Knee degeneration doesn't always mean surgery; doctors reveal 'knee-preserving' treatments

A significant portion of Taiwan's population, exceeding 3.5 million individuals, is grappling with joint degeneration, a condition particularly prevalent among those aged 60 and older, affecting over 20% of this demographic. Many patients mistakenly believe that their only options are pain management or eventual knee replacement surgery.

Dr. Wu Chen-yi, an orthopedic specialist at Jia Yun Clinic, explained that degenerative arthritis is a progressive structural decline. He stressed that a spectrum of treatments exists between simply managing pain and undergoing surgery. Early intervention, he noted, can effectively alleviate pain for most patients and significantly postpone the need for artificial joint replacement.

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Degenerative arthritis is a progressive structural degeneration. Between pain relief and surgery, there is a diverse spectrum of clinical treatments.

Dr. Wu categorized knee degeneration into four stages. The first two stages typically manifest as stiffness after prolonged sitting or discomfort when ascending or descending stairs. He emphasized that these early phases are the "golden period for cartilage repair." During this time, cartilage has not completely worn away, and interventions like regenerative therapy or personalized physical therapy can support repair, effectively slowing joint deterioration. Delaying treatment until the fourth stage drastically limits therapeutic options, often necessitating consideration of knee replacement surgery.

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These first two stages are the 'golden period for cartilage repair.' If actively intervened with regenerative therapy or personalized rehabilitation, the underlying structure can still support repair, which is most effective in delaying joint deterioration.

Treatment options include traditional methods like steroids and hyaluronic acid for acute pain relief and joint lubrication. For patients seeking to delay surgery, regenerative medicine techniques guided by ultrasound, such as high-concentration platelet-rich plasma (PRP) or bone marrow concentrate (BMAC), are available as self-paid options. Research indicates these therapies can improve joint function in patients with mild to moderate degeneration, potentially delaying or even preventing the need for artificial joints.

Beyond medical interventions, daily joint care is crucial. Dr. Wu advised that strengthening exercises and weight management are more effective than supplements. He recommended joint-friendly exercises like swimming or water aerobics to reduce weight-bearing stress, and cycling or brisk walking to strengthen the quadriceps, which act as natural knee braces. Patients should avoid deep squats beyond 90 degrees and climbing downhill. Weight is identified as the most significant variable in the rate of degeneration; each kilogram of weight loss reduces knee pressure by four kilograms. Dr. Wu concluded that knee degeneration is manageable with consistent weight loss and proper exercise, enabling individuals to maintain joint flexibility and delay surgical intervention.

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Weight is the biggest variable in the rate of degeneration. For every kilogram lost, the knee pressure is reduced by four kilograms.