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Osteoarthritis of the knee is a common affliction that often responds well to conservative, nonsurgical treatments. Anti-inflammatory medications, such as aspirin, acetaminophen, ibuprofen, and the new COX-2 inhibitors do a good job at reducing swelling in the joint. Sometimes, however, more powerful nonsurgical treatments are necessary, such as injections of medication into the joint space.

Corticosteroid injections have been helping arthritis sufferers for years. The injections serve as an anti-inflammatory, reducing the swelling and pain within the arthritic joint. Benefits may last up to three months.

Orthopedic surgeons also are enthusiastic about a new form of injectable therapy called sodium hyaluronate (trade name Synvisc), which is administered as a series of three or so injections typically given in your orthopedist’s office. Dr. Edward Miller, orthopedist with The Christ Hospital in Cincinnati and with Wellington Orthopaedic & Sports Medicine, explains that the injections work largely by improving the elasticity and consistency of the fluid that bathes the joints.

A number of scientific studies have found that hyaluronate provides effective relief of pain and stiffness in persons with mild to moderate osteoarthritis of the knee. Patients in these studies have enjoyed significant improvements in physical function, pain reduction, social functioning, and emotional measures up to three years after injections.

Dr. Miller has treated more than 1,500 patients with hyaluronate injections and is a lead researcher in a recent study of the affect of these injections on patients with osteoarthritis of the knee. "Our research has shown that in a group of 108 patients referred to us for a total knee replacement who were first treated with hyaluronan injection, more than half have not needed a total knee replacement out to three years following treatment. Fifteen percent of the patients have had a repeat series of injections." Dr. Miller concludes that these injections "demonstrate the ability to avoid or delay total knee replacement in 51.9 percent of those treated."

The best way to treat arthritis is usually with an integrated approach that uses not only pain relievers and injections, but also lifestyle modifications (such as weight loss and eliminating activities that aggravate arthritis), supportive devices (such as energy-absorbing shoes), regular exercise, and other such nonpharmacologic measures. Your orthopedic surgeon will design a treatment program that is right for you. If you would like to learn more about how you can minimize the impact of arthritis on your life, check our upcoming events to find the next Arthritis Self-Help course.

SOURCE: The American Academy of Orthopaedic Surgeons, articles in the Archives of Physical Medicine and Rehabilitation and the American Journal of Orthopedics, and Dr. Edward Miller, orthopedist, The Christ Hospital in Cincinnati.