The Best Alternative to Knee Replacement for Osteoarthritis

The AHA! Team — Mon, 28 Apr 2025 05:49:10 +0000

Michael Greger M.D. FACLM via Nutrition Facts – Is there a non-surgical alternative to knee replacement surgery that treats the cause and offers only beneficial side effects? The health effects of being overweight The largest study in history on the health effects of being overweight, analyzing data from more than 50 million people from nearly 200 countries, found that excess body weight accounts for the premature deaths of about four million people every year. Most of these deaths are from heart disease, but the researchers “found convincing or probable evidence” linking obesity to 20 different disorders—a veritable alphabet soup of potential health concerns. In the ABCs of the health consequences of obesity, A is for arthritis. Obesity can make rheumatoid arthritis worse and increase the risk of another inflammatory joint disease—gout, the so-called disease of kings. The most common joint disease in the world, though, is osteoarthritis, and obesity may be its “main modifiable risk factor.” Osteoarthritis develops when the cartilage that lines and cushions our joints breaks down faster than our body can build it back up. Our knee is the most commonly affected joint, leading to the assumption that the association with obesity was simply due to the excess wear and tear from the added load on the joints. But non-weight-bearing joints, like our hands and wrists, can also be affected, suggesting the link isn’t “purely mechanical.” Obesity-related dyslipidemia may play a role, with elevations in the amounts of triglycerides, fat, and cholesterol in the blood aggravating inflammation in the joints, just like cholesterol can exacerbate the inflammation in our artery walls. Osteoarthritis sufferers Osteoarthritis sufferers not only have higher cholesterol levels in the blood, but they also have them within their joints, as you can see below and at 1:52 in my video The Best Knee Replacement Alternative for Osteoarthritis Treatment, in aspirated joint fluid and also found in the cartilage itself. When cholesterol is dripped onto human cartilage in a petri dish, the inflammatory degeneration worsens, which helps explain why the higher our cholesterol, the worse our disease, as shown below and at 2:05. Cholesterol-lowering statin drugs Cholesterol-lowering statin drugs may help prevent and also treat osteoarthritis, as can a cholesterol-lowering diet. In fact, a healthy enough plant-based diet may offer the best of both worlds, dropping cholesterol as much as a starting dose of a statin drug—within a single week—and having only good side effects, such as lowering blood pressure and facilitating weight loss. Decrease the odds of developing osteoarthritis by more than 50 percent Even losing only about a pound a year for a decade may decrease the odds of developing osteoarthritis by more than 50 percent. Weight reduction may even obviate the need for knee replacement surgery. Osteoarthritis sufferers with obesity who were randomized to lose weight improved their knee function as much as those undergoing surgery—and did so within just eight weeks. The researchers concluded that losing 20 pounds of fat “might be regarded as an alternative to knee replacement.” Isn’t it easier to get your knees replaced than lose 20 pounds, though? Rarely discussed is the fact that nearly 1 in 200 knee replacement patients lose their lives within 90 days of surgery. Given the extreme popularity of this surgery—about 700,000 are performed each year in the United States—an orthopedics journal editor suggested that “people considering this operation are inadequately attuned to the possibility that it may kill them.” Arguably, that’s the single most salient fact to share with a patient who is considering the operation. Responding to the question of whether patients should be told about the chance the operation may kill them, an orthopedic surgeon said: “To me, the real question is whether this knowledge will help the patient. Will it add to the anxiety of the already anxious patient, perhaps to the point of denying that patient a helpful operation? Or will this knowledge motivate a less-handicapped patient to stick to a diet and physical activity regime? Ultimately, then, the question boils down to the surgeon’s judgment.” One in five knee replacement patients describe being unsatisfied with the outcome Even among the vast majority who survive the surgery, approximately one in five knee replacement patients describe being unsatisfied with the outcome. Weight loss with a healthy diet, on the other hand, may offer a nonsurgical alternative that treats the cause and has only beneficial side effects. I continue the alphabet of obesity with the next few videos in the related posts below. You may be interested in my book on weight loss, How Not to Diet, and its companion, The How Not to Diet Cookbook, which is full of health-promoting, Green-Light recipes. Request them from your local library. For more on joint health, visit the topic page. Key Takeaways Weight loss through a healthy, plant-based diet may be a nonsurgical alternative to knee replacement surgery, with only beneficial side effects, such as lowered cholesterol, reduced inflammation, and improved joint function. Obesity is a significant modifiable risk factor for osteoarthritis, with both mechanical strain on joints and obesity-related inflammation contributing to disease progression. Elevated cholesterol levels may worsen osteoarthritis by aggravating inflammation in the joints, making cholesterol management important in treating the disease. A plant-based diet may help prevent or treat osteoarthritis by reducing cholesterol levels, which can decrease joint inflammation. Knee replacement surgery carries risks, including a small but significant mortality rate (1 in 200 within 90 days), and one in five patients are unsatisfied with the outcome. Weight loss may provide similar benefits without these risks. To read the original article click here.

