Non-operative treatment for knee arthritis pain relief
Knee arthritis affects approximately 15% of people over the age of 45, causing pain and limiting mobility. For many, it can take up to 10 years from the onset of symptoms to undergoing knee replacement surgery. However, this does not need to be a period of suffering. Instead, it offers an opportunity to embrace effective non-surgical treatments that help maintain an active and fulfilling lifestyle.
Family doctors, physical therapists, and orthopaedic specialists play a crucial role in guiding patients through this journey. By exploring non-operative options, they can help manage pain, improve function, and potentially delay the need for surgery, ensuring that knee replacement remains a last resort.
Overview
If you suffer from inflammation and have knee arthritis pain, nSTRIDE® may be a new biologic treatment that could help you. It uses the natural anti-inflammatory elements in your blood to reduce inflammation and pain. This treatment is designed for patients who are not yet at the stage where knee replacement is necessary.
nSTRIDE® APS is a minimally invasive procedure. The process involves isolating anti-inflammatory elements such as cytokines and anabolic growth factors from your blood using a cell-concentration system. These elements are then reintroduced to your body at the site of inflammation and pain. Studies suggest that this treatment can provide sustained pain relief for up to 18 months or longer.
From a patient’s perspective, undergoing this treatment is simple. Blood is taken from your arm in the usual way and processed to create the final product, which is then injected into your knee. You will be observed for 15 minutes after the injection, but there are no restrictions on your activities after that.
Causes
Osteoarthritis is caused by a complex group of overlapping conditions aggravated by repeated damage to and inflammation in the joint. Several risk factors increase the risk of arthritis, though the cause is not always clear, these include:
- Genetic factors — there are specific genes associated with more vulnerable cartilage
- Age — as we progress through life arthritis becomes more likely
- Gender — joint damage is more common among women
- Obesity — being overweight puts a great deal of strain on the knees. For those with a BMI of more than 36, there is a 14 times increase in the incidence of knee osteoarthritis
- Hypermobility — people with flexible joints are more likely to develop arthritis
- Trauma or infection — major or repeated minor injuries to the joint put us at risk of arthritis
Symptoms
Knee arthritis can cause pain and stiffness in the joint, which can lead to reduced mobility. These symptoms can have a negative impact on a person’s ability to stay active, socialise, work, and enjoy life in general. Those with arthritis may also be more susceptible to depression, early retirement, cardiovascular disease, and a higher risk of mortality.
Diagnostics
To diagnose knee issues, doctors examine the patient’s medical history and perform a physical examination. Medical imaging is also used for a definitive diagnosis. At the Cabot Clinic, the medical team uses X-rays and advanced 3-Tesla MRI scanners when necessary.
Treatments
Although a joint replacement can be a definitive solution, several non-surgical techniques can effectively control symptoms less intrusively and postpone surgical procedures for many years. These include painkillers, knee braces, activity modification, weight loss, physical therapy and exercise.
Injections for knee pain
Various injected therapies are available — in rare instances, these can cause complications, such as infections or allergic reactions. They differ greatly in their duration of efficacy and price. The effects vary between patients significantly, the information below is a guide only:
Steroid (aka Cortisone) injections
Typical duration: 3 months
These can be effective for a limited period. A first-time injection can provide significant relief for up to three months. A second dose is usually less effective and subsequent injections provide diminishing relief. The effects on the knee joint are not well understood and risk having a detrimental effect.
Hyaluronic acid injections
Typical duration: 6 months
This engineered viscous fluid is similar to the natural joint lubricant. It was initially proposed as a shock absorber or joint lubricant replacement but current thinking is that it works more as an anti-inflammatory. Several recent systematic reviews support its use though value for money is debatable.
Stem cell injections
Typical duration: uncertain
This treatment has received a great deal of media attention. Initially, expectations were high that it might be able to regenerate cartilage. An expensive option; results are mixed and poorly reported; science fiction or a miracle cure? The jury is still out.
Standard PRP injections
Typical duration: poor evidence
Researchers have recently studied whether injections of platelet-rich plasma (PRP) can be used to manage osteoarthritis of the knee. In theory, PRP operates by injecting growth factor-rich platelets from the blood into the joint. These treatments have proved to be more successful in treating conditions that require inflammation to heal (such as tennis elbow) than those that are caused by inflammation (such as arthritis).
nSTRIDE® APS biologic injections
Typical duration: 24 months+
nSTRIDE® differs from standard PRP (platelet-rich plasma) injections. Approximately 70% of patients experience a 70% improvement in knee pain following treatment. The process begins with PRP extraction, which then undergoes a secondary step to remove inflammatory elements, leaving behind a potent, long-lasting biologic anti-inflammatory solution. This neutrophil-depleted PRP product is more affordable than stem cell injections and has undergone extensive testing. Zimmer Biomet, a leading global biotech company, has conducted laboratory studies, veterinary research, safety testing, and human clinical trials. The efficacy data shows promising results, with sustained pain relief reported for over 24 months.
Percentage change from baseline in WOMAC pain score
- nSTRIDE®
- Placebo
Zimmer Biomet. A multicenter, double-blind, randomized, placebo-controlled pilot study of a single, intra-articular injection of autologous protein solution in knee osteoarthritis patients.
Recovery
Once the patient receives the nSTRIDE® injection, they can leave the clinic without any limitations on their activities. There have been reports of some patients experiencing improvements within 24 hours. An in-depth study has shown significant reductions in pain levels within six weeks, peaking at 12 weeks and remaining stable for the following 24 months.
Are you tired of knee pain affecting your mobility?
If you are in pain and suffering from knee arthritis, speak to our surgeons about treatment options. Click here to book a one-stop appointment. Consultations are available within one week.