Osteoarthritis (joint wear) is one of the most common causes of chronic hip and knee pain — especially over the age of 50. A joint replacement is not always needed straight away. Exercise, strength training and, if needed, losing weight help the most; injections can also ease the pain.
Non-surgical options
Hyaluronic acid can ease the pain somewhat in mild to moderate osteoarthritis: it lubricates the joint, but does not restore the cartilage. The British guideline (NICE NG226) advises against it and the Dutch GP guideline does not recommend it either, because the effect in research is small. We will discuss honestly whether it makes sense for you.
Prolotherapy stimulates the repair of ligaments and joint capsules. It works less well in advanced osteoarthritis; in mild to moderate osteoarthritis it can be an option, but research is still limited.
Arthrosamid is a newer option for knee osteoarthritis: a polyacrylamide hydrogel that stays in the joint for years. We closely monitor developments and offer this to selected patients.
Your recovery journey
Every course of treatment is tailored, but this is what a typical course looks like — from the first intake to recovery; how quickly that goes differs from person to person. You are not tied to anything and always know where you stand.
Functional analysis
We look at how far the joint moves, how you walk and how much pain you have; often an X-ray is already available. Then we make a plan together, including, if needed, an assessment of whether hyaluronic acid (Dordrecht, on Thursdays also Rotterdam) or PRP (Dordrecht) makes sense.
Pain relief
Gently moving the joint by hand and gentle chiropractic. If the symptoms are severe enough, the doctor can inject hyaluronic acid (Dordrecht, on Thursdays also Rotterdam). You also learn which movements trigger the pain.
Muscle building & losing weight
Strength training for the thigh and buttock muscles: the best-supported approach for osteoarthritis. If weight plays a role, you receive dietary advice. A PRP injection is sometimes also possible.
Lifelong management
Occasionally treatment can help with osteoarthritis, for example hyaluronic acid. When you come back, you decide; you are not committed to anything.
Frequently asked questions
Does losing weight help?
Yes — Losing 1 kg of weight means 4 kg less stress on the knee with each step.
Can I continue running with osteoarthritis?
Often yes, provided good footwear and a gradual build-up. Swimming and cycling are alternatives.
When a new hip/knee?
In case of severe limitations after conservative treatment of 6-12 months — discuss with orthopedist.
Do glucosamine and chondroitin help?
Usually not: in research, glucosamine and chondroitin work no better than a placebo, and the Dutch GP guideline advises against them.
Does PRP or hyaluronic acid stop osteoarthritis?
No. In some people it eases the symptoms for a while, but it has not been shown to delay surgery.
Sources
Independent information from Thuisarts.nl, the patient website of the Dutch College of General Practitioners (in Dutch).
