What is Osteoarthritis?
Osteoarthritis of the knee occurs when the cartilage between our bones breaks down naturally, making it difficult to avoid as we age. Cartilage is a hard but slippery tissue which serves as a cushion between the bones of joints, allowing the bones to glide over one another. Cartilage also absorbs shock from physical movements. When cartilage loss occurs, the joint can deteriorate to the point of rubbing bone against bone. Changes in structures around the joint (muscles and tendons), fluid accumulation, and bony overgrowth (e.g., bone spurs) can develop, causing severe chronic pain, loss of mobility, and disability.
What Causes Osteoarthritis in the Knee?
Although the cause of osteoarthritis of the knee is unknown, your risk of developing osteoarthritis with symptoms is influenced by several genetic factors, such as age, gender (females have a higher incidence) and family history.
Other factors include:
Repetitive strain on or use of the joint Improper joint alignment
Overweight or obesity
What are the Symptoms of Osteoarthritis in the Knee?
Pain while standing or walking short distances, climbing up or down stairs, or getting in and out of chairs
Pain during activity
Startup pain or stiffness when activities are initiated from a sitting position
Stiffness in joint after getting out of bed
Swelling in one or more areas of the joint
A grating sensation or crunching feeling (particularly when you use your knee)
How is Osteoarthritis in the Knee Diagnosed?
If you are experiencing joint pain, you should see a physician qualified to diagnose and provide treatment. Your medical history and symptoms will be reviewed and your physician will observe the natural movement of the joint while in motion. The physician will also check joint alignment, reflexes and muscle strength, range of motion and ligament stability. X-rays may be ordered to determine the extent of joint or bone damage, if cartilage has been lost and if there are bone spurs present. Additional diagnostic imaging, such as computed tomography (CT) or magnetic resonance imaging (MRI), may be ordered to determine the exact location and extent of the damage.
The most common surgical procedure performed for osteoarthritis in the knee is a total knee replacement. This procedure involves removing the natural joint and replacing it with an artificial implant. This option is usually offered to patients with late-stage osteoarthritis of the knee. If you have early-stage or mid-stage osteoarthritis, a total knee replacement is not always the optimal procedure. MAKOplasty® Partial Knee Resurfacing/Replacement may be a better option for you. Click here to learn more.
Treatment of Osteoarthritis in the Knee
Your physician may recommend certain lifestyle changes to reduce stress on your joints. Physical therapy, steroid injections, over-the-counter pain medications such as acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs) or topical pain relieving creams may be recommended. If your symptoms are not responding to non-surgical treatments, or your pain is no longer controlled by medication, you may be a candidate for surgery.
Recommendations for knee osteoarthritis prevention: there are certain genetic risk factors that may determine if someone will develop osteoarthritis. These may be outside of your control, however, you there are certain lifestyle changes you can make which may reduce or prevent development of the disease.
There are six basic recommendations for knee osteoarthritis prevention:
1. Maintain Your Ideal Body Weight
It has been estimated that the force of three to six times a person's body weight is exerted across the knee while walking. In other words, being 10 pounds overweight increases the force on the knee by 30 to 60 pounds with each step taken. Losing weight will reduces the stress on your joints.
2. Exercise Regularly and Participate in Regular Physical Activity
For optimal joint health, it is recommended that people perform 30 minutes of moderately strenuous exercise at least five days a week. Lower levels of exercise can also be beneficial, according to study results. It's better to get some exercise as opposed to no exercise.
3. Protect Your Joints
There are several joint protection principles, which if followed will help conserve energy and preserve joint function. The advice is quite simple, but you must be mindful of proper movements and recognize body signals (e.g., pain). Good posture and proper body mechanics will protect your joints, and is a factor in osteoarthritis prevention.
4. Avoid Repetitive Stress on the Joints
Too many uninterrupted repetitions of an activity or motion, unnatural or awkward motions, overexertion, incorrect posture, and muscle fatigue all contribute to joint stress. These types of activities are usually associated with your occupation, so try to find solutions at your workplace and avoid prolonged periods of repetitive stress.
5. Listen to Your Pain
This recommendation seems so obvious, yet people don't always do it. Learning to view pain as a signal that you are overdoing it and that it's time to rest requires conscious effort. Balancing rest and activity is optimal for healthy joints. It's part of self-management to learn not to overuse your joints or push past your limits. Consider the pain is like a stop sign.
6. Avoid Injury to Joints
Previous joint injury is recognized as a common cause of knee osteoarthritis. In joints burdened by improper alignment due to injury, articular cartilage wears away and osteoarthritis can begin to develop. Avoid injury if at all possible - and if you do injure a joint, seek treatment immediately. Studies support an appropriate exercise program as part of multidisciplinary management of osteoarthritis. It's common for osteoarthritis patients to have deficiencies in gait, range of motion, strength, and flexibility - even endurance.
As part of a multidisciplinary approach, a healthy lifestyle focusing on good nutrition and weight management is realistic. Educating yourself about the role of diet and exercise and a consultation with your doctor is a positive approach.
If you have questions or concerns about osteoarthritis of the knee, we can assist with finding the right physician, treating your pain at our hospital-based pain management center or developing an exercise plan with our Health & Rehabilitation Team. From our pre-hab therapy team, pre-operative education classes, highly-skilled surgical team, physical therapists, and certified exercise physiologists, our trained orthopedic team has the expertise and compassion to get you back on your feet again. Expect Excellence, You deserve it! And at The Anderson Family Orthopedic & Spine Center at Jupiter Medical Center, excellence is what you'll get.