Table 1.
Option grid for Osteoarthritis of the knee. This grid is designed to help you and your clinician decide how best to manage your knee pain and activity level. The first steps are to become as fit and close to your ideal weight as possible and to consider having physiotherapy. Surgery is normally recommended only after other treatments have been tried 
| Frequently asked questions | Pain killers | Joint injections (steroids) | Knee replacement surgery |
|---|---|---|---|
| Will this reduce the pain I have in my knee? | It depends on which tablets are taken. Tablets like ibuprofen are effective for 50 in 100 people. Over the counter tablets, like paracetamol, including those that have codeine, are also effective. | Some people get good symptomatic relief after an injection, which may include pain relief and/or reduced swelling. | About 90 in 100 people who have this operation say it leads to relief of most or all of their pain, over time. 10 in 100 people say it does not lead to significant pain relief. |
| Will this treatment help improve which activities I can manage to do? | It may. As you get pain relief, you should be able to be more active and this in turn can also help to reduce pain. It helps to take painkillers before doing physical activity. | Yes, usually for up to a month or so. Plan to be more active as a result of the pain relief. Advice from a physical therapist may help. | Yes, the majority of patients experience improvement in their activity level. However, not everybody sees differences in their ability to walk or climb stairs. |
| Are there any risks to this treatment? | As with all medications, pain killers have some side‐effects. For example, codeine often leads to constipation and prolonged use of anti‐inflammatory tablets like ibuprofen increases your risk of stomach bleeding. |
There is a small risk of frequent injections causing cartilage damage, especially in weight‐bearing joints. Allergic reactions and infections due to joint injections are uncommon. You might feel slight pain at the injection site for a few days. |
Wound infection needing treatment occurs in 5 in every 100 people. Blood clots in the leg occur in 2 in 100 people. The risks from surgery increases if you have other conditions, such as heart or lung disease, are a smoker or are overweight. |
| How long will it take me to feel better after the treatment? | You may start experiencing pain relief within a few days of when you start taking the medication. | Most people who experience relief feel better within the first week or so after the injection. | Pain relief is gradual. You will stay in the hospital for around 3‐5 days. Most people walk unaided after 3 months. Full recovery usually takes between 6 and 12 months. |
| Will I need to have more treatment or surgery? | If things don't get better, talk to your clinician about other treatment options. | Pain relief lasts for up to a month or so. You can only have up to 4 injections per year. | Most knee replacements can last 15 years, many last longer. |
| What are the outcomes for people with arthritis who have this treatment? | Many people cope well by using medication, being active and losing weight. Reducing your pain may help you achieve the benefits of exercise. | Some people have good relief by having injections when swelling and pain cause problems. | Surgery is usually considered after other options have been tried. About 80 in every 100 people are satisfied after having a knee replacement. About 20 in every 100 are not satisfied. |
Editors: Katy Marrin, Peter Alf Collins, Alan Nye, Mark Porcheret, Jo Protheroe, Victoria Thomas, Glyn Elwyn.
Evidence document: http://www.optiongrid.org/resources/osteoarthritisoftheknee_evidence.pdf.
More information: http://www.optiongrid.org/about.php.
Last update: 29‐Aug‐2012 Next update: 29‐Aug‐2013 ISBN: 978‐0‐9571887‐6‐1.
Creative Commons License: Attribution‐NonCommercial‐NoDerivs 3.0 Unported (CCBY‐NC‐ND 3.0).