Alternative Treatments for Joint Replacement | OrthoVirginia (2022)

There are more than a hundred types of arthritis, and 70 million Americans, or about one in three people, suffer from arthritic pain. Of these variations, osteoarthritis is the most common. It affects roughly 20 million Americans and is what we call a "wear and tear" arthritis. Osteoarthritis in your joints is like wearing the tread off your tires.

What are the treatment options for osteoarthritis?

There are three categories of treatment options: physical modifications, medications, and injection treatments.

Physical modifications

One of the most important things you can do to better manage your arthritis is physical therapy. You can do formal physical therapy in one of our clinics or you can regularly perform therapy exercises at home.

As you develop arthritis, your joints will become stiff and you won’t want to move them as much. Not moving stiff joints is the worst way to treat them. You want to stay active and keep moving your joints.

When it comes to exercising, do low weight workouts with high repetitions. Another great exercise for arthritic joints is pool therapy, also known as aqua therapy or aqua aerobics. Being in the water lessens the weight-bearing burden on your joints, making it easier to move and work out.

Maintaining a healthy weight is also incredibly important for managing arthritic pain.

The best thing you can do to help an arthritic joint is to reduce the weight load on that joint. For example, for every pound you lose, you reduce the pressure on the knee joint by four pounds. Weight loss is not easy. A nutritionist can guide you through the dietary options that are right for you.

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Bracing is the final type of physical modification. Arthritic joints are often also unstable. A brace can stabilize the joint. For the right kind of brace, talk to your orthopedist.

A brace also provides pressure around the joint and to the skin. Your brain can only handle so many sensations at once, and many times the pressure sensation will override the pain sensation so your joint hurts less.&

The final thing a brace can do is provide warmth, especially in the winter. Arthritis often feels worse in the winter, and a brace can warm the joint and soothe pain.

Medications

There are various types of medications people can take for arthritis. The most common are NSAIDs or non-steroidal anti-inflammatory drugs such as ibuprofen or naproxen. If you have other medical issues besides arthritis, you should consult your doctor before taking any medication.

I encourage my patients to consistently take anti-inflammatories for a short course (a week or two), similarly to how they would take antibiotics. Taking anti-inflammatories in this manner will build up a level of anti-inflammatory in your system, and there is a greater chance of the medication working to reduce the pain.

The second medication option is acetaminophen. If you're on a blood thinner or otherwise can’t take an NSAID, acetaminophen can help with pain. However, it only helps when it’s actively in your system, so it doesn’t have the build-up advantage that anti-inflammatories have.

There are also some topical medical creams and ointments such as Voltaren cream. These do not provide as much medicine to the area but are still helpful. Your physician can also write a prescription for more powerful topical medical creams if needed. This type of treatment doesn’t affect the kidneys and is a little bit safer if you have a history of gastric ulcers.

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If you're interested in herbal remedies, I suggest looking into are curcumin and turmeric. They are spices that have anti-inflammatory properties. There isn’t any scientific data on them, but they are safe to try if you don’t want to try other medications.

One thing I must stress in terms of medications is in regard to narcotic medications. In my opinion, there is no role for narcotics in treating arthritis.

Injections

Injections are a slightly more aggressive treatment option than pills. They allow us to administer medicine directly to the area of arthritis.

When you take a pill, it is absorbed through the stomach. Some of the pill is broken down; some gets to one joint; some gets to a different joint. A pill follows an indirect route to the area of pain.

The two types of injections we usually use are corticosteroids and viscosupplementation shots, which people often recognize as lubricant shots. Steroid injections act like we injected an NSAID directly into the joint. Viscosupplementation shots don’t reduce inflammation but make it easier to move the joint.

There are some more progressive treatments available to patients, including a PRP (platelet-rich-plasma) injection. For a PRP injection, we take a sample of your blood and spin it in a machine. We take the anti-inflammatory components created in the blood from the spinning process, and we inject it into your joint.

This treatment is fairly new for arthritis, although it’s been used for other purposes for over a decade. While we are still looking at the effectiveness of this treatment, the injections are completely safe. Many studies show that PRP injections can be beneficial in reducing pain and inflammation.

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The newest type of injection treatment uses stem cells. These stem cell injections are taken from bone marrow, adipose tissue, or umbilical blood. The philosophy is that if injected into a joint, stem cells can help reduce inflammation. Again, research is being done to see how effective the treatments are.

