Knee osteoarthritis

Knee osteoarthritis, commonly known as wear-and-tear of the knee, is a condition in which the cartilage, which is the natural cushioning between joints, wears away. This causes the bones of the joints to rub more closely against one another, reducing the shock-absorbing benefits of cartilage. The rubbing results in pain, swelling, stiffness, decreased ability to move, and sometimes, the formation of bone spurs.

What are the risk factors causing knee osteoarthritis?


Wear and tear of the knee occurs naturally as we age. Hence, almost everyone will eventually develop some degree of osteoarthritis. However, several factors increase the risk of developing significant arthritis at an earlier age. Systemic factors

  • Age - The ability of cartilage to heal decreases as a person gets older.
  • Weight - Weight increases pressure on all the joints, especially the knees. Every kg of weight you gain adds 6-8kg of extra weight on your knees.
  • Genetics - Genetic mutations might cause a person to be more likely to develop osteoarthritis of the knee.
  • Gender - Women age 55 and older are more likely than men to develop osteoarthritis of the knee.
Mechanical factors
  • Repetitive stress injuries - Usually due to the type of job a person has. Occupations that include a lot of activity that can stress the joint, such as kneeling, squatting, or lifting heavy weights (25kg or more), are more likely to develop osteoarthritis of the knee because of the constant pressure on the joint.
  • Injuries - Athletes involved in soccer, tennis, or long-distance running may be at higher risk for developing osteoarthritis of the knee, as they have a higher chance of injuring their knee during their sporting career.
  • Muscle weakness - Having muscles strong enough to support our usual activities reducing the amount of stress the knee joint receives. Regular moderate exercise strengthens joints and can decrease the risk of osteoarthritis.
  • Joint morphology and alignment - Inherited abnormalities in the shape of the bones that surround the knee joint can increase mechanical stress around the knee joint.




What are the stages of knee osteoarthritis?





What are the symptoms of knee osteoarthritis?


1. Pain - usually over inside of the knee, but can be on both sides or on the outside

  • Prolonged walking or running
  • Walking up/downhill
  • Climbing up or down stairs
  • Kneeling down
  • Bending your knee
2. Stiffness - last for a few minutes, subsides with movement and gentle stretching
  • Short periods in the morning on getting up
  • After sitting or prolonged resting
3. Crepitus - grinding, creaking, crunching, or grating sensation you may feel or hear when moving or bending your knee
  • Crepitus is normal if there is no pain on movement
4. Swelling - warmth and swollen
  • Swelling inside the actual knee joint space
  • Swelling of the bursa (fluid filled sacks near the knee




Treatment options for Knee osteoarthritis


Non-surgical treatment

  • Weight loss - Losing even a small amount of weight, if needed, can significantly decrease knee pain from osteoarthritis.
  • Exercise - Strengthening the muscles around the knee makes the joint more stable and decreases pain. Stretching exercises help keep the knee joint mobile and flexible
  • Non-steroids anti-inflammatory drugs (NSAIDS) - Your doctor may give you a prescription anti-inflammatory drug or other medication to help ease the pain if the pain is severe.
  • Injections of corticosteroids or hyaluronic acid into the knee. Steroids are powerful anti-inflammatory drugs. Hyaluronic acid is normally present in joints as a type of lubricating fluid.
Surgical treatment
  • Arthroscopy uses a small telescope (arthroscope) and other small instruments. The surgery is performed through small incisions. The surgeon uses the arthroscope to see into the joint space. Once there, the surgeon can remove damaged cartilage or loose particles, clean the bone surface, and repair other types of tissue if those damages are discovered. The procedure is often used on younger patients ( ages 55 and younger) in order to delay more serious surgery.
  • Joint replacement surgery, or arthroplasty, is a surgical procedure in which joints are replaced with artificial parts made from metals or plastic. The replacement could involve one side of the knee or the entire knee. Joint replacement surgery is usually reserved for people over age 50 with severe osteoarthritis. The surgery may need to be repeated later if the prosthetic joint wears out after several years. But with today's modern advancements, most new joints will last over 20 years. The surgery has risks, but the results are generally very good.





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