What is Osteoarthritis?
Osteoarthritis (OA) is a chronic, progressive condition that affects the articular cartilage in joints, most commonly the knee. While it is often associated with ageing, OA is not simply a result of getting older. In fact, many people develop OA in just one knee, often triggered by an old injury to the ACL or meniscus. When both knees are affected, causes are more likely to include genetics, body weight, and limb alignment.
OA typically begins in a small area and slowly spreads. Over time, as cartilage wears away, parts of the joint may become bone-on-bone, leading to pain, stiffness, and swelling. Bony growths, called osteophytes, can limit movement further, especially in people with a form of OA known as hypertrophic osteoarthritis.
Non-Surgical Management of Osteoarthritis
Surgery is usually considered a last resort. Non-surgical treatment focuses on reducing symptoms and slowing the progression of the disease.
1. Weight Loss & Exercise
If you're overweight and have mild to moderate OA, weight loss is the most important step you can take.
Diet plays a crucial role—what you do in the kitchen matters more than what you do in the gym.
Exercise should be low-impact. Cycling is highly recommended for knee OA.
2. Exercise Programs
Programs like GLA:D (Good Life with Arthritis: Denmark) are evidence-based, physiotherapist-led programs tailored to OA.
3. Medications and Supplements
OA treatments fall into two broad categories: Ingestables (taken orally) and Injectables (injected into the joint).
Ingestables
Paracetamol: Mild benefit; does not slow disease progression.
NSAIDs (e.g. Naproxen, Diclofenac): Moderate relief, best used during flareups. Risk of kidney, stomach, and cardiovascular side effects, especially in older adults.
Glucosamine & Chondroitin: Safe supplements, possibly helpful in slowing disease progression. Must be taken regularly.
Injectables
Corticosteroid: Strong anti-inflammatory, especially effective if the knee is swollen. Used during flareups. Temporary blood sugar spikes can occur in diabetics.
Hyaluronan (Viscosupplementation): Offers short-term relief for some but is expensive, inconsistent, and not covered by Medicare.
Platelet-Rich Plasma (PRP): Shows promise, especially leukocyte-poor PRP administered as a series of three injections. May slow progression. Not Medicare-funded.
Note: Stem cell injections are currently not recommended. They are expensive, unsupported by strong scientific evidence, and not covered by Medicare.
For personalised advice and treatment planning, please discuss your symptoms and goals with your Pinnacle Orthopaedic specialist.