Tip summary

Keep those joints moving. If we don't move, our joints become stiff, so do your exercises. Walk on cushioned surfaces. Avoid asphalt if possible. Make sure you have the proper shoes to work out in.

Watch your diet. Weight has such a significant impact on our joints in terms of deterioration as well as causing pain when you already have arthritis. Stay away from pasta, breads, and very carb-heavy foods. Shop around the outside of the grocery store to avoid more processed foods and don’t shop hungry.

Start treatments early. Don’t wait until you can’t move due to pain to go see your orthopedist.

Frequently asked questions

What are your thoughts on CBD products?

There are a lot of supplements on the market, and the problem with them are that they only have to be proven safe. They don’t have to be proven to be effective.

The only experience I have with CBD is that some patients have told me it has helped. I think I's safe, and if you want to try it out, there’s no harm in doing so.

What are some treatments for arthritic pain in feet?

The foot is difficult because the structure is made up of a lot of different joints. Topical creams for the feet are helpful, and I often prescribe a cream that has lidocaine as well as an anti-inflammatory. If it’s neurogenic pain (from diabetes or nerve pain), there are also medicines your physician can prescribe to help.

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Make sure your footwear is not too tight. I often see patients come in wearing sandals that are too tight which increases the pressure on their feet.

Do cryotherapy or ice packs help joint pain?

I don’t think it helps with joints. We use cryotherapy and ice treatments with athletes after training sessions. The cold constricts the blood vessels, decreasing the generation of lactic acid so an athlete can recover faster.

Cold therapy can help with swelling, however. If you have a swollen joint, then ice will be very beneficial.

Can you have hip arthritis after a hip replacement?

No, you cannot have hip arthritis after a hip replacement.

You no longer have any cartilage in your hip, so therefore you cannot have arthritis. You can have pain after a hip replacement from soft tissue impingements, loosening, or any multitude of things.

However, if you’ve had a partial hip replacement, you can develop arthritis on the other side of that hip that was not replaced.

Learn more about arthritis care

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FAQs

What helps bone on bone knee pain without surgery? ›

Non-invasive treatments for knee pain
  • R.I.C.E. Rest, ice, compression, and elevation are the four basics applied to simple knee injuries. ...
  • Physical therapy or massage therapy. ...
  • Corticosteroid injections. ...
  • Hyaluronic acid injections. ...
  • PRP and stem cell injections. ...
  • Radiofrequency Ablation (RFA)

What are the 2 most common joint replacements? ›

Hip replacement surgery and knee replacement surgery are most common, but replacement surgeries for other joints, including ankle replacement and shoulder replacement, are also possible.

What are the alternatives and improvements to hip replacement surgery? ›

Exploring the Alternatives to Hip Replacement Surgery
  • Conservative therapies could delay need for hip replacement. A clinical study conducted in Norway, has revealed that conservative therapies could delay the need for hip replacement surgery. ...
  • Injections to relieve hip pain. ...
  • Cartilage transplant. ...
  • Partial replacement.
1 Oct 2020

What can be done for a knee that is bone on bone? ›

Non-Invasive Treatments

Ice and over-the-counter pain medication like acetaminophen or ibuprofen can help. Sometimes physical therapy or a guided exercise program can provide bone-on-bone knee pain relief by strengthening the muscles that support the knee, particularly the quadriceps.

Can knees be fixed without surgery? ›

The first alternative to knee surgery most physicians try is lifestyle modification. This may include weight loss; avoiding activities such as running and twisting, which can aggravate the knee injury; modifying exercise to no- and low-impact; and other changes in your daily routine to reduce stress on your knee.

How can I naturally lubricate my knees? ›

Consuming healthy fats can increase joint health and lubrication. Foods high in healthy fats include salmon, trout, mackerel, avocados, olive oil, almonds, walnuts, and chia seeds. The omega-3 fatty acids in these foods will assist in joint lubrication.

What is the best painkiller for knee pain? ›

Over-the-counter medications — such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) — may help ease knee pain. Some people find relief by rubbing the affected knee with creams containing a numbing agent, such as lidocaine, or capsaicin, the substance that makes chili peppers hot.

