Non operative management of hip or knee osteoarthritis is the mainstay of treatment, until it comes to the time when all modalities have failed, and your quality of life is experiencing a significant decline. We judge this by assessing your walking, pain levels, and functional requirements, as each patient has different expectations on themselves. When the time comes, a total hip or total knee replacement is a fantastic choice, but until then, all patients should undergo some form of non operative measures, if possible, to delay their surgery. That way, we will know that when it is no longer working, that you’ve tried everything you can to avoid surgery. At that point, it’s time to see me to talk about the total hip and total knee replacement techniques.
Does Chondroitin work?
The original large studies on chondroitin did not show a statistical advantage in taking Chondroitin for the management of osteoarthritis of the hip and knee. Subsequent studies published in the journal of physiotherapists confirmed that chondroitin may have a positive effect when taken with Glucosamine. Whilst the jury is still out on this, it can be taken with minimal side effects in most people, and therefore, the same regimen of trial and adjust should be used.
How long should I try these measures before considering surgery?
There is no strict time limits and all of it really depends on the speed of deterioration and how much it is affecting your quality of life. Every patient has different demands, expectations and a different trajectory of deterioration so exact timeframes are not as important as each individuals demands. Speaking to your local doctor first is a good start, as they would have seen many patients go through the same thing.
When should I make an appointment to see you?
Once you’ve exhausted the non operative measures in the video above, and you still feel that you are limited in activities that enrich your quality of life, then its time to see an orthopaedic surgeon. In general, we look at general things like walking speed and distance, ability to walk up and down stairs, and functional elements such as putting on shoes, socks and doing the things that you want to do day to day. There is no role to have a total hip replacement or total knee replacement if you are doing everything you want to do, and there is minimal discomfort.
We never judge the time frame for doing a hip or knee replacement in advance – we take things as they come. It’s impossible to look at an Xray and determine how long it will take before someone will need a hip or knee replacement. It’s all based on symptoms.