Non-Operative Treatments for Osteoarthritis

There are many non-operative treatments that can be considered before a patient undergoes a joint replacement surgery.  Dr. Durkin likes to exhaust conservative measures before performing surgery on a patient. Once conservative measures fail the patient would be a candidate for a joint replacement. Conservative measures include:

• Knee Bracing: An unloader brace is a knee brace used to reduce pressure from the arthritic side of your knee. This is accomplished by pressing on the non-arthritic side of the knee to open the space between the bones on the arthritic side. The brace is designed for active people and allows patients to continue their current activities with less pain. Therefore delaying the need for a knee replacement.
• Physical therapy or Home Exercise Program: Physical therapy uses strengthening exercises, range of motion exercises and modalities to help alleviate pain. Modalities include heat packs, ice, electric stimulation, ultrasound, iontophoresis, phonophoresis, traction, paraffin and TENS unit etc. Dr. Durkin and Hinsdale Orthopaedics work closely with ATI physical therapy to provide excellent patient care. http://www.atipt.com/locations
• Cortisone Injections: Cortisone is a steroid used to decrease swelling and pain caused by degenerative changes due to osteoarthritis. Cortisone is often given in the shoulder, hip and knee. Patients often feel relief immediately after an injection due to the local anesthesia. This will wear off by the end of the day however patients often feel the effects of the cortisone within 3-7 days. Cortisone can be given 3-4 times per year.
• Zilretta is an encapsulated cortisone injection that lasts longer than traditional cortisone injections as it slowly releases the medication over 3 months. Zilretta is a great option for diabetic patients because it raises diabetics blood sugar less than traditional cortisone injection. It also is an option for patients who have short relief from traditional cortisone injection
• Viscosupplement Injections: These injections are composed of thick viscous fluid that mimics healthy joint fluid that is soaked up by the cartilage in the joint. Viscosupplements delay the need for a joint replacement. Some patients know these as “Rooster comb shots”. There are several different brands of viscosupplements including Synvisc, Gel-one, Euflexxa, Supartz, Monovisc and Orthovisc. Viscosupplements can be given every 6 months. With the exception of Medicare these injections require insurance pre-authorization. We work closely with your insurance to determine which brand is covered by your insurance.
• Physical activity/Activity Modification: Studies have shown that that weight loss can reduce pain, pressure placed on the joints and reduce risk outcomes of joint replacement surgery. Physical activity should be performed on an as tolerated basis. We recommend that patients with osteoarthritis avoiding high impact activities.
• Medication: NSAIDs (anti-inflammatories) such as Aleve and Advil are effective in reducing pain and inflammation caused by osteoarthritis. Narcotic pain medication has limited effects for long term osteoarthritis treatment