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- Non-surgical treatment options
for osteoarthritis of the knee
come down to three choices.
First off all, there's physical therapy.
This physical therapy is done with a focus on
decreasing the swelling and stiffness in your knee.
Improving the range of motion,
and finally, strengthening the muscles around the knee.
Education on how to minimize
impact loading and twisting forces to your knee
is also very important.
Secondly, we have nutraceuticals.
these are naturally occurring substances,
these are actually supplements,
which consist of either pills or shots.
The most common pill form is that of
glucosamine and chondroitin.
The other pill form is omega-3,
also known as fish oils.
When we give injections,
they are usually hylauronic acid.
This is, again, a supplement.
That is, hylauronic acid is already found in your body.
We're simply adding to it.
This mimics the natural lubricating fluid
that is found in your knee.
These injections are given in a series
of either three or five injections,
over a three to five week period.
While it can take several weeks to begin
to feel relief from your symptoms,
once you have relief, it can last for several months,
or even several years.
The third category is that of pharmaceuticals.
These are medications.
Once again, they come in two flavors,
either pills or shots.
The most common form of pill
is that of a non-steroidal anti-inflammatory drug.
A very common example is Motrin, or an ibuprofen.
These medications, once again,
are used to control both swelling and pain.
The injection form is that of cortizone.
This is a very powerful anti-inflammatory medication.
These injections are typically spaced
at least three to four months apart.
Once they're given, they can give relief
for several weeks, or even several months.
Let's talk about the role of arthroscopy
in osteoarthritis of the knee.
Let's, once again, revisit the parts list.
We have the thigh bone,
that sits on top of the leg bone.
And on top of the leg bone,
we have those two shock absorbers called the meniscus.
With osteoarthritis of the knee,
we noted that the ends of the thigh bone
become frayed, little chips coming off it.
In general, kind of beat up.
The meniscus, in turn,
tears most often in the back, here,
and the tear can extend and worsen.
Again, thigh bone, end of the thigh bone.
Big chips, small chips, rough surface.
Wear and tear.
Osteoarthritis.
The meniscus has a tear.
That tear often separates
when we kneel, squat,
sometimes just sitting in the car,
so that it looks something like this.
Where that flap or tear actually separates.
The front often stays intact without any tears.
This is a torn meniscus,
as we often find in osteoarthritis.
With arthroscopy of this condition,
our aim is, first of all,
to vacuum these pieces and smooth this surface.
We actually have a little vacuum cleaner
that comes in, vacuums the pieces,
then it turns into a little high-speed planer
that smooths these surfaces.
In summary, then, step one is vacuum and polish.
Step two is to remove that little flap
on the torn meniscus and smooth that inner surface,
so that when we're finished,
it looks something like this.
Flap's been removed, surfaces have been made smooth.
There we go, the front stays often intact.
This is step two, trim meniscus.
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