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Knee Arthritis or Osteoarthritis

Knee Arthritis or Osteoarthritis

Introduction and Overview

Today in India, we have more number of elderly people than ever before. According to the latest estimates available, more than 5% of our population is aged above 65 years (UNICEF.org, India, Wikipedia.org). In the year 2000, 4.5 crore people in India were above 65 years of age and this number increased to 5.8 crore in 2010. The number of people above 65 years of age has increased to 7.1 crore in the year 2015 and is expected to be 7.6 crore in the year 2020. Therefore, the diseases more commonly seen in the elderly people are also increasing proportionally. According to the data published in the Indian Journal of Community Medicine in the year 2007, more than half of all people in the age group 67- 74 years suffer from arthritis. In the same research, it was reported that, almost all people beyond 85 years of age suffer from some form of arthritis or other. According to another survey "TNS Arogya 2006-07' by an ISO accredited independent market research agency, conducted in 16 cities in India, including Nagpur, it was estimated that there are 7.8 crore people with osteoarthritis in India. This data was corroborated by World Health Organisation data which estimated 7 crore people with osteoarthritis in India.

Knee Arthritis

Arthritis

What happens in Knee Arthritis ?

In simple terms, 'arthritis' or ‘osteoarthritis’ is a disease condition where in, the normal smooth bearing surface of the knee-joint is damaged or lost . This condition produces pain and sometimes deformity, which in turn lead to loss of function and finally disability and dependence. The various common causes of knee arthritis include age related wear & tear (osteo-arthritis), wear & tear due to extra demand (e.g. obesity), injury to the knee (contact sports, accidents), inflammation (rheumatoid arthritis) and others.

Arthritis

What are the symptoms of knee arthritis?

Pain is the most important symptom. Pain may be accompanied by swelling. Because of pain, there is loss of motion (stiffness) and restriction of activity. As the patient experiences pain, gradually there is restriction of provus ““"* outdoor activities first, and eventually patient mo becomes house-bound. There is pain on simple activities like walking and climbing stairs. It becomes extremely difficult to sit on the ground or get up from a chair. In the later stages even house-hold activities like bathing, cleaning and toilet become painful. In some patients there is also bone damage, leading to “En | bow-knees or knock-knees. There is a feeling of Advanced arthritis loss of balance and loss of confidence. These patients become dependent on spouse, children, relatives or neighbours. Thus there is dependence on others and independence is lost. Dependence is associated with disability and finally the patient becomes handicap even though he or she may be otherwise mentally and physically healthy .

RA or Rheumatoid Arthritis?

Arthritis

What is RA or Rheumatoid Arthritis?

Rheumatoid arthritis is a chronic inflammatory disorder that damages various joints including small joints of hands, feet and knees. An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues. Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis damages cartilage by causing a painful swelling that can eventually result in joint damage and deformity. While new types of medications have improved treatment options dramatically, rheumatoid arthritis can still cause physical disabilities. Among women, the incidence increases in 25 to 55 years age group. RA is rare in men under 45 years of age. Rheumatoid arthritis patients are often younger (by approximately 10 or more years) than osteoarthritis patients at the time of permanent knee damage. The Treatment of Arthritis

The Treament of Arthritis

Medical / Conservative treatment of knee arthritis

In the earlier stages of arthritis, pain relieving medicines have a very important role. However, taking pain killer medicines over a longer period are associated with major side effects. Thus pain-killer medicines must be administered with due care; especially in arthritis, as some patients may need to take these medicines over a longer period. Physicians, who regularly look after patients with knee arthritis, commonly prescribe cartilage preserving medicines. Most popular cartilage preserving medicines are nutritional supplements like glucosamine and chondroitin sulphate. Although there is no , convincing evidence that these medicines help build new cartilage, there is definite evidence that these medicines can reduce pain and improve — function.

Body Weight & Roles

Arthritis

Maintaining ideal body weight

Extra kilos on the body are bad for weight bearing joints such as the hips and knees. Research has conclusively linked weight gain and obesity to osteoarthritis, specifically knee arthritis. The impact of extra weight is multiplied 5-6 times at the knee joints when bearing weight. If a person is overweight by 10 kilos, the forces acting on the knees are increased by 50- 60 kilos. This is like carrying another person on one's shoulders all the time; and the resultant strain on knees can be easily imagined. Staying lean and fit is one of the most important things that one can do to improve the life of one's joints.

Arthritis

Role of exercises

Exercises of the muscles around the knee help to keep the joints healthy. In osteoarthritis, patients — prefer to curtail their activities and take rest, which can be detrimental to the arthritic joints. As a result of lack of exercise, patients lose strength and flexibility of their muscles. The range of motion at the joint becomes limited and bones become weak. This results in progression of osteoarthritis. Exercises strengthen the supporting structures (muscles, tendons and ligaments) and increase the range of motion, shock absorption and flexibility of the joints. Strong muscles can bear the brunt of forces that crash into the joints as we move, while helping the bones to support the body. Exercises also strengthen the bones.

Arthritis

Role of joint preservation

When medicines no longer relieve pain and patient's day to day life is affected, surgical options can be thought of. Various surgical options include joint preservation and joint replacement. In younger patients with early arthritis an effort is made to preserve the natural joint as long as possible by Impact of extra weight on your knees

What is knee replacement surgery

When to consider a knee joint replacement

When arthritis has progressed to advanced stage, cartilage is worn off and pain is not relieved by medicines, a knee replacement surgery can offer long term pain relief. When in addition to pain, there is stiffness, instability, loss of; confidence, restriction of day to day activity,dependence and disability, the best treatment alternative available to the patient is a joint replacement surgery.

What is Knee replacement surgery

When to consider a knee replacement

In a joint replacement surgery, the damaged surfaces of the knee joint are replaced by metal prosthesis (artificial joints) generally made of cobalt-chromium alloy or titanium. Metallic prosthesis glides over a polyethylene bearing, thus providing pain free range of movement and ambulation. The prosthetic components are fixed to the bone using bone-cement or rarely using cement less technique, where in the bone grows onto and into a porous coated component. The right decision about choice of an appropriate prosthesis for a particular patient is made by the treating surgeon in consultation with the patient, best suited to the patient's daily needs and demands.A knee joint replacement can be either partial knee replacement or total knee replacement. In a partial knee replacement only damaged parts of knee joint are replaced such as patello-femoral replacement or unicompartmental knee replacement i.e. replacement of only one compartment (uni=one).

Knee replacement surgery

What to expect after a Knee replacement

Patient is hospitalised for less than 1 week after surgery. The patient usually starts walking on the next day of surgery. This is a major operation and may take a couple of month in some patients. In others, the recovery is much faster, especially in thinner patients and those who participate enthusiastically in rehabilitation. After a knee replacement patient can comfortably participate i n activities , like long distance 4 Unicompartmental knee replacement walking, light jogging, a) Before Aer cycling and swimming. Some patients also go back to sports like tennis and badminton without extra risk of damaging the new knee. Before After Patellofemoral replacement Knee replacement is a highly successful operation in patients disabled by pain, Total knee replacement and helps them recover fully from disability and gain their independence. All the patients disabled by knee arthritis are enabled by a knee replacement, so that they can perform all usual activities of , daily living.

Happy Life!