Sorting Fact from Fiction in Knee and Hip Osteoarthritis

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There is an urban myth alive and well in western society... It seems to be that if you have Osteoarthritis in your knee or hip, well that's it - you hands down need a joint replacement. Or it’s only matter of time before you will need one. This prolific line of thinking probably isn’t helped by some surgeons reinforcing the theory at the end of assessments - “i’ll see you in two years for a knee replacement.” 

The first line of defence against arthritis is education, and a Physio directed exercise program. There are now huge international studies with amazing results to prove the effectiveness of this. 

The second line of defence is pharmaceutical intervention, with the option of natural alternatives. 

There is also no relationship between Osteoarthritis severity and pain!

I have been seeing a lot of people lately in there 40’s and 50’s, who are booking themselves in for knee and hip replacements as a first line of defence because they have arthritis on imaging. This should never be your first line of defence. There are exceptions, but usually only if the pain is extreme, or if you have had a serious accident.

In Australia there is amazing work being done by La Trobe University, where exercise and education is the first line of defence. These studies are part of a broader international study called the GLAD knee and hip osteoarthritis program. This massive international paper has demonstrated that after doing the 8 week program, 75% of people had clinically meaningful results a year later, and 75% no longer wanted surgery. That is huge.

So what is Osteoarthritis?

OA is a disease that affects all of the joint structures of a particular joint. There are risk factors for the disease such as 

  • Being sedentary (move it or lose it)!

  • Changes to your hip joints like hip dysplasia or cam/ pincer lesions

  • Soccer/ Hockey

  • Physically demanding work as a career

    FACTS

  • Scans are poorly related to pain and disability 

  • Pain doesn’t equal damage 

  • Exercise is safe and helps 

  • Rest and avoidance makes pain worse 

    So what can you do if this sounds like you?

    I would genuinely recommend you see a Physio that has knowledge of OA and a good command of exercise therapy. 

    Getting an exercise program that gets progressed every week for 8 weeks can be an absolute game changer. 

    I’d also get a program you could do in a pool or join a hydrotherapy program, run by a Physio, if you are in a lot of pain. If you reply to this I can recommend who you see depending on where you are.

    Secondly if you lose 5kg’s you will more than likely be in less pain. It is worth the investment to see a good dietician who can keep you on track to get results. 

    What else could I do?

I’d try supplements such as Glucosamine, Chondritin, or Turmeric.

If you really want to get your pain under control so you can really give an exercise program a good crack, I would strongly recommend working with your GP to create a plan around pain management. Even if it is just a short blast to get your pain manageable so you can begin exercise.

If you have tried all of the above, or your hip or knee has “fallen off a cliff” and the pain has suddenly become severe, then it is time to get a referral to a good surgeon. Alongside your Physio and GP, you will know when it is time for plan C. A joint replacement.