latimes.com

My husband has severe osteo-arthritis in one of his knees. (His other knee was replaced several years ago.) He is in his 70s and doesn't want to undergo another surgery. His doctor has him on a pain-pill regimen. Should he walk for the sake of exercise, or in his case is it best to stay off the knee as much as possible?

Joyce

Quartz Hill

There are many nonsurgical regimens that your husband can undertake to relieve pain and improve function, says Dr. Michael Bronson, a joint replacement specialist and associate professor of orthopedics at Mount Sinai School of Medicine in New York.

These include over-the-counter anti-inflammatory medications such as Motrin, Advil, Aleve and Nuprin as well as prescription anti-inflammatory drugs such as Naprosyn, Indocin and Celebrex; knee braces; physical therapy; and injections of cortisone and lubricants, such as a product called Synvisc, directly into the knee. These products mimic the lubricating fluids in the knee.

But none of these things, he cautions, will change the natural history of the arthritis. "The arthritis will continue to get worse over time," he says.

The worst option, he says, is to adopt a sedentary lifestyle.

"It is critically important for a person of any age to maintain an active lifestyle for heart health, circulatory function, lung function, as well as mental health," he says. "Staying off his knee and assuming a sedentary existence is a terrible choice for all these reasons."

Bronson recommends exercise that takes weight off the joints, such as swimming and cycling.

And finally, he says, "When a patient has utilized all these nonsurgical options and still cannot function as a person of his age should, then surgery is the only reasonable alternative."

Bronson has performed hip and knee replacement surgery on patients in their 90s. When it comes to surgery, he says, "it's more important to assess physiological age than chronological age."

-- Janet Cromley