To answer your question, your doctor needs to determine what type of arthritis you have in your knees. If this is due to the most common form of arthritis, osteoarthritis, then treatment options include acetaminophen, NSAIDs, topical therapies, intra-articular injections, and physical therapy. If this is due to an inflammatory arthritis (such as rheumatoid arthritis or psoriatic arthritis) then treatment options include immunosuppressive agents such as methotrexate or biologics. Ultimately, if there is severe destruction, pain, and disability from either type of arthritis, knee replacement surgery can be an option.
Osteoarthritis Q & A
If your mother is in reasonable health, a knee replacement is not out of the question. Seek an opinion from an orthopedic surgeon in your area, who has lots of experience with total knee replacement.
Don’t throw out the calcium yet !! IT is probably not at all the cause of the Heberden’s node. Heberden’s nodes are outward manifestations of degenerative arthritis (also called osteoarthritis and “wear and tear”” arthritis). The node is a bone spur. Degenerative arthritis occurs commonly as we get older.
This is a question that only you can answer. You need to look at your current quality of life, and determine the risks and benefits of total knee replacement now verses later. Consider how your knee(s) affect your activity level, your pain, and any restrictions on work or leisure activities. Another important step is a second opinion; this is a big decision and a second opinion may ease your mind and answer lingering questions. Once you have addressed these factors, have a frank discussion with your orthopedic doctor about your options.
These are just two of several agents used in OA called viscosupplements which contain hyaluronic acid. The medications you mention are inected directly into the knee joint once a week for 3 weeks. There are otheres that are five injections, and one that is a single injection. All are for treatment of pain in osteoarthritis in knee in patients who have failed nonpharmacologic treatment and simple analgesics. They are so much alike that we would not recommend one over the other. Check with your insurance company, they may have a preffered medicaiton. These injections work for some people but not all. Some people can experience a flare up of joint pain after the injection. If this happens, you should contact your doctor.
You ask an interesting question. We know from research that increased activity is actually good for osteoarthrtis of the knee. We encourage those with OA of the knee to begin a low impcat exercise routine, such as walking, for at least 30 minutes a day, 5-7 days a week. Another important factor is that people with OA of the knees should maintain a healthy wieght. The more overwieght a person is, the more stress put on the knees. If the stairs in your house are a source of apin, or if your wife feels unsafe on the stairs, please factor that into your decision. The stairs may hurt but will not harm the knee joint. A refferal to physical therapy for quad strenthening and gait training may be helpful.