Which treatments are effective for Osteoarthritis of the knee?

[Fiona2011231]

May I ask for your advice?

I have a friend who lives abroad and her mother suffers from Osteoarthritis. She plans to go to the UK for private treatment but wants to ask if the treatments are actually effective, due to the possible costs.

This website attempts to list available treatments and their impact:

kneease.com/uk/arthritis.php

Reading this, it seems to me that there is no cure for Osteoarthritis. Even surgery may be risky. Do you agree?

"Anti-inflammatories (NSAIDS, Brufen)

Anti-inflammatories are the first line of treatment for OA knee pain. For long term use they need to be taken with a proton pump inhibitor to reduce the risk of gastric ulcers and bleeding but can still produce significant side effects over the long term. Your doctor or surgeon will advise you on the correct dosage.
Average cost: £40 for 3 months treatment including inhibitor.

TENS (Transcutaneous Electrical Nerve Stimulation)
TENS is a method of pain relief where electrical impulses are fed through the knee to reduce the pain. TENS units can be purchased at most high street chemists. Ideal for use on the back, they are difficult to use on the knee joint and not for portable use. There is also an ongoing cost of disposable pads to be considered.
£40-£50 plus ongoing costs of disposable pads and gel.

Hyaluronic Acid (Durolane, Synvisc, Hyalgan)
An injection into the knee to act as a cushion or lubricant for the joint. Although approved in the USA, results vary with some reporting moderate improvements in joint stiffness and a reduction in pain. (more)
Average costs are £240 per injection at a private UK clinic.

Steroid (Cortisone) Injection
An injection into the knee to act as an analgesic. Effective in giving pain relief by reducing inflammation but only in the short term. No more than three injections per year is recommended.
Average costs are £60 per injection at a private UK clinic. Free on the NHS.

Surgery
Partial or total knee replacement surgery involves removal of the joint and an artificial replacement. With a long waiting list for NHS operations, the inherant risks of surgery and availability limited to the older patient, a knee replacement should be considered only as a last resort."

Yes, there is no cure as such for OA, but it can be managed. Which treatment option is best depends on both the severity of the OA and the pain/functional problems your friends mum is getting. It would be impossible for someone over the Internet to give advice on which was best. I would however, suggest looking at the arthritis research UK website www.arthritisresearch.org for up to date, evidence based information on treatment options. Generally it involves, pain relief and physio (mostly strengthening but can be other things), progressing to (possibly) a steroid injection then an arthroscopy (keyhole surgery to "wash out" the joint), and then onto a total or partial knee replacement. All of these can be effective for the right person at the right time, but without an examination no one could say which your friends mum needs currently. Hope that helps