Hello Jessica,
The most common management options for osteoarthritis include:
1. Nonpharmacologic treatment - patient education and support, exercise, weight loss, joint protection
2. Pharmacological therapy - Paracetamol (Acetaminophen) up to 4g per day for pain relief, NSAIDs if more pain relief is necessary.
3. Surgical management - Osteotomy or joint replacement.

Now, in the context of emphysema, only two of the above options are of some concern:
1. Weight loss - Shortness of breath may limit the exercise tolerance
2. NSAIDs - as they are known to induce bronchospasm, especially in patients with chronic obstructive pulmonary disease, emphysema being one such condition.

To add to this, as you have mentioned, increased anesthetic risk is another concern, but can be overcome to some extent by utilizing non-general anesthesia - like spinal block etc.

Let me know if this information is useful, or you need any further help.

Regards