The most common and most disabling cause of knee arthritis is osteoarthritis (OA), or "wear and tear". The most common symptoms of OA are pain, swelling, stiffness, catching, instability, and deformity.
Treatment of symptomatic OA includes several levels of management, akin to a step-ladder approach, with higher steps carrying higher risks:
1st step: observation (watch and "wait and see" approaches)
2nd step: rest, modification of activities to avoid painful triggers, ice, knee sleeves, elevation, shoe shock absorbing inserts, physical therapy, etc.
3rd step: supplements like glucosamine and chondroitin sulfate, medications like acetominophen (tylenol)
4th step: medications like aspirin and non-steroidal anti-inflammatory drugs (check with your MD first, these carry a risk of bleeding ulcers and other potential problems); narcotics are rarely used because of the potential for accomodation, addiction and abuse
5th step: injections like "cortisone" and hyaluronic acid
6th step: arthroscopic debridement (i.e.- clean-out, wash-out, tune-up, "oil-change"), which usually has limited benefit
7th step: knee reconstruction- osteotomy (change shape of knee to correct deformity), partial or total knee replacement ("resurface and rebuild")
Click here: Frequently asked questions regarding knee replacement surgery.
Click here: Knee replacement technique and photos
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