Non-operative management

Management usually includes a detailed history of the condition, details of the current symptoms and disability, current and previous medications and past medical history. Clinical examination is undertaken by Mr. Johnson and subsequently radiographs or MRI scans can be arranged if necessary. From the clinical examination, the radiographs and scan results Mr. Johnson can determine the appropriateness of unicompartmental, total or patella-femoral replacement. The opinion is usually then available and discussed with the patient.

Mr. Johnson will outline options for further treatment, and patients will then be encouraged to participate in the decisions about which treatment options are most appropriate. Initial management for early degeneration may include physiotherapy, use of anti-inflammatory medication (Ibruprofen, diclofenac, vioxx etc), and bandages and supports. Joint injections either with hyaluronic acid (Synvisc) or methyprednisiolone may occasionally be considered. For early degeneration or in patients in whom there has been a rapid deterioration or injury keyhole arthroscopic treatment may prove to be very helpful. Alternately joint replacement may be appropriate because of advanced disease or where the other treatments prove to be ineffective.

Also see the following articles: Viscosupplementation and Chondroitin and Glucosamine

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