Osteoarthritis (OA) of the knee occurs when the cartilage in the knee joint breaks down, causing an overgrowth of the bone beneath. The cartilage becomes rough and disintegrates. This results in inflammation, pain, and difficulty in moving the joint.
According to the American Academy of Orthopaedic Surgeons (AAOS), OA can develop at any age, but it most often occurs in individuals aged 50 years and above.
Thomas & Bigler Knee & Shoulder Institute, led by board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler, provides orthopedic surgery to patients in Las Vegas, Nevada, and surrounding locations.
Treatment Options
The treatment options are determined by the stage of osteoarthritis and how rapidly it is progressing.
Stage 1
In this stage, any symptoms are typically minor. In general, acetaminophens or other over-the-counter (OTC) can usually offer pain relief.
Performing specific exercises can help build mobility and strength.
Certain doctors may recommend taking supplements, such as chondroitin and glucosamine. But, the AAOS have come to the conclusion that there is not sufficient evidence to support that supplements help.
Stage 2
The treatments at this stage include:
- Taking pain relievers
- Attending physical therapy sessions to maintain or build flexibility and strength
- Wearing a knee brace meant to relieve pressure on the surfaces of the joint
- Wearing shoe inserts to relieve pressure on the knee
Individuals with OA of the knee may require modifications in their daily activities to avoid pain at this stage.
Stage 3
The treatments at this stage include:
- Taking OTC pain relievers, such as acetaminophen
- Taking prescription pain relievers, such as codeine or oxycodone
- Receiving injections of hyaluronic acid or corticosteroids
A doctor will inject three to five hyaluronic acid injections over a span of three to five weeks. While it may take time for the results to manifest, relief can last for over six months.
The AAOS has expressed concerns on the use of corticosteroid and hyaluronic acid injections. These medications can be expensive, and long-term corticosteroids use can have adverse effects.
Stage 4
By this stage, the cartilage would have either significantly reduced or disappeared entirely.
The individual may require surgery to replace or realign the joint.
Osteoarthritis patients may try the following:
- Acupuncture
- Magnetic pulse therapy, although there is inadequate research to support its effectiveness
- Lateral wedge insoles
- Supplements of chondroitin, glucosamine, or both
- Needle lavage, which involves inserting a needle into the joint and injecting a saline solution
But the AAOS either don’t recommend these treatments or believe that sufficient evidence does not exist to support their effectiveness and safety.
Stem Cell Therapy
There has been on-going research on whether stem cell therapy can regenerate cartilage in individuals with osteoarthritis.
But there are various challenges with this approach. For instance, this treatment is expensive, and an individual may need to undergo multiple rounds before seeing results. This treatment may also be ineffective if a person’s BMI is above 35.
A 2018 meta-analysis assessed the different ways in which doctors were using stem cells to treat OA and how this affected long-term results. The study concluded that the findings of high-quality studies were not consistent.
While some clinics offer stem cell therapy for osteoarthritis, the United States Food and Drug Administration (FDA) issued a warning to people in November 2017 asking them to not “believe the hype.”
The side-effects of unapproved stem cell treatments include:
- Adverse reactions at the injection site
- Cells regenerating in the wrong location
- Failure of the cells to function as expected
- Risk of tumor development
People considering stem cell treatment for osteoarthritis should consult their doctor first.
Board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler receive patients from Las Vegas, Nevada, and nearby areas for orthopedic surgery.If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.