Osteoarthritis of the Knee
What is osteoarthritis?
Osteoarthritis, the most common form of arthritis, is also called degenerative joint disease or “wear and tear” arthritis. Almost everyone is affected by it to some extent as they grow older. It most frequently occurs in weight-bearing joints, mainly knees, hips, and ankles. This form of arthritis slowly and gradually breaks down the cartilage that covers the ends of each bone in a joint. Normally, cartilage acts as a shock absorber, providing a smooth surface between the bones. But with osteoarthritis, the smooth surface becomes rough and pitted. In advanced stages, it may wear away completely. Without their normal gliding surfaces, the bones grind against one another, causing inflammation, pain and restricted movement. Bone spurs may form.
What are the symptoms of osteoarthritis?
The number one symptom is pain. The pain is caused by irritation and pressure on nerve endings, as well as muscle tension and fatigue. The pain can progress from mild soreness and aching with movement to severe pain, even when resting. The second symptom is loss of easy movement, such as bending or rising normally. Morning stiffness is a problem for many people. This lack of mobility, in turn, often causes the muscles serving the knee or hip to weaken, and overall body coordination suffers.
How is osteoarthritis diagnosed?
A simple weight-bearing X-ray and examination by a skilled orthopedic doctor will determine if you have osteoarthritis. Time-consuming and costly diagnostic procedures are not required.
What is the treatment for osteoarthritis?
There is no cure for arthritis, but the past decade has seen dramatic new ways to manage the pain, lack of mobility, and fatigue that are among its most disabling symptoms.
• Hyaluronate - The new treatment lubricates the knees and can reduce pain for 9-12 months. It’s the first major breakthrough in 20 years for arthritis knee pain. Hyalgan and Synvisc are the brand names, and five injections are given into the knee one week apart.
• Medicines - Coated aspirin helps relieve pain and has few side effects. Non-steroidal anti-inflammatory drugs (NSAIDS), such as Voltaren, Feldene, Naprosyn, and Clinoril, are prescription drugs for pain and inflammation. Do not take aspirin if you are taking NSAIDS.
• Cortisone Shots - Cortisone shots are given for inflammation. For many people, joint arthritis is often made symptom-free for months or even years after cortisone shots. Four to six shots a year can be given without any dangerous side effects.
• Diet - There is no evidence that any specific foods will prevent or relieve arthritis symptoms. It’s important to keep thin, however, because excess weight aggravates arthritis by putting added pressure on the knee and hip.
• Exercise and Rest - Prolonged rest and days of inactivity will increase stiffness and make it harder to move around. Motion is lotion for arthritis! At the same time, excessive or improper exercise can overwork your arthritic joint and cause further damage. A balanced routine of rest and exercise is best. Physical therapy may also be an option.
What about surgery?
• Arthroscopy - Arthroscopic procedures may be recommended and can provide some relief in certain cases, but cannot cure arthritis. In some cases, a “flap” of torn knee cartilage can aggravate arthritis and cause additional pain. The cartilage flap can be removed by arthroscopy.
• Knee Replacement - Knee replacement may be a very positive solution to the pain and disability of advanced osteoarthritis. The rough, worn surfaces of the joint are relined with smooth-surfaced metal and plastic components.