Mr James Lewis
As mentioned, improvements can be gained from weight loss and an increase in exercise levels, which seem to have an anti-inflammatory benefit and help with muscle strengthening. Occasionally insoles can help, as well as effective anti-inflammatory supplements, such as turmeric. I’d recommend avoiding a high fat/high carb diet as this directly leads to activation of damaging cells in the knee.
The next level of treatment is injections into the knee. Cortisone is now ’out’ following a study that showed that although there is pain relief for perhaps three months, the articular cartilage (the surface of the knee) fails at double the rate compared to no cortisone1. So the knee actually becomes worse because of the cortisone!
In younger patients there can be a role for straightening the leg, which involves part cutting the bone and straightening it. This is called a realignment osteotomy.
Finally there is knee replacement surgery. Knee replacements generally have a record of lasting 10 years without having to be redone. More up-to-date knee replacements are custom made and fit precisely at surgery. They match the patient’s own knee shape and can feel more like their own knee. Furthermore, the custom knees can have much better patient satisfaction, fit, alignment precision, often quicker recovery and even lower blood loss. These have been in use since 2011 and I have personally carried out over 200.