“Let Us Save Our Knees”

Management of Osteoarthritis (OA): Looking Beyond Total Knee Replacement (TKR)

Prof. Dr. Naresh K. Agrawal

Key Points:

1.     Osteoarthritis Overview:
A degenerative joint disease causing cartilage breakdown, pain, stiffness, and reduced mobility—commonly affecting the knees.

2.     Challenges with Total Knee Replacement (TKR):

o    Invasive surgery with risks and complications

o    Not suitable for all patients, especially younger or less severe cases

o    Long rehabilitation and variable outcomes

3.     Conservative and Alternative Management Strategies:

o    Lifestyle modifications: Weight loss, activity modification, ergonomic adjustments

o    Physical therapy: Strengthening muscles, improving joint stability and function

o    Pharmacological treatment: NSAIDs, analgesics, topical agents for symptom relief

o    Intra-articular therapies: Corticosteroids, hyaluronic acid, and regenerative options like PRP

o    Nutritional support: Supplements (glucosamine, chondroitin) and anti-inflammatory diets

o    Orthotics and bracing: To offload stress from affected knee compartments

4.     Regenerative and Emerging Therapies:

o    Platelet-Rich Plasma (PRP), stem cell therapy, and other biologics to promote cartilage repair and reduce inflammation

5.     Patient Education and Shared Decision Making:
Empowering patients with knowledge and options to delay or avoid surgery

Conclusion:

Managing knee OA effectively requires a multi-modal, patient-centered approach that prioritizes joint preservation and function, aiming to delay or eliminate the need for total knee replacement.