Knee Osteophytes: Treatment Options for Seniors

Could you please provide more details about the issue with bone spurs in the knee joint?

Hello, Doctor.
My mother visited the hospital about 20 years ago due to discomfort in her knees.
After examination and X-rays, the doctor diagnosed her with bone spurs.
Due to the widespread belief and advice from friends that bone spurs cannot be cured, she has not sought any treatment and has delayed it until now.
For the past three years, she has only been supplementing with glucosamine, chondroitin, and MSM.
Currently, she needs to support herself on the edge of a table for a few seconds before she can walk.
When going to the market, it takes about 1 to 2 hours round trip, and that evening and the next day (sometimes even for several days) she can hardly walk.
At the end of last year, she felt that her condition was worsening and returned to Gengxin Hospital in New Taipei City for examination.
The doctor suggested that she needs surgery to install a prosthetic joint.
However, she is fearful of surgery and the impact on her daily life during the recovery period, so she hesitated.
I would like to ask the doctor: 1.
My mother is over 80 years old, has hypertension, diabetes, high cholesterol, and osteoporosis.
Given her current condition, is she suitable for surgery? Are there other treatment options available? 2.
If treated with acupuncture in traditional Chinese medicine, will it only alleviate her discomfort temporarily without curing it? How likely is it that her condition will recur in the future, and how long will the treatment take? 3.
My mother has heard some not-so-optimistic treatment experiences from others, which makes her unsure of which hospital or clinic to go to.
Should she pursue treatment through Western medicine or traditional Chinese medicine? Can the doctor provide recommendations? Thank you very much for your advice!

Chen Maozhi, 40~49 year old female. Ask Date: 2016/08/23

Dr. Shi Guozheng reply Orthopedics

Severe degenerative arthritis of the knee may require surgery for complete resolution, as other treatment methods only address the symptoms and not the underlying issue.
Conservative treatments include rehabilitation, medications, and intra-articular injections (such as hyaluronic acid or platelet-rich plasma).
Acupuncture is not recommended due to a lack of evidence-based research.
Surgical treatment typically involves total knee arthroplasty, which has a high success rate.
With careful anesthesia management, patients up to 80 years old can still undergo the procedure.
Additionally, if a minimally invasive approach with smaller incisions is used, recovery may be faster.
For more detailed information, please refer to the articles in the public section of the Miaoli Hospital website.

Reply Date: 2016/08/23

More Info

Understanding knee osteophytes, commonly referred to as bone spurs, is crucial for seniors, especially those experiencing significant discomfort and mobility issues. Osteophytes are bony projections that develop along the edges of bones, often in joints affected by osteoarthritis. They can cause pain, limit movement, and lead to further complications if not addressed appropriately.

1. Surgical Considerations for Seniors
Given your mother's age (over 80) and her existing health conditions—hypertension, diabetes, high cholesterol, and osteoporosis—surgery can be a complex decision. While total knee replacement (TKR) can significantly alleviate pain and improve function, the risks associated with surgery in older adults must be carefully weighed. Factors such as her overall health, the severity of her knee osteoarthritis, and her ability to undergo anesthesia and rehabilitation are critical considerations.

In many cases, if the osteophytes are causing severe pain and limiting mobility, and conservative treatments have failed, surgery may be recommended. However, it is essential to have a thorough discussion with an orthopedic surgeon who specializes in geriatric patients. They can provide a tailored assessment based on her specific health profile and the potential benefits versus risks of surgery.

2. Non-Surgical Treatment Options
For seniors who are not candidates for surgery or prefer to avoid it, several non-surgical treatment options can help manage symptoms:
- Physical Therapy: A physical therapist can design a personalized exercise program to strengthen the muscles around the knee, improve flexibility, and enhance overall mobility. This can help alleviate some pain and improve function.

- Medications: Over-the-counter pain relievers such as acetaminophen or topical analgesics can provide relief. If your mother is not allergic to NSAIDs, they may also be considered, but always under a doctor's guidance.

- Injections: Corticosteroid injections can reduce inflammation and provide temporary pain relief. Hyaluronic acid injections may also be beneficial for some patients, as they can help lubricate the joint.

- Weight Management: If applicable, losing weight can significantly reduce the stress on the knees, potentially alleviating pain and improving mobility.

- Assistive Devices: Using canes, walkers, or knee braces can help support her mobility and reduce pain during movement.

3. Alternative Treatments
Acupuncture and other forms of traditional Chinese medicine may offer some relief. While these treatments may not cure osteophytes, they can help manage pain and improve quality of life. The effectiveness of acupuncture varies from person to person, and it may require multiple sessions to see significant benefits. It is essential to consult with a qualified practitioner who can tailor the treatment to her needs.

4. Choosing the Right Healthcare Provider
Finding the right healthcare provider is crucial. It may be beneficial to seek out a geriatric specialist or an orthopedic surgeon with experience in treating older adults. They can provide a comprehensive evaluation and recommend a treatment plan that considers her overall health and lifestyle.

Additionally, consider seeking a second opinion if there are uncertainties about the recommended treatment options. Many hospitals and clinics have multidisciplinary teams that include orthopedic surgeons, physical therapists, and pain management specialists who can collaborate on a comprehensive care plan.

Conclusion
In summary, while knee osteophytes can significantly impact mobility and quality of life, there are various treatment options available. Surgery may be appropriate for some, but for others, non-surgical interventions can provide relief and improve function. It is essential to have open discussions with healthcare providers to determine the best course of action tailored to your mother's specific health needs and preferences. Regular follow-ups and adjustments to her treatment plan will be vital in managing her condition effectively.

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