Q: My father is a diabetic for the last 8 years and is 54 years old. He is suffering from severe knee pain for the last one and a half years and it is gradually increasing. The doctor took an X-ray and suggested surgery. Is there any other way he can get rid of this pain? Will exercises help?

A:If the radiographs showed advanced arthritis and the doctor has recommended knee replacement, then there are not too many alternatives. You can try cortisone shot or synvisc shots, which may help temporarily. If the x-rays don't show arthritis, then what surgery has the doctor recommended? For non-operative treatment of arthritis, following is the protocol: 1. Anti inflammatory - celebrex, diclofenac. 2. Modifying activities - avoid squats, stairs, impact activities (he can walk and stand with rest in between). 3. Loose weight, if overweight. 4. Ice after increased use of the knee. 5. Cortisone shot. 6. Synvisc shot. 7. Glucosamine, chondroitin sulfate (nutritional supplements but no scientific data to recommend it). 8. The last resort is surgery.