Joint surgery and physical therapy

There is currently an unmet need for surgery in the Canterbury region (Stuff/national/health.co.nz). If you are sitting on a waiting list what can you do to help delay, or better avoid the risks associated with surgery? In some instances conservative management involving a patient-specific rehabilitation programme and other lifestyle changes can be enough. These changes are important before and after surgery.

In the instance of joint osteoarthritis (OA) and cartilage damage, for really severe arthritis your GP may recommend surgical intervention, but up until then OA can be managed in the mild and moderate stages. Tips and hints can be found on the Arthritis NZ website. These include planning ahead and pacing your self, trying to get a good nights sleep, eating a balanced diet, regular exercise and making contact with Arthritis NZ. Here at Merivale Physiotherapy Clinic we can provide an exercise program to minimise your pain and maximise your functional ability. There is an optimal activity level for cartilage maintenance, with high and low activity resulting in cartilage degeneration.

Defect size of cartilage damage is currently used as one of the primary indicators for treatment selection– surgical or non surgical. Debridement can be considered as an initial treatment for defects <2cm2 . However, research has shown that in patients with OA, arthroscopic debridement has no advantage over optimal physical and medical care. Other surgical techniques used for larger defects include microfracture augmentation and autologous chondrocyte implantation.

Reference: Tommy S. de Windt M.D., Ph.D. (2016). Current Knee Cartilage Repair Alorithms. Asperta Sports Medicine Journal, Volume 5 June/July. Hama Alizai, Alic Guermazi (2016). Quantitative MRI of Catrilage. Asperta Sports Medicine Journal, Volume 5 June/July.