THE TREATMENT OF CHOICE FOR DEGENERATIVE OSTEOARTHRITIS OF THE KNEES
October 2, 2009, Fred Kahn MD, FRCS(C)
I recently read the enclosed article in the Financial Post September 30, 2009. Whereas the article in its context
is largely correct and points out a significant number of alternative therapies for the treatment of degenerative
osteoarthritis of the knees, it misses out on the most important option of all.
Before I proceed with this commentary, I should state that degenerative osteoarthritis of the knees affects over
30%of the adult population over 50 years in age. It is particularly prevalent in athletes who have played contact
sports both at the amateur and professional level. In those instances, the process is accelerated and often
becomes symptomatic in the early and mid 40's.
With all due respect, medications both oral and injectable have not provided a solution nor as the enclosed
article indicates, has surgery. Knee replacements, when they work, are more than satisfactory but in a significant
percentage of cases, they result in failure. (I.e. pain, inflammation and the ability to be ambulatory). Sometimes,
this is followed by the insertion of a replacement prosthesis, again with less than desirable results.
At our clinics, these unfortunate patients present, not infrequently and unfortunately it is not possible for them to
return to their pre-surgical state.
From the therapeutic perspective, we have been utilizing Laser Therapy over the past 15 years and out of over
200 knees treated on an average annualized basis, less than 3% have required replacement surgery. Often, we
see patients who are already scheduled for surgery and are allowed 3 to 4 weeks to prove the effectiveness of
Laser Therapy. Almost invariably, we succeed. Why this approach should not be more widely used is therefore
difficult to understand.
Several years ago, I circulated a letter to every provincial health minister in Canada requesting that their ministry
permit us to treat 100 knees waiting for knee replacement. I indicated that these could be rehabilitated at a cost
of less than $2,000.00 per patient, significantly less than continuing procrastination or pursuing the surgical
route. Not one health minister responded. Despite this, we continue to treat individuals suffering from this entity
on a daily basis and achieve consistent, outstanding results. Whereas I am exasperated with this current state
of affairs, I wonder what can be done to rectify this situation in a constructive manner.
In conclusion, I can state unequivocally that the treatment of choice for degenerative osteoarthritis of the knees
is Low Intensity Laser Therapy. Surgery, if required on rare occasions, can always be performed at a later date.
