What treatment is available for knee osteoarthritis?

The treatment of osteoarthritis of the knee can be divided into conservative treatment and surgical treatment. The conservative treatment is something that we normally start with if the symptoms are mild to moderate to try and preserve the native knee for as long as possible. The important factors in conservative treatment are having regular exercise, such as walking, ideally on flat ground, proper footwear to try and avoid any pressure on the knees, wearing supportive knee supports, there have been quite a few developments now in the knee supports that are available, especially the carbon fiber ones which are fairly lightweight, and they have to, they can offload some of the weight off the knee and decrease the amount of pain that you're getting from the osteoarthritis. And then taking painkillers when needed, painkillers are those, there's quite a few options of painkillers available starting with paracetamol and then non-steroidal anti-inflammatory drugs such as ibuprofen and Voltro and then in more severe cases opioids although I try and avoid opioids due to the side effects of Fostol. Sometimes we use creams such as Voltro cream or anti-inflammatory cream and that can be used in the morning and evenings. Wearing also a knee support like a tubigrip which is like a tight stocking, elasticated knee stocking can help to reduce the swelling and make the knee feel more secure especially when you're walking or exercising. Some GP's will prescribe capuscaine topical cream to help relieve the pain which is a topical treatment. Arthritis UK have also recommended the use of Flexi SEQ which is a natural cream that's available over the counter. It's a fairly expensive cream to be used to be applied and I think it can be useful in mild symptoms or mild to moderate symptoms of arthritis. Also correcting any instability by wearing the right supports if there is evidence of instability in the knee can relieve the symptoms of arthritis, so if you have a knee that has a deficient ligament, by supporting that ligament such as your ACL and wearing an anterior cruciate ligament where a specific brace can help. And then in the conservative treatment as well, injections. Injections are variable and there are various types of injections, they include steroid injections, PRP injections and the final thing which is currently being sort of sold in the marketing world is stem cell injections although there is no evidence that they provide any improvement, long term improvement in the symptoms. I think the safest options are the steroid injections with hyaluronic acid substitute which have been shown to reduce the pain in knee osteoarthritis. They can be useful especially in cases where we are not going to operate or in cases where there is mild to moderate arthritis and they can help to relieve the pain. But they are a temporary solution, they are not a long term solution and they do have side effects as well. Combining that with hyaluronic acid substitute injections or collagen injections basically that can help to also lubricate the knee and alleviate the symptoms. Walking is a relatively good exercise. I recommend walking, swimming, cycling and physiotherapy to strengthen the muscles at the front of the knee and the back of the knee as well as the core muscles are a fairly important part of conservative treatment and should be part of any management plan for osteoarthritis. Thank you.