New Options for Treating Osteoarthritis of the Knee
Osteoarthritis of the knee (knee OA) affects more than 20 million people in North America. This disease inﬂicts a growing burden of morbidity, health care costs, and lost productivity on affected patients and society. It accounts for a considerable portion of the $185.5 billion in expenditures attributed to OA in 2009. Medical treatments and less invasive surgical approaches for knee OA are variably effective, and total knee arthroplasty (TKA) is generally reserved for the most severely affected. The care gap between more conservative treatments on the one hand and TKA on the other leaves many patients with unresolved pain and loss of function for long periods.
The purpose of this paper is to inform physicians about two effective, but underprescribed nonoperative treatment modalities that offer additional long-term beneﬁts for patients with moderate to severe knee OA. Unloading braces provide rapid pain relief and improve joint stability, while BioniCare® pulsed electrical stimulation (PES) provides more gradual, but sustained overall improvement in knee OA, and is cleared by the US Food and Drug Administration (FDA) for this indication. BioniCare treatment also allows many patients to reduce or discontinue nonsteroidal anti-inﬂ ammatory agents (NSAIDs) and analgesics, and to defer or avoid TKA surgery. In addition, the safety of bracing and PES are more favorable than both NSAIDs and TKA, and their costs are lower over time in comparison to these and other treatments.
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