Non-Surgical Knee Surgery Alternatives
Thank you for opting to have your surgery done with us.
I hope that you are cognizant of the other methods of treatment of your problem which has been discussed with you by me, my staff and assistants in my clinic, in advance, at the time of your consultation, and I trust if you have had any queries, they have been answered.
Based on our discussions, we have determined the suggested plan of action as the best option under the circumstances, keeping in mind your requirements and our current expertise.
To help you understand the process, I am comparing it to taking a flight from Mumbai to a foreign destination.
Just like before a flight, you need passports, visa, ticket bookings, like-wise for the operation, you need to book a date for admission and a date and time for surgery.
Just like the visa process, we need to know that you are fit for surgery and therefore, you need to share your medical history with us, alongwith ALL the medication that you normally take including tablets such as Aspirin and Clopilet which are blood thinners and can cause bleeding at the time of surgery, and medication for Asthma (you may need more oxygen during the surgery) and Diabetes (if your blood sugars are high, then wound healing is very poor). All inputs by you help make us more prepared to help you.
Specific medication & conditions of the heart (ECG, 2D Echo), lungs (PFT/X-rays), liver and kidney etc., need to be known as various drugs can interact with these functions. The physical act of giving you anesthesia may require extra tests like specialized x-rays of your spine, CT or MRI screening of parts of your body, so that we are better prepared to tackle your spinal position during the process of the surgery.
Just like you have a security check before taking a flight, we need the Physician and the Anesthetist to look through these pre-operative medical reports and to examine you so that we may reduce the risks still further.
Just like in an aircraft before take-off, there is a safety drill in case of any risks, likewise, in any surgery we are taking RISKS but minimizing it by trying to cover as many events as we can.
Just as every landing at an airport, the pilot has to contend with cross-winds, haze, other flights, weather changes, quality of communication etc., similarly every surgical procedure is individualized, some are longer, some are shorter and there are multiple variables.
The OTC is like a ticket. Just like you pay for a ticket before your travel. The Hospital expects you to do an OTC (Operation Theatre Clearance) so that the hospital and you are both aware of the expected expenses. Against your paid ticket you get a boarding pass, likewise against an OTC, the institution permits you to be taken to the theatre for surgery. This is based on averages, but in your individual case the total expenses may be more if there are complications or emergency requirements which may or may not be related to the actual surgical procedure.
You need to be aware therefore that this is an estimate only based on an AVERAGE and is NOT a PACKAGE.
Recovery thereafter is a natural process, and we as doctors help nature help you, with medication, nursing, physiotherapy and other techniques required for your recovery. I reiterate that healing is a process dictated by nature, we only help in this. Just as nature has storms, weather changes, etc, recovery can sometimes in your individual cases be slower and therefore worrisome to you.
Such delays are also worrisome to us as individuals and as a team. The nurses, other staff and my team help the recovery process. Your concerns will be addressed.
Just like in the airline industry the cost of the ticket for travel supports the airline staff, the salaries, the fuel for the aircraft etc., for our team to successfully execute the whole process, there is staff in the hospital which is supported by the expenses incurred for your case, for administration, security, laundry, dining, meals, air-conditioning, water, catering etc.,
Like certain budget airlines offer cheaper fares and skeleton services many doctors and medical facilities will be able to offer you these at lesser rates. In our institutions we have overheads to ensure that checks and measures are carried out for your safety and these necessitate the charges quoted by us.
Just like in any travel there is an Economy class or Business Class or First class at different charges, helping you reach the same destination, similarly in the hospital there are various classes of admission with different levels of comfort, helping you attain the best results. My team’s training, experience, etc., should make this a smooth landing.
I hope this helps you understand the process and I really look forward to greeting you on the other side with every success in your case.
– DR. SANJAY AGARWALA
SA:bf:10th July 2018
Before deciding on knee surgery, your physician may try several knee surgery alternatives to relieve the pain and inflammation in your knee.
