Knee Replacements for Osteoarthritis: Necessary or Not?

How many of you have had to consider surgical intervention for degenerative knee pain?

According to new guidelines outlined by the Australian Commission on Safety and Quality in Healthcare (ACSQHC), arthroscopies “don’t provide long-term benefits and can cause harm” and any replacement surgery should be looked as a last resort.

In light of this, a weight loss and exercise program approach has been shown to be the most effective form of managing ongoing knee pain and improving function, but how many people experiencing this pain actually explore this conservative option before surgery?

Incorporation of exercise and lifestyle modifications to encourage weight loss to reduce pain would seem to be a logical option to explore prior to considering surgery, however studies have shown that only 10% of Australians incorporated weight loss as part of osteoarthritis treatment.

Exercise for osteoarthritic pain management (including stretching, strengthening, exercise programs) is even more effective in decreasing knee pain and improving function than passive modalities (e.g., therapeutic ultrasonography, electrical stimulation, taping, cryotherapy, heat).

Keep in mind, exercise cannot be undertaken in isolation. Patients with a body mass index greater than 25 kg per m2 should be encouraged to lose weight through the addition of a calorie restricted diet combined with an aerobic/strength-training program.

Exercise-based treatment for Osteoarthritis can take a variety of different modes. From Hydrotherapy to land based gym or home exercises, an individually tailored assessment and exercise programme can be provided by an Accredited Exercise Physiologist can help with daily pain management and knee function.

If you are reading this and thinking “this is me!”, take the time to look at the flow chart below before thinking that you’ve exhausted your conservative options. Perhaps booking in with a Physiotherapist or Exercise Physiologist might be the best option towards avoiding surgery and reducing pain. For more information on Move’s exercise services, enquire in clinic today or phone 8373 5655.

Figure 1. Algorithm for the treatment of knee osteoarthritis

Figure 1. Algorithm for the treatment of knee osteoarthritis
Jones, B et al 2015, ‘Nonsurgical Management of Knee Pain in Adults’ American Family Physician, Volume 92 Page 875-884



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