Ways To Lower Your Chances For Needing New Knees Down The Road

Knees not what they used to be? Some new procedures—one that's already
available and one that could be available soon—might allow knee patients to
avoid or delay knee replacement surgery. Doctors are already starting to use an
injectable bone-graft substitute that fills in bone defects. And, in the future,
stem cell injections could help people build new bone and cartilage
themselves, without the need for artificial substitutes. Clinical trials of these
stem cell injections are still in the early phases.

5 Tips to Avoid Knee-Replacement Surgery

By Steven Sampson, D.O.
Doctors are faced with an epidemic of younger patients with advanced knee arthritis. Once thought
of a disease in the elderly, osteoarthritis is becoming more and more common in women and in
patients 20-50 years old after sports injuries of the meniscus and ACL. According the Journal of
Bone and Joint Surgery (JBJS), there will be a 670 percent increase in total knee replacements
(artificial joints) by 2030, which may include you unless you take steps to avoid it.
Here are five steps you can take to keep your knee joints healthy and avoid the knife.
1. Weight loss. Your body has been kind enough to match your weight loss, much like an employer
offers a 401(k) program — every pound of weight you lose equals four pounds on the knee. So
losing just 5 pounds equals 20 pounds of pressure off the knee.
2. Exercise and strengthen your thigh muscles (quadriceps). A recent Australian study showed
that patients that had thicker quadriceps muscles developed less pain and cartilage damage with less
risk of joint replacement surgery compared to those with smaller quadriceps muscles over four
years. Swimming, cycling, and Pilates are among the best non-traumatic knee-strengthening
exercises to improve blood flow and build muscle.
3. Hyaluronic acid (HA) injection. This popular treatment used in plastic surgery to fill wrinkles is
FDA approved for injection into painful knee joints. A WD-40 like viscous lubricant derived from a
rooster comb, HA regulates inflammation and provides a cushion between cartilage of the knee.
Best results are seen with early intervention of mild to moderate knee arthritis.
4. Platelet-rich plasma (PRP) injection: This blood-spinning procedure, made popular by athletes
like Kobe Bryant and Tiger Woods, is now available for weekend warriors with knee joint pain.
Concentrate your body’s own growth factors (proteins) contained in platelets to heal naturally.
5. Bone marrow concentration (BMC) injection: The body’s most powerful regenerative cells are
stored in every adult in the interior of our bones. Our ability to heal from injuries is partly due to
loss in the “fitness” and quantity of stem cells, our mobile paramedics. These regenerative cells are
spun down in a centrifuge to mimic the makeup of younger patients. This same-day procedure,
while considered experimental, is reserved for advanced arthritis and more research is needed.
These five steps, including two you can do on your own, may add miles to your knees without
surgery.
Ten Ways to Avoid a Knee Replacement in Your Future
Osteoarthritis treatments and self-help can slow the progression of the disease.
Osteoarthritis is the most common form of arthritis, affecting millions of people around the world.
Often called wear-and-tear arthritis, osteoarthritis occurs when the protective cartilage on the ends of your
bones in your joints wears down over time. While osteoarthritis can damage any joint in your body, the
disorder most commonly affects joints in your hands, neck, lower back, knees and hips. Osteoarthritis
gradually worsens with time, and no cure exists. When the chronic pain of arthritis affects the knee, it can
have a huge impact on general health, as the resultant decrease in exercise can worsen or contribute to
obesity, diabetes, an increased cancer risk, and high cholesterol. But osteoarthritis treatments and self-help
can slow the progression of the disease, relieve pain and improve joint function.

Of course, should the pain continue and become life-altering—in other words, miserable—there is
the option of an artificial knee replacement. Still, any surgery has its risks, and an artificial ‘anything’ is
generally not as good as the real thing. In terms of patient satisfaction, hip and knee replacements rank at the
top. In fact, more than 95 percent of patients said they are satisfied with the outcome of their total knee
replacement one year after surgery, according to a study presented at the 2010 annual meeting of the
American Association of Orthopaedic Surgeons.

Here are some tips to avoid the operating room, or at least postpone your arrival there:

1. Weight loss. Shedding just 15 pounds can cut knee pain in half, according to a study presented at a
recent meeting of the American College of Rheumatology. Should you need arthritis knee surgery
later, you will decrease your risk of complications and reduce strain on your knees, which will make
your rehabilitation go more smoothly.

2. Physical activity. Strong muscles surrounding the knee joint support the joint and relieve pressure.
If you end up having knee surgery, the rehab will be easier if you start strengthening muscles before
surgery.

3. Braces. Prescribed by a doctor and fitted by a physical therapist, braces can improve the alignment
of the knee, relieving pain.

4. Corticosteroid injections. Administered into the knee joint help to reduce inflammation, this
procedure can alleviate pain without causing side effects associated with oral corticosteroids.

5. Electrical stimulation. This may reduce pain by strengthening the quadriceps (the large muscles on
the front of the thigh that help stabilize the knee joint), or it may even encourage regeneration of
cartilage cells.

6. Hyaluronic acid injections. These supplement a naturally occurring lubricant lacking in the joints
of people with osteoarthritis, and may decrease pain and increase function for some people.

7. Botox injections. These may relieve severe knee osteoarthritis pain and buy time before knee
surgery.

8. Over-the-counter medications. Drugs such as the analgesic acetaminophen (Tylenol) and the
nonsteroidal anti-inflammatory drugs (NSAIDs) ibuprofen (Advil, Motrin) or naproxen (Aleve), ease
pain. But several recent studies indicate that some NSAIDs may delay healing of connective tissues
such as cartilage or tendons.

9. Prescription medications. These are available to ease pain and decrease inflammation. Whether
they improve tissues in the joint continues to be investigated.

10. Dietary supplements. The National Institutes of Health is funding a study to see whether the
combination of glucosamine and chondroitin helps repair cartilage. This dietary supplement has been
shown to reduce pain in people with moderate-to-severe knee pain.