoothed down using special tools.
stiffness or swelling around your knee – the swelling may not start for a few hours or days. difficulty bending, straightening or moving your knee. your knee giving way when you try to stand. a crunching or clicking feeling when you move your knee.
Avoid high-impact workouts and exercises if you have osteoarthritis of the knee, hip, or ankle. These activities often place stress on weight-bearing joints. Basketball, football, hockey, and soccer are all examples of high-impact sports.
Pushing through pain is not the thing to do. If your joints are hot or swollen, exercise can increase the damage and cause more pain. Remember, arthritis pain and pain from a strenuous workout are not the same. A little soreness a day or two after a workout is OK.
'” Genetics notwithstanding, Sheth said there are some factors that can potentially stave off a knee replacement. Keeping body weight down eases the impact on the knee. And when exercising, Sheth said avoiding activities that cause pounding or other possible trauma to the knee can better preserve cartilage.
Many patients ask this question when considering TKR and the consensus is that the spring and early fall are the best seasons. You'll want to wear as little clothing as possible during your recovery because it makes cleaning the wound and moving around easier.
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.