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I don’t want a knee replacement - what can I do?


I just wasn’t ready to have a double knee replacement – who would look after me?  So I jumped at the chance of joining the osteoarthritis chronic care program. After  six weeks of doing the exercises I noticed a difference and now, after a year, I feel so much better. I no longer have pain going upstairs and I’ve come off the list  for surgery.
- Yarie Nikolic

Simple exercises are turning around the lives of patients with this painful and debilitating disease.

Osteoarthritis affects three million Australians – and climbing. By the time they get to their doctor, most people already have quite advanced disease and the only solution is often painful surgery – there are more than 80,000 joint replacements every year, each costing the health system around $30,000.

Basic scientists at the Kolling are working together with their clinical colleagues in rheumatology and surgery to find ways of preventing and treating osteoarthritis in the patients they see every day.

One study, led by Professor David Hunter, is using multidisciplinary treatments including diet and physiotherapy exercises to treat osteoarthritis without surgery or medication. He has shown that losing 10% of body weight reduces patients’ pain
by on average 50% (compared to 20 to 30% with
anti-inflammatory medication).

Exercises which focus on strengthening the muscles around the knees and hips can remove or delay the need for surgery in about 15% of patients who are already on the waiting list. In people with less advanced disease, the benefits can be even greater.

Surgery was the only option for Yarie Nikolic, a grandmother from Belrose, until she was offered a place on Dr Hunter’s trial. After a thorough assessment, she was given various simple daily exercises by a physiotherapist, such as elevating each leg 20 cm off the ground, and standing on her toes and holding for a number of seconds.

After a year, the results have been so dramatic that her pain has virtually gone and she is no longer a candidate for surgery.

“Before, I couldn’t walk up the stairs without clinging to the handrail and dragging myself up,” she says.

“It wasn’t until I went overseas and stopped the exercises for a while that I realised how much they were helping. Now I can walk up one or two flights of stairs without any problem, my stamina has improved and I enjoy going to the gym.”