Consider innovative approaches to cure knee osteoarthritis before surgery: Expert

Many patients who undergo total knee arthroplasty struggle with adhering to the rigorous postoperative rehabilitation spanning several months, which compounds their distress.

Hyderabad: In recent years, with the proliferation of hospitals in Hyderabad, total knee arthroplasty has become a widely-accepted surgical method for addressing osteoarthritis.

Osteoarthritis (OA) stands as a prevalent cause of knee pain among individuals over 50. It entails the deterioration of the protective joint cartilage, essential for smooth joint movement and weight-bearing. OA often manifests earlier in those who are obese, chronic smokers, or lead sedentary lives.

While total knee arthroplasty undoubtedly offers remarkable relief to patients with severe OA, studies indicate a dissatisfaction rate as high as 30-20%. Many patients who undergo this procedure struggle with adhering to the rigorous postoperative rehabilitation spanning several months, which compounds their distress.

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In this regard, orthopaedic surgeon Dr Abid Ali Khan of Orthocare Speciality Clinics has advised citizens to exercise caution regarding hospitals’ persuasive marketing tactics.

“It’s essential to remember that total knee arthroplasty is a major surgical undertaking. Many patients undergoing this surgery also grapple with multiple comorbid conditions, such as hypertension, uncontrolled diabetes, and hypothyroidism, putting them at high risk. In such cases, patients often resort to medication and injection-based therapies,” he explains.

For some, Hyaluronic acid injections are a favoured non-surgical alternative. However, their accessibility remains limited, especially for patients with issues in both knees, due to the elevated medication costs.

“Recent scholarly studies have revealed that Hyaluronic acid does not contribute to cartilage regeneration. This is where emerging regenerative therapies come into play,” says Dr Abid.

Regenerative treatments, such as Platelet Rich Plasma (PRP) and Bone Marrow Aspirate Concentrate (BMAC), prove to be valuable options for younger patients, those averse to surgery, or those with financial constraints.

PRP and BMAC involve concentrating the body’s natural growth factors present in the blood or bone marrow, without any external additives.

Recent meta-analyses conducted in France and Poland have determined that PRP offers longer-lasting effects compared to Hyaluronic acid injections. Studies also suggest PRP’s effectiveness even in stage-3 Osteoarthritis.

Moreover, recent research consistently favours BMAC over PRP for moderate OA, potentially delaying the need for surgery by up to one year.

“Regenerative therapies, therefore, stand as viable treatments that should be explored before opting for total knee arthroplasty. The associated risks and complications are minimal. However, patients should also be aware that the quality of PRP/BMAC is a critical factor for success,” says the doctor.

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