Knee Arthritis and Treatment Options
Knee arthritis, a condition marked by inflammation and degradation of knee joint cartilage, can significantly impact daily life. It's the annoying creaking and stiffness that turns a simple stroll into a bit of a struggle, and there's often a persistent ache, like a dull discomfort. Sometimes, people feel a catching or clicking when they bend or flex their knee. An X-ray of a knee with arthritis will show the space between the upper and lower bones is often reduced or, in some places, even absent due to loss of cartilage - the shiny material which covers the ends of the bones.
There are several types of knee arthritis: gout related arthritis, juvenile idiopathic arthritis, psoriatic arthritis, rheumatoid arthritis, and osteoarthritis - the most common type. A long-term condition, osteoarthritis wears away the shock-absorbing cartilage and causes the bones to rub together. The entire knee joint starts to malfunction, due to deterioration of the soft tissues – cartilage, ligaments, tendons, muscle – and the bones themselves. As a result, the joint becomes stiff, swollen and painful.
Although more prevalent in older people, younger patients may get post-traumatic arthritis. This is a form of early onset osteoarthritis that results from an injury to the ligaments, cartilage and/or bone in or around a joint. People who are born with abnormalities in the shape of their bones or joints can also have osteoarthritis at earlier ages.
Although there is no permanent cure, various treatment options exist to manage symptoms and enhance mobility. They include:
Exercise:
Low-impact activities, such as swimming, can help maintain mobility without excessive stress on the knee.
Physio and tailored exercises ease arthritis, strengthen surrounding muscles, improve joint support, flexibility, reduce pain, and enhance overall mobility and function.
Weight Loss: Weight management is crucial as excess weight places added stress on the knee joints.
Medication:
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Help alleviate pain and reduce inflammation.
Analgesics: Over-the-counter pain relievers like acetaminophen can offer relief.
Corticosteroids: Injections directly into the knee joint can provide short-term relief for inflammation.
Viscosupplement Injections: Typically lasting for up to 3-6 months, Hyaluronic Acid (HA) injections can provide lubrication to the joint, easing movement and reducing pain. HA doesn’t weaken joints with repeated injections so can be repeated indefinitely.
Canes or Braces: Provide additional support, reducing strain on the affected knee.
Capsaicin Cream: Although not that commonly used, Capsaicin (a component extracted from chilli peppers!) has indeed been used for the treatment of osteoarthritis. Capsaicin can desensitise or reduce the amount of substance P in your nerves (therefore reducing pain) as well as reducing the inflammation and swelling that people with osteoarthritis experience. Usually available in the form of gel, creams, and plasters.
Alternative Therapies: Chiropractic care and acupuncture may offer relief.
A comprehensive approach often involves a combination of these treatments, tailored to individual needs. Previously, when these therapies failed, it was thought that surgical interventions such as arthroscopy, joint resurfacing or total knee replacement surgery were the only options. However, thanks to the efficiency of several clinical trials and experiments that researchers have done over the years, there are now several breakthrough ways for treating osteoarthritis.
Below we discuss two of the new treatment options that can be used, and that are offered at our practice the Leigh Injection Clinic, based in Leigh on Sea, Essex.
Prolotherapy
Suited to mild to moderate arthritis, Prolotherapy and Prolozone injections offer pain relief without the use of cortisone. It involves the injection of a regenerative solution which provides a direct supply of what is required to heal and repair.
Prolotherapy injections consist of local anaesthetic and dextrose. The dextrose acts as an irritant and promotes healing and improved ligament integrity. Prolozone injections consist of local anaesthetic and a variable mix of homeopathic anti-inflammatory, dextrose and medical ozone gas. Damaged and degenerative tissues have poor oxygen utilisation, which in turn inhibits the healing process. Ozone helps to increase oxygen in the area, so rejuvenating the healing process.
Research suggests that 3-6 sessions of prolozone gives relief of symptoms in 75% of patients, even chronic conditions which have been affecting the patient for many years. The remaining 25% will need a prolozone top up to keep their symptoms at bay, every few months.
Arthrosamid®
Arthrosamid® is a single injection treatment for anything from mild to severe knee osteoarthritis, in fact it is the only injection indicated for severe bone on bone arthritis. It is based on an innovative, non-biodegradable hydrogel technology and is actually classed as an implant.
Arthrosamid® is 2.5% cross-linked polyacrylamide and 97.5% water. When injected into the knee Arthrosamid® has been shown to provide a structural cushioning, reducing pain, decreasing stiffness, and helping movement for a sustained period, all with one injection. It has been shown to be safe, and studies are suggesting years of pain relief!
These exciting developments in arthritis management gives us hope. If you’re in pain, the chances are you can’t do the things you love, or even the things you need to do - treating arthritis is important to get you back to your everyday life. It's crucial to consult with a healthcare professional to determine the most suitable course of action based on the severity of knee arthritis and the impact on daily life.