Providing Better After Care For Patients
We’re funding research which aims to provide a standardised approach and assessment for virtual clinic follow-up of total joint replacement patients and subsequent management of patients identified as ‘at risk’ by this approach. This study would enable us to deliver better and more streamlined after care for patients.
What Is Partial Knee Replacement
A partial knee replacement is an alternative to total knee replacement for some people with osteoarthritis of the knee. This surgery can be done when the damage is confined to a particular compartment of the knee. In a partial knee replacement, only the damaged part of the knee cartilage is replaced with a prosthesis.
Once partial knee replacement was reserved for older patients who were involved in few activities. Now partial knee replacement is often done in younger people as their recovery is quicker and usually less painful. About 5% to 6% of people with arthritic knees are estimated to be eligible for partial knee replacement.
The Evidence For Prolotherapy Injections For Knee Osteoarthritis
For extensive research please see our article Prolotherapy Injections for knee osteoarthritis
The knee is the most common joint treated with Prolotherapy at Caring Medical. We use a comprehensive Prolotherapy injection approach that stimulates the natural repair of connective tissue. This is a treatment available quickly for knee osteoarthritis and a possible alternative to knee replacement surgery.
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An Alternative To Knee Replacement: The Bioknee
Heal biologically. Rebuild and regenerate naturally. If you are looking for an alternative to a total knee replacement, consider our BioKnee program which rebuilds knees without the use of artificial materials.
The BioKnee® program combines Dr. Kevin Stone’s most innovative surgical procedures to create a revolutionary treatment for arthritis. The program has permitted hundreds of people with moderate to severe arthritis to stay active and delay or avoid a total knee replacement.
If you have arthritis and have been told you need to wait until you are older for a knee replacement or if you’ve been injured and wish to avoid arthritis and a possible knee replacement in the future, then BioKnee may be for you.
A unique offering of The Stone Clinic, the BioKnee replaces, regenerates, or rebuilds damaged portions of knee cartilage and injured ligaments using advanced biologic techniques, including an articular cartilage paste graft and a meniscus transplant. The BioKnee program was developed in 1991 by Dr. Kevin Stone. Since its inception, BioKnee has been followed by clinical research studies that prove that BioKnee patients recover faster, return to sports, and are far less likely to report pain than with an artificial knee replacement, even many years post-surgery. Hundreds of patients with a BioKnee are now enjoying their active lifestyles.
Reasons To Choose A Knee Replacement Alternative
Its important to understand that a TKR isnt always avoidable, but it is an elective procedure. Methods exist to help patients manage long-term knee pain safely and effectively, including the treatments listed above. Also, lowering your body weight by even 10% with exercise could have dramatically positive effects on your knee pain.
Furthermore, not all patients are good candidates for TKR. Reasons include comorbid factors such as diabetes, obesity, and heart disease, which means such patients are at higher risks for complications. Other patients simply want to avoid TKR out of concern for the risks of it not working or risks of other complications. With some patients, age is also a factor and the risks may out-weigh the benefits.
Ultimately, you have choice when it comes to treating your knee pain. So, before you start down the path toward major surgery, we first recommend researching all of the best possible alternatives you have to Total Knee Replacement.
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What Is A Knee Replacement
In a standard knee replacement the aim is to resurface the end of the bone. Small amounts of bone and remaining joint suface cartilage are removed and resurfaced with metal and plastic. Parts of the femur and tibia bone are cut and resurfaced with metal, inbetween a piece of plastic is used. If the kneecap is also degenerated, this can also be resurfaced.
Stem Cell Knee Replacement Alternative
An interesting medical advancement is the stem cell alternative to knee replacement. In theory, this type of therapy uses the bodys natural healing abilities to repair cartilage damage. The goal is to:
- Slow and repair damage
- Reduce pain and inflammation
- Prevent knee replacement surgery
The procedure involves taking blood from the patient, concentrating the stem cells, and injecting those cells into the knee.
At this time, the Arthritis Foundation, the American College of Rheumatology, and the FDA do not recommend this form of treatment. It is considered investigational because there is not enough evidence to prove it is safe or effective. These entities will not endorse a treatment simply based on anecdotal evidence. However, as of August 5, 2020, a new clinical study was underway to test whether stem cells are effective for patients with osteoarthritis of the knee.
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The National Joint Registry
The National Joint Registry collects details of knee replacements done in England, Wales, Northern Ireland and the Isle of Man. Although it’s voluntary, it’s worth registering. This enables the NJR to monitor knee replacements, so you can be identified if any problems emerge in the future.
The registry also gives you the chance to participate in a patient feedback survey.
It’s confidential and you have a right under the Data Protection Act to see what details are kept about you.
Steroid Injections To Reduce Inflammation
Steroid injections for knee pain are typically corticosteroids shots. Cortisone mimics the effects of a substance called cortisol that is naturally produced by the adrenal glands.
