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  • Q&A with Australian Health Practitioners

    How can I manage my knee osteoarthritis?

    Have backers cyst on back of my knee. Around three months back given synvisc one injection for osteo pain. did not work at all. Ultra sound is showing too much fluid. Would like to know injection did not work because of backers cyst or what could be the reason? Is there any option for me to reduce pain apart from surgery?
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    Mr Dirk Van Bavel

    Orthopaedic Surgeon

    Mr van Bavel completed his medical degree through the University of Melbourne in 1995, winning the ‘Neil Bromberger prize in Orthopaedics’. His Orthopaedic training was … View Profile

    There are many aspects to managing the pain from osteoarthritis of the knee. Non operative measures include;
    Pain killers
    simple analgesics ( such as panadol or panadol osteo),
    anti inflammatory medication such as nurofen, voltaren or Indocid)
    stronger medication such as panadeine forte and endone

    Weight loss
    To take the stress off the knee

    Muscle strengthening
    this can be through;
    Physiotherapy
    Hydrotherapy or simple exercises such as waling/swimming and riding a bike

    Avoid activities that upset the knee

    Nutriceuticals - there is a lot of talk about Glucosamine, fish oil, krill oil etc but little evidence for them. Glucosamine has a very large randomised trial in the Lancet that did show some improvement.

    Injections
    prednisolone, Symvisc, Durolane, PRP and Orthokine have all been used with variable results.

    When the pain becomes severe, when you start waking at night and other options do not help then you should consider surgery which would normally involve either a partial knee replacement or Full knee replacement.

    Occasionally in young patients we would consider realigning the knee in an operation called an Osteotomy .

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