What is the best painkiller for arthritis of the knee? ›

NSAIDs are the most effective oral medicines for OA. They include ibuprofen (Motrin, Advil) naproxen (Aleve) and diclofenac (Voltaren, others). All work by blocking enzymes that cause pain and swelling.

What is the most difficult joint replacement? ›

Knee replacement is technically more difficult to get right than hip replacement and this is one important reason why some patients have poorer results than others. A surgeon who does a good number of knee replacements will tend to have better results, but this is not the whole story.

How long do joint replacements last? ›

The usual estimate: 10 to 15 years

That was an average, of course. Rare complications requiring re-operation can occur soon after surgery; for others, a replaced joint can last two decades or more.

Which joint in the human body is most commonly replaced? ›

Hip and knee replacements are the most commonly performed joint replacements, but replacement surgery can be performed on other joints, as well, including the ankle, wrist, shoulder, and elbow.

Is there anything you can do for arthritis in your hips? ›

Physical therapy exercises can help improve strength in the hip. Engaging in low-impact exercises and activities, such as swimming and cycling, and remaining physically active are key to managing hip arthritis symptoms. Heating pads can help soothe inflammation in the hip.

Does stem cell therapy work for hips? ›

Stem cell therapy is one of the solutions that provide long-lasting results for hip arthritis and hip pain. However, unlike the other alternatives — such as surgery — stem cell therapy has the added benefit of being quick to work and causing less downtime and recovery.

Can hips be repaired without replacement? ›

Hip resurfacing

This is an alternative to hip replacement for young and active patients. Instead of removing the femoral head and replacing it with an artificial joint, the femoral head is reshaped and then fitted with a metal covering that fits in the joint socket.

Is walking good for bone on bone knee pain? ›

Walking is a fantastic option for many patients with knee arthritis because it is a low-impact activity that does not put undue stress on the joints. Furthermore, walking can increase the knee's range of motion and keep it from becoming overly stiff.

Do knee injections work for bone on bone? ›

The idea behind these injections is that they will temporarily restore the natural function of the knee by injecting a substance which will provide cushioning and reduce bone-on-bone contact. Individual responses vary, but many patients experience months, if not potentially a year or more of relief.

What is the downside of knee replacement? ›

Disadvantages. Possible disadvantages of knee replacement surgery can include replacement joints wearing out over time, difficulties with some movements and numbness. We now know that knee replacements aren't so likely to be effective in the early stages of arthritis.

How do you regenerate knee cartilage naturally? ›

Stretch as often as possible. A simple stretch can help prevent stiffness in your joints and lubricate and nourish the cartilage with synovial fluid. Stretch exercises like yoga and pilates can help alleviate the symptoms of osteoarthritis and also strengthen your muscles to prevent further joint injury.

Can you fix bone on bone in knee without surgery? ›

Regenerative rehabilitation will heal micro tears in the ligaments that have occurred with regular wear and tear. This will bring stability back to the joint. Cellular therapy treatments can be used to regrow cartilage in the knee joint.

Can they clean out arthritis in your knee? ›

Your knee can be cleaned or flushed to remove loose bone or cartilage pieces that may be causing pain. Most people can get back to their usual activities a few days later. The recovery usually isn't painful. Arthroscopic surgery may provide short-term relief from pain and possibly delay more complex surgery.

What is the downside of knee replacement? ›

Disadvantages. Possible disadvantages of knee replacement surgery can include replacement joints wearing out over time, difficulties with some movements and numbness. We now know that knee replacements aren't so likely to be effective in the early stages of arthritis.

Do cortisone shots help bone on bone knees? ›

Researchers say: Do not give cortisone for knee osteoarthritis. Although surgery and cortisone are common, randomized trials have failed to produce evidence for the effectiveness of surgery or cortisone injection or how much they do work. Cortisone can make bone on bone worse by thinning out the meniscus.

Can you regrow cartilage in your knee? ›

Cartilage Regeneration Options

MACI is a surgical procedure that uses cartilage-forming cells from your body to restore damaged cartilage in the knees. It involves a biopsy to harvest chondrocytes (cartilage-forming cells), which are allowed to multiply in a lab, and surgery to implant them into the damaged area.