Steroids help reduce the inflammation and offer pain relief, because knee pain is often caused by inflamed tissue.
It usually takes about three to seven days for steroid injections to work to their full effect. But its possible to feel relief as soon as 24 hours.
Though they offer significant pain relief, the effects of steroid injections are temporary. On average, steroid shots relieve pain for three months, though you may feel relief for up to six months.
Steroid injections may cause side effects. Its common to experience minor pain and swelling in the knees for a couple days after the shot. Your doctor will be able to answer any questions you have about side effects.
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Choosing An Alternative To Knee Replacement Surgery
Each patient is different and has different goals and priorities when it comes to dealing with painful and limiting knee conditions. Its important to weigh the medical options carefully with the advice of your physician as well. The data weve provided here may help you come to a decision, along with a consideration of your current medical condition, your motivation to adhere to a treatment program, and the availability of the treatments. We invite you to find out more about AposHealth® and what it can do for you.
The Best Alternative To Knee Replacement Surgery
With high costs, long recovery times, and uncertain outcomestotal knee replacement should really be the last resort when it comes to treatment of arthritis and knee pain. The best alternative for anyone who is serious about avoiding knee replacement surgery is to get STRONGER. To limit the impact that goes through our knees by building full body strength.
One of the indications for surgery that your doctor will mention is when conservative treatment fails. Unfortunately, their idea of conservative treatment is two weeks of some cookie cutter physical therapy program that was doomed to fail from the start. But at least they can say they tried before cutting you open.
Keep in mind that strength training is NOT physical therapy. Strength training is a full-body, progressive exercise plan designed to build muscle and improve your ability to function in your daily life. The best part? While an extremely effective alternative to knee replacement surgery, the benefits of building strength extend far beyond your knee pain. Less joint pain, less arthritis, less osteoporosis, better balance, better immune system, cardiovascular benefits, less stress, better sleep, and even lower mortality.
If those arent good enough reasons to give strength training a shotI dont know what is :
How To Get Started with Strength Training to Avoid Knee Replacement Surgery
Its not important where you start, its just important that you do start.
The Squat
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Looking After Your Knee Replacement
Your new knee will continue to improve for as much as two years after your operation as the scar tissue heals and you exercise your muscles. You’ll need to look after yourself and pay attention to any of the following problems:
Stiffness Sometimes the knee can become very stiff in the weeks after the operation for no obvious reason. Try placing your foot on the first or second step of the stairs, hold on to the banister and lean into your knee. This should help to improve movement and flexibility in your knee. Its very important to continue with the exercises you were working on in the hospital.If the stiffness doesnt improve after about six weeks your surgeon may need to move or manipulate your knee. This will be done under anaesthetic.
Pain Pain caused by bruising from the operation is normal in the first two months, and you’ll probably still need to take painkillers at six weeks to help you sleep through the night. You may still have some pain for as long as six months. If you still have pain after this, speak to your physiotherapist or GP.
Infection You should speak to your GP or hospital if you notice any signs of infection, for example:
- breakdown of the wound with oozing/pus or sores
- increased pain
- redness and the affected area feeling warmer than usual or smelling unpleasant.
You should also look after your feet see a doctor or podiatrist if you notice any problems such as ingrown toenails that could become infected.
Unispacer Knee Replacement Alternative
When a patient has osteoarthritis, their knee cartilage progressively wears away, leaving the femur and tibia bones to rub against each other without a cushion. The result is pain, stiffness, inflammation, and bone spur development.
Scientists have developed a device called the Unicondylar Interpositional Spacer or Unispacer. The device is inserted into the knee joint. It acts as a spacer to separate the two leg bones. The procedure is less invasive than knee replacement surgery but is not as effective for most patients with advanced arthritis.
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What Is The Meniscus
Hank Grebe/Shutterstock
The meniscus is a spacer that helps to cushion the knee cartilage. This structure can get normal tears as we age, much like your face naturally wrinkles over time. While a huge industry has emerged around removing parts of the meniscus when tears are seen on an MRI, theres little hard scientific evidence that this is a good idea.
Use Pain Medications With Care
Except in very rare cases, the American Association of Hip and Knee Surgeons advises against using opioid medications for knee osteoarthritis. Opiate pain relievers, in addition to being addictive, are not proven to address knee pain over the long term any better than nonsteroidal, anti-inflammatory drugs .
Though safer than opioid drugs, NSAIDs arent for everyone, and Valaik advises caution in using them. Even over-the-counter drugs like naproxen and ibuprofen can have side effects, so check with your doctor, he says.
You can get an increase in blood pressure with NSAIDs. Larger studies have linked some of these pain relievers with a small increase in the risk of heart attack.
And the more you take, the more likely you are to have heartburn, stomach irritation or even bleeding ulcers, he notes.
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How Patients Can Reduce Painful Symptoms Between Now And Their Treatment Date
If a patient has tried multiple non-invasive treatments without success and their next step is surgery, they can take steps to reduce their pain until their surgery date.
