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Osteoarthritis of the Knee: Understanding Treatment Options

By Dr. Timothy C. Payne, MD

Healthy, functioning joints are frequently taken for granted. Every year in the United States, runners train for marathons, overworked executives hit the gym, thousands brave the winter weather to hit the slopes, and families hop on their bikes for a ride around the neighborhood. However, if you are one of the millions of Americans living with osteoarthritis, simple and mundane tasks such as climbing stairs and walking can be a challenge.

Osteoarthritis is a disease of the joints. Inflammation, pain and loss of functionality occur when the cartilage protecting the joint breaks down and the two bones rub together.

The Centers for Disease Control reports that an estimated 46 million adults in the United States are told by a physician that they have some form of arthritis, rheumatoid arthritis, gout, lupus or fibromyalgia. The most common form of arthritis is osteoarthritis, and in 2005, an estimated 27 million adults were diagnosed with the disease.  Arthritis and other rheumatic conditions (AORC) cost the United States billions of dollars each year. In fact, in 2003, reports showed that AORC cost the US $127.8 billion dollars ($80.8 billion in medical care expenditures and $47.0 billion in lost earnings).
As a former college wrestler and football player, an avid golfer and a physician with over 30 years of experience in orthopaedic surgery and sports medicine, I’ve seen first-hand the adverse affects of living with osteoarthritis. Many patients are told by their physicians that their only options for treatment are exercise, non-steroidal anti-inflammatory drugs, hyaluronic acid injections or total knee replacement surgery.

What are the treatment options for osteoarthritis of the knee?

Exercise is the number one recommended treatment for osteoarthritis (OA) of the knee because it builds muscle mass which can help stabilize the knee. Further, with obesity contributing to the progression of OA due to the stress of added weight on the joints, exercise can also help with weight loss, thereby reducing pressure on the knee.


Another treatment option for OA of the knee is non-steroidal anti-inflammatory drugs that reduce the inflammation of the joint. However, adverse side effects of pharmaceutical treatments include stomach irritation, possible stomach ulcers, elevated blood pressure or aggravation of heart conditions. Viscosupplementation injections are given in a series of one to five shots over the course of several months (depending on the product used). These injections are effective in relieving the pain of osteoarthritic knees, but the results may vary from patient to patient.

Total knee replacement surgery (TKR) is the most invasive of all treatment options. In this surgical procedure, the end of the femur (thigh bone) and the top of the lower leg (tibia) are replaced with artificial components to create a synthetic joint. Since the surfaces that were previously rubbing on each other have now been replaced and realigned, this reduces the patient’s pain, but full range of motion after this surgery may not be possible if there were significant anatomical changes preceding surgical intervention. Total knee replacement surgery carries risks for patients such a blood clots in the leg or lung, infection, heart attack, stroke and loosening of the artificial knee. Additionally, depending on wear and tear, the joint may need to be replaced at a later date if loosening becomes painful. Rehabilitation time to restore knee function can take several weeks to months.

Knee Replacement Alternative

In May of 2009, I began prescribing VQ OrthoCare’s OActiveTM knee brace and BioniCare® System, the first non-invasive, non-pharmaceutical, non-surgical treatment option for osteoarthritis of the knee. The treatment delivers a low-level pulsed electrical signal to the knee through two electrodes held in place on the inside of a joint unloading brace, developed specifically to treat osteoarthritis by mimicking the naturally occurring signal present in a healthy knee joint. The low-level pulsed electrical signal is not felt by the patient.

Because not every patient is a good candidate for surgery, drugs or injections due to age and other risk factors, the OActive knee brace and BioniCare System alleviates risks associated with surgery, pharmaceuticals and injections, while helping to alleviate pain and allow patients return to their normal, active lifestyles. As a prescribed treatment for osteoarthritis of the knee, the OActive knee brace and BioniCare System patients are under the care of a physician at all times. On average, patients using the OActive knee brace and BioniCare System have reported experiencing positive results after 750 hours.

Unlike a standard knee brace, the BioniCare device is integrated into the OActive “unloader” knee brace to reduce the impact of body weight on the knee and reduce the patient’s pain. The OActive Knee Brace is worn undetected under clothing and allows for optimal movement of the entire leg.
Within the first year, I have seen a 70% improvement rate in pain, symptoms and knee function with the OActive knee brace and BioniCare System.
Ultimately, taking care of ourselves at every stage along the way is the best treatment to preventing disease and illness as we grow older. This begins with exercise and nutrition, and continues by educating ourselves on the best treatment options. Always consult with your physician and ask questions about the risks and results you can expect from every treatment option.


Timothy PayneDr. Timothy C. Payne, MD specializes in sports medicine, arthroscopic surgery and back rehabilitation at M&M Orthopaedics in Downers Grove, Illinois. For more information please visit www.mmortho.com or call 630-968-1881. For more information on VQ OrthoCare or the OActive Knee Brace and BioniCare System please visit www.bionicare.com or call 800-444-1456.