Treating Osteoarthritis of Knee: Surgery versus Physiotherapy

Introduction

Osteoarthritis is a situation that involves the wear and tear of the cartilage/natural cushioning between joints. The shock-absorbing capacities of the cartilage are reduced and results in the bones at the joints rubbing against each other causing pain, swelling, stiffness, inability to move, and emergence of bone spurs.
Knee pain is a standout amongst the most well-known yet ignored musculoskeletal conditions. Osteoarthritis is one of the leading causes of knee pain. While it can happen even in youngsters, the possibility of osteoarthritis ascends after the age of 45. Women are more prone towards it. Cases of osteoarthritis are rapidly increasing in India due to the changing lifestyles and eating habits.

Causes

The most common causes for knee osteoarthritis include factors of age; weight gain; heredity factors; gender (women above 55); repetitive stress injuries such as kneeling, squatting, or lifting heavy weights (55 pounds or more); athletics involving soccer, tennis, or long-distance running; and other illness such as rheumatoid arthritis, metabolic disorders (iron overload) and excess growth hormones.

Treatment: Surgery Versus Physiotherapy

Surgery is said to be the last resort for treatment of osteoarthritis of the knee. This is because, in a revolutionary study on meniscal tears and the treatment of Osteoarthritis by the New England Journal of Medicine, it was resolved that there were no irrelevant contrasts between patients settling on surgery over an escalated regiment of non-intrusive treatment/physiotherapy.

The differences between the two procedures include:

1. While surgical procedures involve arthroscopy, osteotomy, and arthroplasty; physiotherapy includes hamstring stretches, calf stretches, standing quadriceps stretches, seated leg raises, step-ups, straight-leg lifts, single-leg dips, hamstring curls, wall squats, half squats, knee stabilization series, static hamstring contractions, sit/stands, heel cord stretches, leg extensions, hip abductions and adductions and leg presses with resistance bands, in accordance to the physiotherapist’s guidance.
2. The underlying problem with surgery is the possibility of adverse effects/risks due to intrusive procedures. Due to this, physiotherapy being a non-intrusive technique is considered safer.
3. Surgery focuses on the realignment of bones in joints, artificially, by the addition of artificial parts, cutting off the excess bone, and general realignment. Physiotherapy, however, focuses on restoration of mobility and strengthening of muscles, in addition to weight management. Stretching, strengthening, and flexibility exercises, along with proprioception and balance exercises, and joint mobilization and manipulation, are effective in pain management, lowering inflammation, and restoring optimal balance after an injury.
4. Most patients can administer to themselves and resume typical everyday exercises inside 6 weeks and drive inside 4 to 6 weeks. It might take 3 months to a whole year to completely recoup and acknowledge the advantages of knee surgery. Physiotherapy, on the other hand, needs no special recovery time and it spans over a period of 6 to 12 weeks only.
5. In addition to all of this, it is to be acknowledged that surgeries are costly, unlike physiotherapy.

Conclusion

Despite the problems posed by surgery, it is a definite tool in the treatment of osteoarthritis of the knee but only recommended in extreme conditions. Physiotherapy is in every way the best procedure to go about it. Physiotherapy is aimed toward biomechanical corrections of the affected knee, thereby preventing the osteoarthritis from taking a serious shape. It’s therapeutic nature and capacity to provide relief often postpones the need for surgery or dismisses it altogether. We at Eva Physiocare are working on preventive care that includes diet management in the integrated wellness programme.