Non-Surgical Therapies

As in all cases of arthrosis, therapy depends on the seriousness of the symptoms and the degree of cartilage degeneration.

Painkillers and anti-inflammatory drugs serve to alleviate symptoms in the initial phases of the disease. However, the side effects that chronic inflammatory drug-based therapies may cause make them unsuitable for prolonged use.

Day to day habits like physical exercise (preferably with the limb unloaded as with cyclettes, swimming and water gymnastics) make it possible to maintain good muscle tone and retard the arthritic process. In particular, keeping good quadricipital muscle tone helps delay instability. Overweight patients must lose weight, both to reduce overloading of the joint (and thereby slow down cartilage degeneration) and in view of arthroprosthesis surgery, to reduce possible complications and accelerate post-operative la physiotherapy.

Physical therapies, such as TENS, laser therapy and ultrasound therapy are rarely effective.

Infiltration therapy alleviates symptoms and slows down the development of the disease. Two categories of drug are used for infiltration therapy: cortisone-based and hyaluronic acid. Infiltration of cortisone is indicated in cases of acute pain. Inside the articular capsule the drug acts against inflammation to reduce/eliminate pain. Intra-articular cortisone has a degenerative effective on the cartilage if therapy is excessively long, which is why it is not indicated for young patients. Infiltration of hyaluronic acid is only indicated in the initial phases of the disease, when degeneration of the cartilage is only partial.
 
BIBLIOGRAPHY
1. Knoop J, Steultjens MP, van der Leeden M, van der Esch M, Thorstensson CA, Roorda LD, Lems WF, Dekker J. Proprioception in knee osteoarthritis: a narrative review. Osteoarthritis Cartilage. 2011 Apr;19(4):381-8.
2. Vaquero J, Calvo JA, Chana F, Perez-Mañanes R The patellar thinning osteotomy in patellofemoral arthritis: four to 18 years’ follow-up. J Bone Joint Surg Br. 2010 Oct;92(10):1385-91.
3. Feeley BT, Gallo RA, Sherman S, Williams RJ. Management of osteoarthritis of the knee in the active patient. J Am Acad Orthop Surg. 2010 Jul;18(7):406-16.

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