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How to delay or avoid joint replacement surgery

June 15, 2017 | David So, MD
joint replacement 264

Wondering what to do about your painful knees or hips?

Joint pain is often a sign of osteoarthritis, which may be caused by aging, injuries, heredity and/or obesity. This type of arthritis occurs when the articular cartilage in your joints wears away. Articular cartilage is the smooth, glossy tissue lining the ends of the bone that cushions impact and allows the joint to move smoothly.

While joint replacement surgery has become an increasingly popular option, nonsurgical options should always be tried first. It is only after such a treatment plan fails should surgery be considered.

I’m a physician on the UC Irvine Health hip and knee orthopaedic team, and I regularly emphasize to all my patients that there are a number of options that can help you avoid — or at least postpone — the knife.

How to ease joint pain without surgery

Your nonsurgical options for troublesome hips or knees may include:

Diet and weight loss

Hips and knees are both weight-bearing joints, so weight loss is often a recommended first step. This can be difficult when your mobility is limited by arthritic joints. As a result, proper diet may need to be emphasized over exercise. If you are considering surgery, be aware that we generally require that you have a BMI (body mass index) of 40 or less to be a candidate for joint replacement surgery. How to lose weight and keep it off ›

Exercise

Many patients with arthritic joints can still participate in a low-impact exercise program. I often recommend this approach to help strengthen joints or help shed pounds as part of a weight loss plan. Swimming, cycling and use of an elliptical machine are all excellent low-impact activities. How to start exercising and stay motivated ›

Medications

For some patients, I may recommend anti-inflammatories such as ibuprofen to temporarily reduce inflammation and pain.

Injections

Intra-articular corticosteroid injections can help reduce joint swelling or pain. Similarly, viscosupplementation is a therapy that injects hyaluronic acid, which is similar to the fluid found naturally in knee joints, to manage pain and help you stay active.

Physical and occupational therapy

Physical therapy emphasizes the strengthening of muscles that cross the affected joints. For knee osteoarthritis, this generally means targeting your quadriceps. Occupational therapists teach you ways to perform your daily activities with less pain.

Mobility aids

Depending on the extent of your joint damage, I may suggest wearing knee braces or using a walking cane to help you keep your mobility.

Other therapies

Treatments featuring glucosamine sulfate or chondroitin sulfate are also available, but there is less data to support their use. As a result, we rarely prescribe them. Stem cell therapy also gets mentioned as a possible treatment, but as of yet there’s no data to indicate that this approach makes a difference. Research is being done, but the therapy is not mainstream and is not considered the medical standard of care.

All of the mainstream treatments described above can help put off or even avoid the need for surgery, which is a preferable outcome. However, should surgery eventually be desirable, the good news is that patients tend to be very satisfied with the results of their hip replacement and knee replacement surgeries. 

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Comments

Elliott Wlson
June 20, 2017

Another very important way to prevent knee problems is to exercise with a small single-person trampoline. I use mine everyday as part of my workout routine. It helps me keep physically fit and maintain excellent balance.

Shirleyhoward
September 21, 2017

I am 90years of age ,in excellent health except for my left knee. The pain while trying to get about is wearing me out. I have had cortisone shot and synflex injection but see no improvement . I am interested in stem cell replacement. Is this a possible option for me and what is the cost. My insurance does not cover it.

UC Irvine Health
September 21, 2017

Hi Shirley,

Please call our orthopedic team at 714-456-7012. Someone there will be able to discuss your options and costs. Best of luck!

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