Treatment Options for Knee Arthritis

Last month I attended a lecture titled, “State-of-the-art Treatment Options for Knee Arthritis” given by orthopedic surgeon, M. Mike Malek, MD at the Inova Fairfax Hospital. If you suffer from chronic knee pain or osteoarthritis of the knee, then this lecture provided pertinent information.

Dr. Malek first explained that this did not include rheumatoid arthritis which is a systemic disease. Osteoarthritis is a joint problem and a wear and tear problem. It is a degenerative problem that becomes arthritis. Part of osteoarthritis could be genetic and part of it is acquired. The knee is the least protected joint in the body and the most commonly injured.

As a wear and tear problem, the surfaces of the knee become pitted, eroded, uneven, and painful. This has to go on for 18 to 24 months before showing any changes on an x-ray.

Osteoarthritis symptoms include:

  • Pain
  • Loss of range of movement
    • Going up and down stairs
    • Unable to get off the toilet seat or couch
    • Night pain and stiffness
    • All day and night pain and stiffness

Causes include the following:

  • Excessive wear — weight is a major problem
  • Sport injury
  • Age
  • Obesity
  • Deformity — bow leggedness makes it worse
  • Work-related injury
  • Major trauma
  • Weak quadriceps
  • Lack of vitamin D

There is no laboratory test for osteoarthritis. There are 208 joints in the body and any joint can be affected, but the knee is the most common.

What are your treatment options?

  • Activity modification (One person said he’s a runner and he has knee problems. Dr. Malek said to find something else).
  • Physical therapy
  • Anti-inflammatories (NSAID) (Everything has side effects).
  • Cortisone injections
  • Visco supplementation (Joint fluid therapy — hyaluronic acid — something your knee produces).
    • There are five companies in the US that use rooster combs
    • Euflexxa is the only one that’s synthetic
  • PRP (protein-rich plasma)
    • Your own blood is taken and the Growth Factor is injected back
    • Athletes get on a regular basis
    • Makes healing faster
  • Bracing — customized about $1,200
  • Arthroscopy with or without HTO (High Tibial Osteotomy)
  • Arthroplasty — open surgery

With a knee replacement you will never have the full range of motion. Unicondylar knee replacement is a possibility for bowed legs. Only a part of the knee joint is replaced through a smaller incision than would normally be used for a total knee replacement.

The bottom line is your age, activity, use, and abuse of your knee will determine the length of how long your knee will last. However, you have a variety of treatment options for knee arthritis. Remember that nothing will last forever, not even knee replacement surgery. For more information, check out Dr. Malek’s Web site: or

See also a post I wrote last month about arthroscopic knee surgery.

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Prescription Medication and Nutrient Depletion

I came across an interesting study done in 2005 in Minnesota showing an increase in the use of prescription drugs as one ages. The survey results are staggering. Two-thirds of seniors in their 50’s are on prescription medication and the numbers get worse as one ages. So those of us who are not on any prescription drugs are in the minority. Drugs can produce undesirable and even tragic results, but we don’t think often about the nutrients they deplete.

2005 Survey of Older Minnesotans (Statewide Population 50+)
Take Prescription Drugs on a Daily Basis

Age Total Weighted # Take Prescription Drugs Daily No Daily Prescription Drugs
50-59 40,638 59.9% 40.1%
60-74 33,418 78.2% 21.8%
75+ 21,107 87.1% 12.9%

Age Differences Statistically Significant

Prescription drugs have side effects. Ever notice the small print accompanying all prescriptions? Ever notice the last words of TV commercials for prescription drugs? More importantly, though, we don’t realize the nutrients that it depletes from our bodies. Check out this table taken from Drug Induced Nutrient Depletion Handbook, 2nd ed.

Medication (RxDrug) Nutrients Depleted
Antacids Pepcid, Tagamet, Zantac Vitamin B12, Folic Acid, Calcium, Iron, Zinc
Prevacid, Prolosec Vitamin B12
Antibiotics General Aminoglycosides (tentomycin, neomycin, streptomycin), Cephalosporins, Penicillins B Vitamins, Vitamin K
Friendly beneficial intestinal bacteria
Tetracyclines Calcium, Zinc, Magnesium, Iron, Vitamin B6
Anti-Diabetic Drugs Micronase, Tolinase Coenzyme Q10
Glucophage Coenzyme Q10, Vitamin B12, Folic Acid
Anti-Depressants Adapin, Aventyl, Elavil, TofranilPamelor,Sinequan, Norpramin Vitamin B12, Coenzyme Q10
Anti-Inflammatories Aspirin & Salicylates Vitamin C, Folic Acid, Iron, Potassium
Advil, Aleve, Anaprox, Dolobid, Feldene, Lodine, Motrin, Naprosyn, Orudis, Relafen Folic Acid
Betamethasone, Cortisone, Dexamethasone, Hydrocortisone, Methylprednisoone, Prednisone Vitamins C, D, Folic Acid, Calcium, Magnesium, Potassium, Selenium, Zinc
Cardiovascular Drugs Apresoline Vitamin B6, Coenzyme Q10
Catapres, AldometCorgard, Inderal, Lopressor Coenzyme Q10
Betapace, Tenormin, Sectral, Blocadren Coenzyme Q10, Melatonin
Diuretics Lasix, Bumex, Edecrin Vitamins B1, B6, C, Magnesium Calcium, Potassium, Zinc, Sodium
Enduron, Diuril, Lozol, Zaroxolyn, Hygroton Magnesium, Potassium, Zinc
Lescol, Lipitor, Mavacor, Zocor, Pravachol, Crestor Coenzyme Q10, Sodium
Cholesterol Lowering Agents(Statins) Lescol, Lipitor, Mavacor, Zocor, Pravachol, Crestor Coenzyme Q10
Colestid, Quetran Vitamins A, B12, D, E, K, Beta-Carotene, Folic Acid, Iron
Ulcer Medications Tagamet, Pepcid, Zantac Vitamins B12, D, Folic Acid, Calcium, Iron, Zinc, Protein
Prevacid, Prilosec Vitamin B12, Protein
HTR – Hormone Replacement Therapy Evista, Prempro, Premarin, Estratab Vitamins B2, B6, B12, C, Folic Acid, Magnesium, Zinc
Oral Contraceptives Norinyl, Ortho-Novum, Triphasil, etc. Vitamins B2, B3, B6, B12, C, Folic Acid, Magnesium, Selenium, Zinc

Prescription drugs are expensive. In many cases, generics are not available. Consumer Reports has a free service where you can check on best buys for drugs you may be taking.

If you are on prescription medication(s), one of the best and least expensive vitamins on the market today that would help you replace the lost nutrients is VitaOne. Click here for complete information.