Non-operative management of arthritis

Surgery is the last step in the management of arthritis, and the following options should be considered and employed before contemplating surgery.

This is a general overview of options that should be tailored to your specific circumstances by your GP, allied health providers and will be discussed during your consultation with Dr Keighley.

Click on underlined terms to link to more information.

First-line therapy

Pain relief

Regular paracetamol should be the first line therapy analgesic, and non-steroidal anti-inflammatories as guided by your general practitioner for short periods of relief during exacerbations.

Physiotherapy

Strength and coordination of the core and lower limb musculature is key in improving symptoms and outcomes with OA.

There are programs, such as the GLA:D program, specifically designed for patients with hip, knee and lower back osteoarthritis.

Weight-loss

While easier to say than do, weight loss can have a significant impact on your symptoms of osteoarthritis. The knee during flexion can have up to 7 x the weight above it going through the kneecap, which means for every kg you lose, that's up to 7kg less stress through the kneecap.

Activity modification

Identifying exacerbating activities and modifying them accordingly is part of living with arthritis. Changing impact activities for more joint-friendly activities such as walking, cycling, swimming or rowing can help maintain fitness, strength and mobility while reducing the stress on your joints.

Second-line therapy

Steroid injection

Variable in it's relief, corticosteroid injections may be a management option for some patients or situations. This will usually be guided by your GP or surgeon.

Platelet Rich Plasma (PRP)

An alternative to corticosteroids, PRP involves taking your blood, centrifuging it and injecting the plasma component of it back into the affected joint or tendon. Some patients get relief however there are no large level studies demonstrating long term benefit.

Radiofrequency Nerve ablation

Radiofrequency nerve ablation involves an anaesthetic and sterile surgical preparation, then cooled radiofrequency ablation probes are used to target the nerves around the painful joint. Dr Keighley may discuss this with you if he feels it might be a suitable option.

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DR GEFFREY KEIGHLEY
ORTHOPAEDIC SURGEON | Hip.Knee.Trauma