How is osteoarthritis of the knee treated?
Your doctor will recommend therapies to help relieve your pain. Your doctor may tell you to:
- Rest your knee or avoid activities that make your pain worse.
- Put ice on your knee for 20 to 30 minutes a few times a day to reduce inflammation and ease the pain.
- Take an over-the-counter medicine, such as acetaminophen (one brand: Tylenol) or ibuprofen (one brand: Motrin).
- Do physical therapy or certain exercises to help strengthen the muscles around the joint.
Are there other options?
Yes. If oral medicine and physical therapy don't help your knee enough, your doctor may consider giving you an injection (a "shot") with pain medicine (called anesthetic). It can stop the pain for days to weeks. Adding another medicine (called a corticosteriod) to the anesthetic may keep the pain and inflammation away longer. If this doesn't help enough, your doctor may talk to you about surgery or hyaluronic acid injections.
What are hyaluronic acid injections?
Some hyaluronic acid is already in the fluid in your joints. In people who have osteoarthritis, the hyaluronic acid gets thinner. When this happens, there isn't enough hyaluronic acid to protect the joint. Injections can put more hyaluronic acid into your knee joint to help protect it.
Hyaluronic acid injections may give you more pain relief than oral medicines. These injections can help the pain stay away for 6 months to a year, sometimes longer. Unfortunately, these injections don't help everyone.
Hyaluronic acid injections are also expensive but many health insurance programs cover them. Hyaluronic acid injections may be an option for you. Your doctor will talk with you about the pros and cons of hyaluronic acid injections and whether they are right for you.
What about surgery?
Sometimes osteoarthritis of the knee is so severe that surgery is required to relieve the symptoms. Surgical options include:
- Arthroscopy is done with a small scope (or camera) inserted through tiny cuts a surgeon makes in your knee. With the scope, the surgeon can see how badly your knee has been damaged by osteoarthritis. With other small instruments, the surgeon can remove damaged parts of the knee joint (this is called debridement) and clean or flush the joint to remove any loose parts (called lavage or irrigation) that may be causing your pain. Arthroscopy is not for everyone and may only provide temporary relief from pain or delay the need for other surgeries.
- Osteotomy is a surgery that repositions or reshapes the bones in your knee where osteoarthritis has caused damage. This procedure can only be done when only one area or side of your knee is damaged. The procedure changes the position or alignment of the knee so your weight shifts away from the damaged area. This procedure restores movement in your knee and relieves the pain. However, people who have an osteotomy may need knee replacement surgery in the future.
- Arthroplasty is also called joint or knee replacement therapy. A surgeon removes the part of the knee damaged by osteoarthritis and replaces it with an artificial joint made from metals and plastic. All or part of the knee joint may be replaced in this procedure. Although recovery may take a long time depending on the extent of your surgery, the results of arthroplasty are often successful. Knee replacement therapy can help put an end to your pain and improve or restore movement of your knee.
Intra-articular Hyaluronic Acid Injections for Knee Osteoarthritis by DY Wen, M.D. (American Family Physician August 01, 2000, http://www.aafp.org/afp/20000801/565.html)
Written by familydoctor.org editorial staff