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Acupuncture Reduces Pain and Opioid Use for Total Knee Replacement Surgery Patients

AHA Publisher — Tue, 12 Oct 2021 07:00:31 +0000

American Society of Anesthesiologists (ASA) via Newswise – SAN DIEGO – Patients who have acupuncture during total knee replacement surgery report less pain and need far fewer opioids to manage their discomfort, according to a study being presented at the ANESTHESIOLOGY® 2021 annual meeting. Results of the study showed that 65% of patients who received acupuncture during surgery achieved a low-dose or opioid-free postoperative experience, compared to 9% of patients outside of the study. “Total knee replacements are one of the most common operative procedures in the United States and often very painful, so there’s a great need to explore non-opioid pain relief techniques for this type of surgery,” said Stephanie Cheng, M.D., DABMA, lead author of the study and assistant attending anesthesiologist at the Hospital for Special Surgery and assistant professor of clinical anesthesiology at Weill Cornell Medicine, both located in New York City. “Acupuncture is extremely safe and can help reduce pain with few unwanted side effects, but it has not been well researched as part of surgical anesthesia.”The study included 41 patients undergoing primary total knee replacement at the Hospital for Special Surgery. All patients received the institution’s standard opioid-sparing multimodal analgesic protocol, with the addition of electroacupuncture — a modified form of traditional acupuncture that applies a small electric current to thin needles that are inserted at known acupuncture points on the body. The acupuncture was administered during surgery by Dr. Cheng, who is board-certified in medical acupuncture, to eight specific points in the ear to provide targeted pain relief in the knee. With the addition of acupuncture, the majority of patients had a significant reduction in postoperative opioid use, compared to historical controls. Sixty-five percent of patients maintained a low-dose opioid regimen of 15 oxycodone pills or less (57.5%) or remained completely opioid-free (7.5%) from induction of anesthesia to 30 days after surgery. Historically, only 9% of patients outside of the study maintained a low-dose or opioid-free regimen post-surgery. All patients studied discontinued opioid use after 30 days following surgery. “Our study shows that if a trained medical acupuncturist is available to perform acupuncture in the operating room, it can help patients with postoperative pain recovery,” said Dr. Cheng. “Most studies fail to incorporate nontraditional techniques, such as acupuncture, to help decrease the dependance on opioid medications for postoperative pain control.” In the context of the opioid epidemic, achieving low-dose perioperative opioid consumption is critical to reducing the risk of long-term opioid use in patients. With acupuncture being commonly used outside of the hospital as an effective therapy for pain management and treatment for a range of health issues and symptoms, it’s time to consider its benefits inside the hospital as well, Dr. Cheng said. “Additional research is needed to further define acupuncture’s effects and encourage its use in all aspects of disease treatment.” To read the original article click here.

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The Best Alternative to Knee Replacement for Osteoarthritis

Acupuncture Reduces Pain and Opioid Use for Total Knee Replacement Surgery Patients