Some ways to ease knee pain:
- Exercise/physical therapy: If a patient has a degenerative condition like osteoarthritis, it is best if they seek the assistance of an exercise professional like a physical therapist. They can create a treatment plan that will strengthen the leg and promote flexibility without increasing the risk of pain or joint damage.
- Supplements: In addition to NSAIDs, supplements like glucosamine and chondroitin can reduce pain and increase mobility in some patients.
- Bracing: A knee brace provides stability and properly aligns the joint, easing pressure and reducing pain.
Risks Of Knee Replacement Surgery
Knee replacement surgery is a common operation and most people do not have complications. However, as with any operation, there are risks as well as benefits.
Complications are rare but can include:
- stiffness of the knee
- infection of the joint replacement, needing further surgery
- unexpected bleeding into the knee joint
- ligament, artery or nerve damage in the area around the knee joint
- persistent pain in the knee
- a break in the bone around the knee replacement during or after the operation
In some cases, the new knee joint may not be completely stable and further surgery may be needed to correct it.
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Understanding Why Some Joint Replacements Fail
We’re also supporting research to improve the outcome of knee replacement surgeries, such as a project aimed at increasing the understanding of why joint replacements sometimes fail by investigating whether there are genetic risk factors that influence surgery outcome. This research has the potential to improve patient experience and increase the life of the joint replacement.
In This Video Ross Hauser Md Demonstrates An Ultrasound Examination Of A Patients Knee With Complete Loss Of Articular Cartilage
- At 1:14 the patients knee instability caused COMPLETE LOSS OF ARTICULAR CARTILAGE
- In this patient, we would recommend Prolotherapy to the ligaments and stem cell treatment into the joint. Prolotherapy to address the knee instability and stem cell treatments to address the cartilage issue.
- We rarely offer stem cell treatments. In this case, the complete loss of cartilage in the knee calls for it.
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Alternatives To Knee Replacement Surgery Ranked According To Feedback From Real Patients
- AposHealth Staff
Trying to avoid replacing one or both knees but dont know what to do about that bone-on-bone knee pain? Or are you just fed up that your knee joints are functioning like a pre-oiled Tin Man? Whatever it is, most people try to avoid having body parts replaced, for so many reasons, unless its completely necessary. Add to that how elective surgeries, such as knee replacement, are being delayed and canceled due to COVID-19, now is a great time to discover the top-ranking knee replacement alternatives.
Thats why weve put together this list of alternatives to knee replacement surgery, ranked according to third-party patient questionnaires. Some of the results may surprise you, such as, the second-highest-ranking alternative to knee replacement is a non-invasive, drug-free treatment based on a shoe AposHealth®.
Fun Fact: Measuring the effectiveness of treatments is done by giving patients standardized questionnaires to rate the change in levels of pain and function. The impact that each treatment has had on each patient can be measured in order to discover how effective each treatment is.
Knee Replacement Alternative Relieves Pain Retains Mobility
by Evan H. Argintar, MD, Orthopedic Sports MedicineApril 21, 2017
If youve been told you need a knee replacement due to arthritis, it can feel like youre caught between a rock and a hard place. On one hand, walking around and being active is painful. But while a total or partial knee replacement can relieve the pain and return your mobility, it also means you may no longer be able to participate in high-impact activities like running, jumping and skiing.
I see many patients with knee problems who dont want to give up these activities. Though they have painful, degenerative conditions that gradually wear down parts of the knee, they dont want to transition to a more sedentary lifestyle. They want an alternative to total knee replacement that will let them enjoy being active without pain or discomfort.
Thanks to a number of medical advancements, we now have an alternative option to treat arthritic knees: cartilage restoration.
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Caring Medical Research Case Studies
Our research team has published research on patient outcomes and case studies using bone marrow aspirate. Here is a sample of those outcomes. Again, we must remind you that this treatment does not work for everyone. Unfortunately, if you are reading this article you are probably very attuned to medical treatments that do not work.
In the medical journal Clinical Medicine Insights Arthritis and Musculoskeletal Disorders, our Caring Medical research team published our findings in seven patients. You can read all the case histories here: Bone marrow stem cell therapy and Prolotherapy: Published review 7 case histories.
Patient case Knee pain: A 69-year-old man
A 69-year-old male came into our office with pain in both knees, with his right knee significantly more painful. Pain resulted in frequent sleep interruption and limitation of exercise.
- Two months after the final treatment, the patient reported that he was completely free of pain or stiffness in both knees, had regained full range of motion, no longer suffered sleep interruption, and was no longer limited in exercise or daily life activities.
Patient case Knee pain A 56-year-old woman
A 56-year-old female came into our office with pain in both knees and her right hip. The pain was severe in the right knee, with frequent crepitus and instability, and had forced the patient to discontinue running.
The patient received bone marrow/dextrose treatments for six visits with 810 week intervals.