Knee Surgery Alternatives: Lifestyle Modification
The first alternative to knee surgery most physicians try is lifestyle modification. This may include weight loss, avoiding activities such as running and twisting which can aggravate the knee injury, modifying exercise to no- and low-impact, and other changes in your daily routine to reduce stress on your knee.
Knee Surgery Alternatives: Exercise and Physical Therapy
Exercise and physical therapy may be prescribed to improve strength and flexibility. Exercises may include strengthening exercises such as riding a stationary bike, and stretching exercises such as flexing the ankle up and down, tightening and holding thigh muscles, sliding the heel forward on the floor, leg lifts, and knee extensions.
Exercise can strengthen your leg muscles and reduce your pain. If you really need knee surgery, this may not help, but many forms of knee pain can be mitigated by exercise.
Knee Surgery Alternatives: Anti-inflammatory Medications
Arthritis pain is caused by inflammation in the knee as the bones rub against each other due to eroded cartilage. Reducing the inflammation of the tissue in the knee can provide temporary relief from pain and delay knee surgery.
Anti-inflammatory medications may be prescribed to decrease swelling in the joint. New medications called Cox-2 inhibitors may also be used to reduce inflammation, reducing pain temporarily. A corticosteroid injection may also be used to reduce pain; in this procedure a powerful anti-inflammatory agent is injected directly into the joint.
Knee Surgery Alternatives: Glucosamine/Chondroitin
A dietary supplement called glucosamine/chondroitin may improve the joint’s mobility and decrease pain from arthritis of the knee. Glucosamine and chondroitin sulfate can slow the deterioration of cartilage in the joint, reducing the pain of bone on bone. Both are naturally occurring molecules in the body. Glucosamine is thought to promote the growth of new cartilage and repair of damaged cartilage, while chondroitin is believed to promote water retention, improving the elasticity of cartilage, and also to inhibit cartilage-destroying enzymes.
Knee Surgery Alternatives: Joint Fluid Therapy
While medications and supplements can be helpful in reducing inflammation and pain and help you delay or avoid knee surgery, there are trade-offs. Drug therapies may have side effects, and there is a limit to how much pain reduction can occur.
In a procedure called joint fluid therapy, a series of injections is made directly into the knee joints. This therapy is designed to reduce pain by improving lubrication in the knee, replacing the synovial fluid that lubricates the knee. Hyaluronate is used for the treatment of osteoarthritis knee pain in patients who have failed to get adequate relief from simple painkillers or from exercise and physical therapy.
A solution made of highly purified, sodium hyaluronate (trade name SUPARTZ®) is used in this procedure. SUPARTZ is made from a natural chemical found in the body and is found in particularly high amounts in joint tissues and in the fluid (synovial fluid) that fills the joints.
The body’s own hyaluronan acts like a lubricant and shock absorber in synovial fluid of a healthy joint. Osteoarthritis reduces your synovial fluid’s ability to protect and lubricate your joint.
A physician administers an injection of SUPARTZ solution into your knee once a week for 5 weeks (a total of 5 injections). This helps to re-lubricate your knee and reduce the pain of osteoarthritis, possibly delaying or helping you avoid knee surgery.
A brace may be used to provide external stability to the knee joint. Braces are devices made of plastic, metal, leather and/or foam and are designed to stabilize a joint, reduce pain and inflammation and strengthen the muscles of the knee. By putting pressure on the sides of the joint, the brace causes the joint to realign, which in turn decreases the contact between the two rough bone surfaces and reduces the pain while increasing mobility.
As you can see there are several non-surgical options for treating osteoarthritis. These methods can delay knee surgery by providing short-term relief. However, any drug therapy program is likely to have side effects which should be taken into consideration. Non-surgical procedures may also have limited results compared to the long-term results of knee surgery.
SUPARTZ® is a trademark of The Seikagaku Corporation.
For more information you can read the following booklet (click to open): Arthoscopy Booklet
For more information you can also read this booklet (click to open): Joint Replacement Information Booklet