Osteoarthritis of the knee: Methods used to treat

Physical modalities for treating knee osteoarthritis include physical therapy, exercise, weight loss, and the use of a knee brace or heel brace. A review of physical therapy interventions for patients with knee osteoarthritis concluded that exercise and weight loss help reduce pain and improve physical function. In addition, low- and high-intensity aerobic exercise was equally effective in improving knee function, gait, and pain. At the same time, for the treatment of knee osteoarthritis to be effective, the doctor recommends that the patient should stop any activity that aggravates the knee pain. There is some evidence that the use of a lateral heel brace reduces the use of nonsteroidal anti-inflammatory drugs (NSAIDs).

Many additional knee osteoarthritis drugs such as functional foods have been used and achieved with varying degrees of success. Glucosamine supplements combined with chondroitin have been shown to be beneficial in people with mild osteoarthritis of the knee.
Supplements with S-adenosylmethionine, ginger or turmeric are also valuable in the treatment of chronic osteoarthritis. A meta-analysis found that S-adenosylmethionine was as effective as NSAIDs in reducing pain and disability, and had a better safety profile. Ginger may provide some clinical benefit in patients with knee osteoarthritis. Patients who took 255 mg of the ginger extract twice daily experienced a reduction in pain compared with the placebo group. Turmeric has historically been used to treat arthritis pain, but no clinical trials have shown it to be effective.

Drug treatments can be classified as topical, oral, or intra-articular. The use of topical therapies helps to avoid many of the side effects associated with systemic medications.
Many oral medications are available to control the pain of osteoarthritis of the knee. In particular, acetaminophen is the preferred drug, more effective than placebo in the treatment of joint pain in general. Hepatotoxicity from acetaminophen is extremely rare, although caution should be exercised in patients who consume alcohol daily. Patients taking 3 to 4 g of acetaminophen daily should have regular monitoring of liver and kidney function. In addition, the NSAID class of anti-inflammatory analgesics was slightly superior to acetaminophen in improving knee and hip pain in osteoarthritis patients, especially in those with moderate to moderate pain. heavy. There was absolutely no difference in clinical efficacy between NSAIDs.
Opioids may also have a useful role in the treatment of knee osteoarthritis. Because of the potential for addiction, the use of opioid therapy is recommended only in elderly patients with moderate to severe pain or reduced quality of life when other treatments are ineffective and inappropriate. Tramadol, with or without acetaminophen, significantly reduces pain intensity, relieves symptoms, and improves function. However, tramadol increases the risk of seizures, especially in patients who drink alcohol.

Intra-articular corticosteroid injections are a knee osteoarthritis treatment that can provide short-term symptom relief with a low risk of side effects. The mechanism of action of corticosteroids is to inhibit the accumulation of inflammatory cell lines, decrease prostaglandin synthesis, inhibit leukocyte secretion from synovial cells, and reduce interleukin secretion by the synovial lining. The usual dose for knee injection is 40 mg of triamcinolone acetonide in the amount needed for treatment as two or three times. However, this long-term treatment for osteoarthritis of the knee is not recommended.
Intra-articular hyaluronic acid injection for the treatment of osteoarthritis in general or the treatment of knee osteoarthritis in particular has also shown minimal effectiveness. Furthermore, there are no studies demonstrating that these drugs alter the course of the disease.

Arthroscopic surgery is not an appropriate treatment for knee osteoarthritis unless there is evidence of structural damage to the joint following acute trauma, which increases the risk of subsequent osteoarthritis.
Meanwhile, total knee replacement is considered a last resort. Due to the high cost, the main indication of total knee orthopedic surgery is when osteoarthritis is resistant to pain relievers.
Although it is one of the most studied and common diseases in the population, there is currently no effective treatment for knee osteoarthritis. Until now, exercises in the early stages are still recommended and the next step is to treat knee osteoarthritis by reducing pain, and eventually to joint replacement. In general, the effectiveness of nonsurgical treatments varies, and success depends on many factors.
Currently, Vinmec International General Hospital has successfully treated many musculoskeletal diseases such as meniscus tears, osteoarthritis, elbow fusion, fracture... With modern technical facilities ; a civilized, polite, safe and sterile medical examination and treatment space with a team of highly qualified and well-trained doctors at major Orthopedic and Trauma Centers at home and abroad... You can rest assured when choosing Vinmec to perform surgery and treat bone and joint injuries. Thanks to good medical quality, the examination and treatment always achieve good results, helping patients recover quickly.