Introduction
Knee arthritis is a prevalent condition affecting millions of individuals, particularly those over the age of 45. As a physiotherapist, understanding the various medical treatments available can help you understand what options are available to you. Empowering you to take control of your health and have better more informed conversations. Leading to better knee function and less pain. In this blog, we’ll delve into the various medical treatments for knee arthritis, referencing UK-based research and the National Institute for Health and Care Excellence (NICE) guidelines.
Understanding Knee Arthritis
Knee arthritis primarily manifests as osteoarthritis (OA) or rheumatoid arthritis (RA). OA is a degenerative joint disease characterised by the breakdown of cartilage, whereas RA is an autoimmune condition causing inflammation of the joint lining. Not sure if you have OA or RA? – take a look at this blog.
Medications
Medications play a critical role in managing knee arthritis symptoms. Here are the primary categories:
Analgesics:
- Paracetamol: Often recommended as the first-line treatment for mild to moderate pain. According to NICE guidelines, paracetamol should be considered before NSAIDs due to its favourable safety profile.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs):
- Ibuprofen and Naproxen: Commonly prescribed for their anti-inflammatory and pain-relieving properties. NICE guidelines suggest using the lowest effective dose for the shortest duration to minimise side effects.
- Topical NSAIDs: Preferred over oral NSAIDs for some patients to reduce systemic exposure and potential side effects.
Corticosteroids:
- Intra-articular Injections: These are often used for acute flare-ups of knee arthritis. NICE recommends considering corticosteroid injections when other treatments have not provided adequate relief. The effects can last several weeks to months but should not be used frequently due to potential joint damage.
Injections
Hyaluronic Acid Injections:
- Known as viscosupplementation, hyaluronic acid injections aim to improve the lubricating properties of the synovial fluid in the knee. Research from the UK shows mixed results, with some patients experiencing relief while others see no significant benefit. NICE currently does not recommend hyaluronic acid injections for knee osteoarthritis due to insufficient evidence of their efficacy.
Platelet-Rich Plasma (PRP) Therapy:
- PRP therapy involves injecting a concentration of the patient’s own platelets into the knee joint to promote healing. Emerging UK-based research indicates potential benefits, but NICE advises that more robust evidence is needed before routine use can be recommended.
Stem Cell Therapy:
- This experimental treatment involves injecting stem cells to regenerate damaged cartilage. While promising results have been reported, NICE currently considers stem cell therapy to be investigational, pending further clinical trials and evidence.
Surgeries
For patients who do not respond to physiotherapy, medications or injections, surgical options may be considered:
Arthroscopy:
- This minimally invasive surgery involves using a small camera to repair or remove damaged tissue. However, NICE guidelines suggest that arthroscopy is not routinely recommended for knee osteoarthritis unless there are specific conditions like a locked knee.
Osteotomy:
- This procedure involves cutting and reshaping the bones to relieve pressure on the knee joint. It is often recommended for younger, active patients with misalignment issues contributing to their arthritis.
Partial Knee Replacement (PKR) or Unicompartmental Knee Replacement (UKR):
- This involves replacing only the damaged part of the knee, preserving as much of the natural knee structure as possible. It is suitable for patients with arthritis confined to a single compartment of the knee.
Total Knee Replacement (TKR):
- TKR is considered for severe cases where other treatments have failed. According to NICE guidelines, TKR is highly effective in relieving pain and improving function. UK studies report high satisfaction rates among patients undergoing TKR, with many experiencing significant improvements in quality of life.
You Can Improve Your Arthritic Knee
So we have looked here at the medical treatment options available however Physiotherapy has the main role to play in arthritis management as recommended by NICE suggesting first-line treatment to be therapeutic exercise, weight management, information and support to enable you to manage your knee. This is all covered in the Arthritic Knee Treatment Program. Have you tried exercise but it has made it worse find out why in this video.
The sooner you act the more you can prevent further degeneration and improve the health of your knee. With the appropriate advice and exercises, you can reduce pain and significantly improve how your knee functions. I would love to help you do this, take a look at what my Arthritic Knee Treatment Program entails – Transform your knee.
YOU DO NOT HAVE TO PUT UP WITH AND ARTHRITIC KNEE!
IT IS NOT A CASE OF WAITING UNTIL IT IS SO BAD YOU NEED SURGERY.
THERE IS SO MUCH YOU CAN DO.
Conclusion
Managing knee arthritis requires a comprehensive approach tailored to your needs. As a physiotherapist, staying informed about the latest medical treatments and guidelines is crucial in providing optimal care. You now have a better understanding of available treatments. However, do not forget the important role of physiotherapy in improving your arthritic knee. This should be your first port of call then using other treatments to compliment as needed.
By understanding these various medical treatments, you can better manage your knee arthritis. Knowledge is power after all. Hopefully, this information will empower you to have better and more useful conversations with your healthcare professional. To ultimately improve your mobility and quality of life. Arthritis does not have to be a life sentence!
Take care, Helen
Helen Manders BSc (Hons) MCSP HCPC
Chartered Physiotherapist Since 2001
References
- National Institute for Health and Care Excellence (NICE) Guidelines on Osteoarthritis Care.
- British Medical Journal (BMJ) Articles on Knee Arthritis.
