Osteoarthritis Knee

One in two adults will develop symptoms of Osteoarthritis Knee(OA Knee) during their lives. Osteoarthritis Knee can occur in any joint of the body but Osteoarthritis Knee is the most common Osteoarthritis(OA) than any other joint. Women are slightly more affected than men. People who are obese are also more prone to Osteoarthritis Knee.

Osteoarthritis is due to the wear and tear of the joint (a degenerative disease). The cartilage is a firm rubbery material covering an articular joint and provides a smooth, gliding surface for joint motion and acts as a cushion between the bones. In OA, the cartilage breaks down, causing pain, swelling and problems moving the joint. People usually get confused with osteoarthritis and osteoporosis. Osteoporosis is a condition that weakens bones, making them fragile and more likely to break. It is in the bone itself not in a joint alone.

Osteoarthritis knee is more common in people who are older than 50 years but in my years of practice I have come across a lot of people their thirties without any co morbid conditions which can cause OA knee, probably due to the lifestyle and food nowadays. OA knee can occur in young people due to an old fracture inside the knee joint or a ligament or meniscal injury, medical conditions like rheumatoid arthritis etc. can lead to OA at a younger age.

The symptoms are classical- pain while getting up from a chair or bed especially from the floor, inability to sit on the floor by bending your knees, stiffness especially getting up in the morning or after a period of rest, pain while climbing down or up the stairs,  swollen knees, a crepitus sound or feeling while moving the joint etc. It can affect one or both knees but usually both knees and one knee more painful than the other.

An X-Ray is good enough to diagnose an OA knee but make sure it is taken in the standing position to see the joint space reduction. MRI is usually not required unless your doctor suspects something else. Of course, the diagnosis should be made only by a doctor.

Treatment-Osteoarthritis knees can be mild, moderate or severe. The mild and moderate OA’s can be treated conservatively by pain medications and medications to reduce swelling along with rest. Glucosamine taken orally is helpful in some patients, fish oil or omega 3 still has no solid scientific evidence yet in humans regarding OA treatment. A steroid injection into the knee can help to reduce pain and there are also non steroid injections like Hyaluronic Acid into the knee but remember these are all temporary measures, 3 to 6 months relief only.

The things that you can do are to reduce your weight, avoid strenuous exercises especially the ones on your knees like aerobics or squatting. Knee strengthening exercises like quadriceps strengthening are very beneficial but avoid exercises if the knee is very painful or swollen. Swimming is supposed to be the best exercise since the water takes a share of your body weight. When there is no swelling but severe pain, a hot pack with local ointment or cream can help. When swollen, ice packs can be applied but not more than 15 minutes at a time.

If severe OA and the legs start to bend inside or there is an unbearable pain even at rest or it is really affecting your daily activities and your general health, you can go for a total knee replacement if your medical fitness permits. Knee replacement is the most successful surgery among all joint replacement surgeries.
You should keep in mind not to take any steroid injection before the surgery into the knee at least for 6 months. Also, you should not have any infections in your body especially tooth, urine, ears etc.

There are different kinds of implant or companies available for knee replace
That’s your choice but always remember not to force your surgeon to do something which he is not used to.

I always tell my patients “The knee is like the tyre of a car if u drive carefully on a nice road with a lightweight body car it will run longer without trouble but if you drive on bad roads, uneven terrain and roughly with a heavier body car it will wear out soon”

Tyre can be changed easily but remember it’s your knees.

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