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  • Q&A with Australian Health Practitioners

    Is osteoarthritis steam cell treatment better than knee replacement?

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    Orthopaedics Osteoarthritis
    Which treatment is better for my mother who is 92 years old and is waiting for her knee replacement operation.
    • 2 answers
    • Mr Ilan Freedman
    • Dr David Agolley
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    Mr Ilan Freedman

    Orthopaedic Surgeon

    Mr Ilan Freedman is a Dual-Fellowship trained Melbourne Orthopaedic Surgeon with specialist experience in Direct Anterior Minimally Invasive Hip Replacement, Bikini Anterior Hip Replacement, Conformis … View Profile

    NO. Stem cell treatment may be useful for the treatent of EARLY arthritis, which is unlikely to be the case in a 92 yr old.  There is no role for stem cell injections in advanced arthritis.

    Various medical methods can be used to treat and manage pain.

    If medical non-operative treatment has not been adequate, the definitive treatment would be surgical (knee replacement).

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    Dr David Agolley

    Orthopaedic Surgeon

    Dr David Agolley is an Australian trained Orthopaedic Surgeon, with specialist expertise in hip and knee surgery. Special interests are robotic and computer assisted hip … View Profile

    Stem cell treatment is still considered experimental. The cost makes treatment unobtainable for the majority of people. Stem cell treatment is not recommended for severe arthritis.

    At 90 years of age, she must be quite medically well to have lived this long. Good on her!

    Surgery in the eldery poses significant risks. Depending on her level of pain, I recommend exhausting all non-surgical modalities such as knee bracing, using a mobility aid, considering simple injections like local anaesthetic and steriod or Platelet Rich Plasma (PRP), or viscosupplementation (Synvisc/Durolane). These treatments are not curative, but may make life more comfortable for her with low risk.

    If all else fails, knee replacment surgery is an option, but does pose significant risks. I would have a good chat to your trusted family doctor about it, and if the pain is unbearable, an honest discussion with an orthopaedic surgeon. If you are still considering proceeding with knee replacement, I would also recommend asking for a face to face appointment with the anaesthetist who will be looking after your mother in surgery for another thorough and honest discussion about the risks of surgery.

    At the end of the day, deciding to proceed with joint replacement it is in part a philisophical decision. You mum should ask herself, 'Is my pain and poor quality of life worth taking on the risks of joint replacement surgery for its potential gains, or am I happy to accept that I am 90, my body is not what it was when i was 50, and with the limitations from my knee, can I still have an enjoyable life without surgery?'

    Good luck.

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