Surgery may not always be the first step to treat knee osteoarthritis as some have found success going the non-surgical way.

BY: Eleanor Yap

A 57-year-old woman (who does not want to be named) had been suffering many years of knee pain. This affected her mobility so much that she could only walk 30 minutes at a time. She had seen a number of doctors and was repeatedly recommended for surgery. However, she decided to look at the non-surgical approach at Inliven Center for Osteoarthritis Solutions at Novena Medical Center, which opened its doors July last year. Its parent company is Ossur, a global leader in non-invasive orthopaedics that specialises in the research and development of award-winning technologies that assist people to improve their mobility.

Shared its clinical director, Dr Lim Yii Hong of the patient, “Our diagnosis was that she had moderate knee osteoarthritis, which was deteriorating due to her weak muscle function. To delay the progression of her knee osteoarthritis, we prescribed her with an unloading knee brace to reduce the pressure on her knee joint, which was the underlying cause of her discomfort. With this pain relief she was able to move on to physiotherapy sessions, which we are now working with her to improve her muscle function.” 

He shared that she is continuing to progress well with her on-going treatment plan. “This has not only reduced her pain and increased her mobility, but it has also given her the newfound confidence to enjoy a more active lifestyle, to the extent of being able to go off for an extensive overseas shopping holiday within the first month of treatment!” 

 

Looking at the root cause

Inliven is the first and only clinic in Singapore that focuses on non-surgical treatments for those living with knee osteoarthritis and offers a comprehensive range of treatment plans tailored to the individuals’ needs.

Shared Dr Lim, “Addressing the root cause of the pain, which is caused by stress to their knee joints, we believe that the progression of knee osteoarthritis can be curbed without patients having to resort to the pain, stress and risks that come with invasive surgical treatments.”

He added the treatment modalities “have been clinically proven to not only delay or prevent the need for surgery, but also help patients regain normal function and mobility to return to their active lifestyles again”.

These can include a combination of physical therapy such as physiotherapy and rehabilitation, and advice on nutrition and lifestyle; pain management including acupuncture, injections of hyaluronic acid and medication (such as painkillers, anti-inflammatory creams and corticosteroids); and biomechanical intervention such as knee bracing.

According to Inliven, the physiotherapy and rehabilitation focuses at improving the knee joint function by reducing the pain, swelling and stiffness. Treatments can include cold therapy to decrease swelling, heat therapy to increase blood circulation and decrease stiffness, strengthening exercises to increase the muscle support around the knee joints and flexibility exercises to increase the range of motion and restore normal knee joint function. The Center also helps design balanced diet plans for their patients.

 

Common form of knee pain

Knee osteoarthritis, which occurs when the cartilage on the ends of your bones wear down, causing pain on movement, is one of the most common forms of knee pain. Signs and symptoms can include pain in the knee joints when doing simple activities such as getting up from bed or a sitting position, walking up and down the stairs, playing sports, or when the knee joints are pressed; inflammation in the knees; and sudden swelling in the knee joints, with or without pain.

An independent survey sponsored by Wellchem Pharmaceutical to mark World Arthritis Day in 2012 found that about 40 percent of older Singaporeans suffered from knee pain. The study surveyed more than 200 respondents aged 50 to 69 years on their personal experience of osteoarthritis.

According to Dr Lim, all of its patients have not required any knee surgery and have been progressing well with the non-surgical treatments. However, if surgery is needed, a consultant surgeon is on standby to consult the patient.

He added that the length of treatment depends on a number of factors such as the severity of the condition and how compliant patients are at adhering to the treatment plan. “From our experience, we have patients who have started to see improvements in their movement and pain relief from just a few days into doing their exercises in the treatment plan,” said Dr Lim.

 

Preventive measures

To avoid osteoarthritis, here’s some advice from Dr Lim:

• Keep your joints moving – Movement is essential in keeping our joints healthy and the lack of physical activity increases the risk of degeneration of our cartilage. Our muscles become tight and stiff when we sit for long periods of time, this places stress on the knee joints when we try to stand up from the sitting position. So, take a minute or two to stretch your legs and get the circulation going to avoid stiffness and stress on the knee joints when you stand up from a prolonged sitting position.

• Set aside time for exercise as part of your daily routine – There are simple low-impact exercises older adults can do to help strengthen the muscles around the knees to improve support to the knee joints. If you have not already been exercising on a regular basis, start progressively and properly so as not to cause more damage than good.

• Eat well – Consume foods that are high in nutritional value and low in calories to maintain a healthy and balanced diet, ensuring that your body has all the nourishment it needs for growth and repair. Eating right would also prevent obesity, which places additional stress on the knees.

• Avoid activities that strain the knees – Tasks that place repetitive stress on the knee joints without providing them enough time to heal, pose a risk of developing osteoarthritis. Though an active lifestyle is important, older adults should avoid engaging in tasks such as carrying heavy weights, kneeling down, walking on uneven terrain, etc.

 

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