OSTEOARTHRITIS OF THE KNEE
OSTEOARTHRITIS OF THE KNEE

WHAT DOES IT MEAN?

The word “Arthritis” means inflammation (swelling) in the joint. Osteoarthritis is one of the many types of arthritis, the others being: Rheumatoid arthritis, Infective arthritis, Gouty arthritis, and many more.

In this article we will talk about osteoarthritis, particularly about the knee joint.

Osteoarthritis is the arthritis caused by the wear and tear of the joint throughout life. Needless to say, it mostly affects the joints that are either used the most through life, eg. the joints in the cervical spine (neck), the thumb, the wrist, or the joints that take the load of the body, ie. the lumbar spine (low back), the hips, and the knees.

To understand osteoarthritis better, imagine that the body is a machine and that the joints of the body are hinges. But unlike a machine, the body is able to lubricate these hinges by itself. These well-oiled hinges bring about smooth movements in the joint almost throughout life. The joint surfaces are covered with a protective cover, the articular cartilage, which has many functions:

 

  1. To distribute the weight evenly on the bones of the joint.
  2. To act as shock absorbers.
  3. To lubricate (oil) the joint.

HOW DOES OSTEOARTHRITIS OCCUR?

The joint surfaces are able to keep the joint healthy most of the time. But if the wear and tear is more intense, the cartilage peels off like plaster peeling off the wall, and the joint cannot repair itself. Almost always, the internal damage is because of external causes… an old injury, or excessive use or misuse of some sort. As in any machine or a car, regular care will lead to long-term benefits.

The knee joint especially bears the weight of the body throughout life. The knee can suffer severe wear and tear due to any of the following reasons…

  1. Aging: Wear and tear of the joint surfaces is a normal aging process.
  2. Abuse of the joint throughout life by being overweight: While standing, the weight of the body is equally distributed over both the knees. While walking, this weight is alternately born by each knee. When a man with a body weight falling within normal limits walks, all is fine ,but imagine a 100 kg.(overweight) man walking, and think about how much abuse his knees will take while walking, double that ;;while climbing up the stairs, and up to 7 times while standing up after squatting on the floor!!!!
  3. Overuse of the joint for a period of time: Eg 10 years of playing professional football may cause a series of minor injuries to the joint.
  4. Other causes: Unequal weight bearing on the joint surfaces because of bowlegs/ flat feet/ unequal leg length will cause one side of the knee joint to wear out. An old fracture involving the joint may have caused mal alignment of the joint surfaces.

WHAT ARE THE SIGNS?

All the effect felt by the sufferer (i. e pain), is because of the destruction in the continuity of the weight bearing surfaces of the joint, and the erosion of the underlying bone.

We can roughly divide it into four stages:

  1. Very early wear &tear: Early morning stiffness, stiffness after sitting in one position for too long which disappears when movement is started.
  2. Early osteoarthritis: Early morning stiffness, stiffness after rest, joint aches after use, especially after climbing or descending stairs, and after getting up from squat.
  3. Osteoarthritis: The joint is stiff after any rest. It aches during most activities. It may be slightly swollen or warm. May make creaking sounds.
  4. Severe Osteoarthritis with joint disruption: Stiffness and severe pain during rest and any activity. It may cause sleepless nights. There may be swelling and warmth. Joint may look deformed and knobbly.

CAN IT BE PREVENTED?

Wear and tear of all tissues is taking place all the time in our bodies and we cannot prevent it. As age advances, the natural capacity of our body to repair tissue damage decreases. Hence we cannot actually prevent the wear and tear of our joints, especially the knee joint. But minor changes in the joint surface need not lead to osteoarthritis. There are certain things that we can do to prevent severe damage to our knee joints.

 

  1. Unload the joint: Keep your weight within normal limits.
  2. Strengthen the external supports: Strengthen the muscles around the joint in such a way that their forces are balanced.
  3. Use the joint with care: Remember that you need it for life, so treat it with respect. Try to incorporate different exercises in your week so as to reduce impact on the joint. Alternate running with swimming or cycling for aerobic conditioning. Use good quality deep-soled footwear for running activities. Make it a point to run on wet sand or a treadmill with a cushioned deck instead of a consultant for foot-inserts.
  4. Keep the joint mobile: Perform full range movements of the joint several times a day. Even if you find it a waste of time, stretch each muscle before and after each workout.

WHAT IS THE TREATMENT?

  1. Visit a Doctor to arrive at a correct diagnosis: You may need to carry out some investigations, for eg. a blood test to rule out other types of arthritis, and an x-ray to assess the amount of damage to the knees. X-rays taken a few years apart will also show you how much the arthritis has progressed. You may need medication to take care of the pain and inflammation.
  2. Visit a physiotherapist for advice regarding an exercise program. If the pain is severe, you will be advised to undergo a few treatment sessions followed by an exercise protocol. These exercises are progressive, and should be carried on for several months. Be sure to take a detailed home program and follow up regularly.
  3. Lose weight. Start a weight loss program without delay. Every kilo of weight lost will make a difference. Take professional help if required.
  4. Unload your knee. Do not walk up and down the stairs unless it is absolutely necessary. Never sit down or squat on the floor. Swim or Cycle instead of running or walking.
  5. Keep the joint mobile. Do not sit in one position for too long. Keep moving the joint through its pain free range.
  6. Exercise moderately, Stay active, Stretch well, Maintain a healthy weight, Use Sensible footwear, Eat Healthy, Think Positive, Stay Happy!!

THE LAST RESORT: If the joint destruction is so severe that none of these remedies work, the orthopaedic surgeon will advise a joint replacement surgery. But remember that if this new joint has to last for many years, a lot of care will have to be taken even after surgery: weight reduction, regular exercise, unloading the joint, all these are a must, whatever the treatment.

FACTS:

Message to the young, very young, and not so young: Conserve and Look after the joints of your body, original is the best!

Imagine that your body is a car and your leg is the tyre: Would you run the car for long distances if the tyre was worn out?

When Knee Joint is replaced, it is like RETHREADING the TYRE, NOT REPLACING IT: Only the joint surfaces are replaced, the bones are not!!

Arthritis Does Not Always Progress at the same speed throughout life!! If you make the right changes, you can conserve your joint!!

TRY A GOOD REHABILITATION PROGRAM BEFORE CHOOSING SOMETHING AS DRASTIC AS REPLACEMENT!!! IT MIGHT CHANGE THE COURSE OF YOUR LIFE!!

Do not under estimate the power of positive thinking… try it along with good life style changes!!