1. Introduction
The annual incidence of knee joint pain is estimated to be over 600,000 cases. The majority of these are due to meniscal tears which often develop into degenerative joint disease. Gradual onset knee pain which is aggravated by weight bearing activities, in addition to morning stiffness and localized tenderness, is a common clinical complaint. Many patients with knee joint pain have undergone surgical treatment which has included arthroscopic partial meniscectomy. This procedure has been popular since the 1980s and involves removal of the torn portion of the meniscus. However, as the degenerative changes progress, pain increases and general function and quality of life declines, leading to a significant number of knee joint replacements. The number of knee joint replacements has almost doubled in the last 10 years and it is a procedure which is becoming increasingly common in the aging population. However, total knee replacements are not considered ideal for younger patients due to the lifespan of the prosthetic being approximately 10-15 years. Hence there is a current initiative to increase the awareness of non-surgical treatments for knee joint pain and also to determine the optimal surgical intervention for degenerative knee conditions. The aim is to improve age-specific outcomes for patients in both the short and long term while slowing the progression of knee joint arthritis.
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Non-Surgical Treatment Options for Knee Joint Pain
Weight Loss/Activity Modification: If the patient is overweight, there is a lot of success in reducing knee pain with weight loss. Clinical trial studies have shown that a 5 kg reduction in weight results in a 50% reduction in the rate of joint space loss. This, in turn, slows down the progression of osteoarthritis. A decrease in weight reduces the load and stress placed upon the joint, which causes less pain and discomfort for the patient. Regular exercise is an important factor for weight loss and overall general health. Activities that put high stress on the knee joint, such as running and jumping, may have to be replaced with low-impact sports such as swimming and cycling. This will prevent further damage to the meniscus, another factor that can cause osteoarthritis of the knee.
Physical Therapy: Since the underlying problem and cause of osteoarthritis is deterioration of the articular cartilage, the best way to treat the disease is to rehabilitate the muscle and stimulate the cartilage. Muscle deterioration and weakness occur with osteoarthritis. Muscle action is required to absorb shock and the force that is transmitted across the joint during daily activities. The quadriceps muscle has been shown to be an important factor in the prevention and treatment of osteoarthritis of the knee. It has been proven that two-thirds of knee osteoarthritis patients have less pain and more function after increasing their quadriceps strength. A physiotherapist will be able to develop an individualized exercise program that will increase the strength and endurance of the quadriceps and other muscles that support the joint. Range of motion exercises can help stimulate cartilage growth and provide more mobility for the patient.
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Benefits and Risks of Non-Surgical Treatment
If the patient experiences pain and disability from their osteoarthritis, a good non-surgical alternative is the use of NSAIDs (anti-inflammatory medications). In some cases, doctors may use an injection of a drug called hyaluronic acid that is thought to provide lubrication and cushioning to the knee. Perhaps one of the more reassuring non-surgical treatment options is the fact that it is not permanent. If a patient does not experience satisfying results from their non-surgical treatment, it is not uncommon to then evaluate surgical options. This is particularly true regarding arthroscopy.
The good thing about non-surgical remedies is that they are not invasive. That is appealing to a lot of patients. This means that the procedures do not involve making incisions and there is no prolonged recovery period to endure. These remedies can generally be performed in a doctor’s office with little to no anesthesia. Non-surgical procedures are less traumatic to the body and therefore are usually less risky. There are many non-surgical options available. For example, if a patient has mildly symptomatic osteoarthritis of the knee their doctor may recommend a cane, physical therapy or an exercise program. Non surgical treatment for knee joint pain is available in Singapore.
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Knee Cap Replacement: Procedure and Recovery
Some patients with severe knee cap damages may require a knee cap replacement. This is usually done when a patient is older and less active and then would need a combination of a total knee replacement and a partial knee replacement. A plastic button is used to replace the damaged cartilage and the underlying bone. Basically, the replacement would resurface the kneecap treating the damaged cartilage and bone. This operation removes only the diseased area of your kneecap, sparing the rest of your joint. This surgical option will provide great pain relief, improvement in the function of your knee, and an overall improvement on your quality of life that has been limited by a severely damaging knee ailment. However, there are potential risks and there are limitations to the prosthesis. Make sure to ask your surgeon what type of kneecap prosthesis will be used and about their personal experience with this surgery. Your doctor may offer more information about knee cap replacement.
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Conclusion
An effective treatment of pain in joints can be achieved through exercises, adjustments in lifestyle, physical aids, and supportive therapies. However, for some people, a knee joint replacement surgery may become the only option. Surgical treatment of the knee joint is no doubt beneficial, but it has many limitations like the recurrence of the same problem after a few years, decreased life of the prosthesis, permanent restrictions in movements, etc. Many times, the risk of surgery is not justified by its long-term benefits. Minimally invasive procedures offer a ray of hope to these patients. Non-surgical treatment of knee joint pain through RF ablation or Genicular Nerve block has the potential to postpone the knee joint surgery for a few years, and it’s extremely safe with hardly any complications. High tibial osteotomy, though a form of surgery, is joint-preserving and benefits the patients who have early arthritis in only one part of the knee. Similarly, stem cell therapy is also joint-preserving and beneficial for the patients looking to prolong the age of the joint and delay the joint replacement. So, to sum up, we can say that patients suffering from knee joint pain have a wide variety of treatment options, and they should choose it depending upon their need, severity of pain, overall health, and future expectations from the treatment. With changing times and continuous research, non-surgical treatments are becoming more effective, and there is definitely hope to have a permanent cure without the need for joint replacement. Complete relief from pain and improved quality of life is the ultimate goal of any treatment, and this is what we intend to achieve.
