Did you know that about 600,000 knee replacements are done every year in the U.S.? And hip replacements number a little under one-third that amount every year at about 285,000. They are the most common forms of treatment for osteoarthritis and other forms of arthritis that result in degenerative conditions of the hip and knee joints.
The World Health Organization estimates that 10% and 18% of men and women over age 60 have symptomatic osteoarthritis with the condition being more common in women than men. Yet, did you know that, if you have symptomatic joint issues you may not need to have a knee or hip joint replacement at all? That’s right. There are some successful, noninvasive alternative treatments available that you may want to consider first.
Joint Replacements: Before Surgery, Some Alternatives
Joint replacements of the knee or the hip – though effective at reducing pain most of the time – can have undesirable side effects like the following:
- Sideline you from your activities for weeks, sometimes months, at a time.
- Risk of infection after surgery which can range from mild to severe.
- Risk of blood clots from the surgery.
- Failure to relieve pain that brought the patient in for the procedure.
- Implants can malfunction and necessitate a second procedure to replace them.
- Implants can just plain wear out over time necessitating replacement.
Wouldn’t it be great if there were some alternative treatments that didn’t involve artificial prosthetics and risky surgical procedures at all? Well, there is. Let’s take a look at them:
1. PRP (Platelet Rich Plasma): A noninvasive therapy that’s been used for a little over 2 decades that works by re-strengthening tendons and ligaments. It involves injecting platelet-rich blood plasma into joints under ultrasound guidance. It stimulates stem cell production of the surrounding ligaments, helping them to regenerate and thicken as much as 40%. PRP also initiates a mild inflammatory response that starts a healing process as well as the increase of collagen. As the new collagen matures it causes the tendons and ligaments to tighten and strengthen adding more support to the joint with less pain and more movement. PRP injections can be used in the knees and hips as well as the cervical (neck), thoracic (middle) and lumbar (lower) spine, shoulders, elbows, wrists, fingers, ankles and toes.
Many patients who have this procedure enjoy a marked improvement in symptoms, which eliminates the need for further invasive procedures. It does not fix the problem overnight, but is much faster than surgical procedures. Patients typically resume normal activity and exercise during their rehab period. Many professional golfers, football and baseball players have noted successful results with the therapy. However, some scientific studies claim the results are short-lived. It may depend on the individual’s situation but is worth looking into before going for surgery.
2. Prolotherapy: Very similar to PRP, forms of prolotherapy (sclerotherapy, et al) have been around since the 1930’s. Like PRP, it also involves injecting the joint, ligaments and tendons, not with plasma, but a solution put together by a compounding pharmacy. The solution often contains dextrose, and an alkaline extract from the Sarapin plant that acts like a mild anesthetic. Other ingredients are sometimes added like minerals, zinc and manganese; fatty acids that help decrease inflammation; and sometimes testosterone or human growth hormone.
The prolotherapy solution helps trigger localized repair of ligaments, tendons and fibers helping to strengthen them. As a result, nerves that surround the ligaments and tendons are no longer being stretched and irritated, thereby increasing movement and reducing inflammation, swelling and pain. The treatment requires a series of 6-12 injections over a period of weeks. You are required to perform daily exercises along with the injections to help build the strength of the ligaments and tendons. Like PRP, prolotherapy can be used in the entire spine, the shoulders, elbows, wrists, fingers, hips, knees, ankles, and toes. It can even be used in the jaw joint for TMJ (temporomandibular joint) sufferers.
Prolotherapy is a treatment approved by the American Osteopathic Association and is used in many different bone and joint conditions like osteoarthritis, bursitis, degenerative disc disease, sports injuries, torn tendons, heel spurs and even fibromyalgia.
3. Conservative therapy: One of the most common causes of degenerative arthritis requiring hip and knee replacements is obesity. Yet, surgery is often recommended over advising the patient to lose weight first to see if it eliminates symptoms which it does in most cases. The joints have to support less weight and are thus better able to move with less pain. Adding nonweight bearing activities like swimming, to help a patient lose weight and also relieve swelling and stiffness of the joints, are also helpful. Anti-inflammatory supplements like quercetin, Omega 3 fatty acids, or white willow bark can help reduce pain. Collagen building supplements like hyaluronic acid, collagen, higher protein, low sugar diet and Vitamin C can help along with physical therapy to strengthen the muscles and ligaments to prevent shrinkage and inability to support weight.
If you have symptomatic arthritis of the knees and hips, and/or other body joints and bones, there are several options you can try to reduce your symptoms and improve your mobility before resorting to surgery. Consult a physical therapist for exercise options, and/or an orthopedic doctor who is familiar with PRP and prolotherapy. A naturopathic doctor, or health consultant, can also recommend supplements that may reduce inflammation, and build collagen in your joints to strengthen them. If you are overweight, ask your doctor about instituting a weight loss and nonweight bearing exercise program.
Platelet-rich plasma injections, http://www.ncbi.nlm.nih.gov/pubmed/20740273
Phys Ed: Do Blood Injections Help Sports Injuries? http://well.blogs.nytimes.com/2011/01/26/phys-ed-does-platelet-rich-plasma-therapy-really-work/
Does Prolotherapy Work? Sugar Injections Evaluated, online.wsj.com/article/SB10001424052702304410504575560214236534310.html
Hip and Knee replacement alternatives, http://www.caringmedical.com/therapies/prolotherapy-info/prolotherapy-injection.asp
Statistics Hip and Knee Replacements 2011,http://www.oecd-ilibrary.org/sites/health_glance-2011-en/04/07/index.html;jsessionid=3dln9sdrovedm.delta?contentType=&itemId=/content/chapter/health_glance-2011-35-en&containerItemId=/content/serial/19991312&accessItemIds=/content/book/health_glance-2011-en&mimeType=text/html