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Alternatives To Knee Replacement Surgery And Understanding Their Uses

May 6, 2022
A Patient Doing Physical Exercises With His Therapist

After a patient has knee replacement surgery, their knee implant can last up to 15 years, allowing them to stay active without pain. However, total knee replacement is major surgery. Many patients can find significant pain relief from less invasive treatment methods. Below, Richmond University Medical Center outlines surgical and non-surgical knee replacement alternatives.

Physical Therapy

Arthritis can cause pain, stiffness, and inflammation in the knee joints. Unfortunately, arthritis is a very common condition – according to Cleveland Clinic, about 50 million U.S. adults have some form of arthritis. Structured physical therapy is a smart first step for addressing chronic knee pain with conservative treatment. A physical therapist will use repetitive exercises and movements to stretch and strengthen muscles. They may apply ice, heat, or electrical stimulation to reduce pain and improve blood flow around the knee. Patients typically are assigned a physical therapy regimen for a set period, such as twice a week over six weeks.

A physical therapist also may recommend low-impact exercise such as swimming or walking on a treadmill, to maintain mobility and build up muscle strength. Over-the-counter (OTC) medications also can help reduce pain and swelling.

Injection Treatments

If medication and physical therapy are not effective in reducing knee pain, a medical provider will typically recommend an injection treatment as the next step. There are two common types of injections that help with joint pain in the knee:

  • Corticosteroid injections: A cortisone injection can significantly reduce inflammation and swelling in the knee. This is a quick, non-surgical treatment that can be performed in an outpatient setting.
  • Hyaluronic acid injections: If corticosteroid treatment does not noticeably help a patient, they may find relief with a hyaluronic acid (HA) injection. These also are known as gel injections. Hyaluronic acid mimics the body’s natural joint fluid, reducing pain by acting as a cushion between the joints. An HA injection can provide pain relief for several months, and some patients will find that it reduces their pain for up to a year. Because corticosteroids can raise blood sugar levels, HA injections can be a preferred treatment method for patients with diabetes.

Arthroscopic Surgery

Patients who continue to experience joint pain after a conservative care plan of rest, OTC medication, physical therapy, and injections may be candidates for arthroscopic surgery. This minimally invasive surgery can help identify the causes of a patient’s joint pain. A surgeon will make a small incision near the knee joint and insert a fiber-optic camera, giving the surgeon a clear picture of the inside of the joint. In some cases, a patient will be put under general anesthesia before the procedure. In other cases, they will require only a local anesthetic.

The video image from the camera allows the surgical team to accurately diagnose the source of knee pain. During the procedure, the surgeon may be able to repair cartilage or remove bone or cartilage fragments that are causing issues. This can help reduce the patient’s pain as well as eliminate the need for future, more invasive surgical procedures such as knee replacement. Because the procedure requires only a small incision, there is minimal scarring and patients typically have a short recovery time.

Cartilage Restoration Surgery

A final alternative to full knee replacement is cartilage restoration surgery, often referred to as microfracture. As the cartilage in the joints deteriorates, it eventually can wear down enough to expose the bone. During a microfracture procedure, a surgeon uses a small instrument to create a network of tiny holes in the bone near the damaged cartilage. Blood flows into these holes, clotting and developing into fibrocartilage. The fibrocartilage mimics regular cartilage, so it can help to restore mobility and reduce pain in the knee.

This procedure works best for smaller injuries to cartilage. It is not effective for widespread joint damage or injuries to underlying bones in the knee joint. After cartilage restoration surgery, patients typically need to keep weight off their knee for several weeks and may need to use crutches. Regular physical therapy is recommended after this surgery, often for three to six months.

Find Out More About Alternatives To Knee Replacement Surgery

The medical team at Richmond University Medical Center provides multiple treatment options for patients with knee injuries, fractures, or inflammation, from conservative care to complete knee replacement. With a team of experienced, board-certified orthopedic surgeons, Richmond University Medical Center serves patients throughout Staten Island, NY, and the surrounding area. For more information about knee replacement alternatives, contact us today.