Can cartilage be repaired without surgery? ›

While cartilage does not regrow or replace itself, it can be repaired or supplanted by a few different treatment options. Many cartilage injuries can be treated without surgery, via physical therapy and anti-inflammatory medication. This is especially true if you have a sedentary to moderately active lifestyle.

Can you have arthritis in a knee that has been replaced? ›

Unfortunately, knee replacement surgery does not cure arthritis. Although it can correct the damage caused by arthritis and relieve the pain associated with the condition, it cannot make the arthritis go away.

Do people regret having knee replacement? ›

Research also indicates that 1 in 5 patients are dissatisfied with the results. Most knee replacements are considered successful, and the procedure is known for being safe and cost-effective.

Can you kneel after knee replacement? ›

The majority of patients expect to be able to kneel after TKR,2,4,5 however, these expectations are frequently not met,1,6 with between 50% and 80% of patients reporting that they have difficulty kneeling or do not kneel in the months and years after TKR.

What is the best painkiller for knee pain? ›

Over-the-counter medications — such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) — may help ease knee pain. Some people find relief by rubbing the affected knee with creams containing a numbing agent, such as lidocaine, or capsaicin, the substance that makes chili peppers hot.

What is the new injection for knee pain? ›

Hyaluronic acid gel injections (viscosupplementation)

Hyaluronic acid is a natural lubricant and shock absorber inside of the joints. But the shocks wear out over time. Viscosupplementation injects hyaluronic acid gel into the joint to replace what has been lost. Examples include Hyalgan, Synvisc, and Euflexxa.

What is the new treatment for knee osteoarthritis? ›

Cooled radiofrequency treatment is ideal for patients who are not ready or eligible for surgery, those who have tried steroid injections but didn't get relief and those who have had knee replacement surgery but are still experiencing pain.

How can I naturally lubricate my knees? ›

Consuming healthy fats can increase joint health and lubrication. Foods high in healthy fats include salmon, trout, mackerel, avocados, olive oil, almonds, walnuts, and chia seeds. The omega-3 fatty acids in these foods will assist in joint lubrication.

What vitamins help repair cartilage? ›

Dietary supplements: Dietary supplements such as glucosamine and chondroitin are the non-surgical treatment options for cartilage restoration. Chrondroitin sulphate and glucosamine are naturally occurring substances in the body that prevent degradation of cartilage and promote formation of new cartilage.

How can I rebuild my cartilage naturally? ›

Foods that Help Rebuild Cartilage
  1. Legumes. For optimal joint function, it is important to beat inflammation wherever possible—inflammation is the primary source of collagen and, by extension, cartilage breakdown. ...
  2. Oranges. ...
  3. Pomegranates. ...
  4. Green Tea. ...
  5. Brown Rice. ...
  6. Nuts. ...
  7. Brussel Sprouts.

Does glucosamine regrow cartilage? ›

Glucosamine also hinders hyaluronidase, the tissue-damaging enzyme, and helps to rebuild the damaged articular cartilage. In addition, glucosamine sulfate improves the lubricant properties of synovial fluid.

What herbs build cartilage? ›

Turmeric and Boswellia are potent anti-inflammatory, analgesic and anti-arthritic agents. Glucosamine hydrochloride stimulates the metabolism of chondrocytes and helps maintain the integrity of the cartilage. Chondroitin sulfate and Calcium offer building blocks for the formation of the joint matrix structure.

How can I regenerate my knee cartilage without surgery? ›

NYU Langone doctors often recommend nonsurgical options as a first-line treatment for a knee cartilage injury. These include anti-inflammatory medication, physical therapy, and injections into the joint, including steroids; hyaluronic acid, also known as synthetic joint fluid; and platelet-rich plasma (PRP).

Videos

1. Apollo Hospitals | What are the latest alternatives to knee replacement surgery? | Dr. Madan M Reddy
(Apollo Hospitals)
2. Regenexx Alternative to Knee Meniscus Surgery / Meniscectomy
(Regenexx)
3. Repairing Knee Joints Without Replacement Surgery
(CBS New York)
4. What are My Alternatives to Hip Replacement Surgery?
(Daniel J. Albright, MD)
5. What Are Some Alternatives to Hip Replacement Surgery?
(Los Robles Regional Medical Center)
6. Knee Replacement vs. Regenexx Orthopedic Regenerative Treatment
(Regenexx)

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