Osteoarthritis is the most common type of arthritis affecting more than 30 million people in the US and more than 50 million in India. Osteoarthritis is often known as a degenerative joint disease as it leads to the slow breakdown of the bones and cartilage within a joint. Knee joints are the most commonly affected joints, others being hips, shoulders and hands. The common symptoms include pain, stiffness, impaired motion, and swelling. It is an ageing-related condition, mostly affecting people above 45 years of age or those with previously injured joints.
Early diagnosis and treatment go a long way in reducing pain and improving mobility for people affected by arthritis.
What are the Causes of Osteoarthritis Knee Joint
As the name suggests, it is related to degeneration and wear and tear of the cartilage surrounding the bones. The cartilage is a cushion over the bones which allows for normal gliding motion of bones in a joint. With age, this degenerates and wears away, exposing the bones to rub against each other, leading to pain. With time, this leads to joint deformity and the formation of irregular bone deposits, known as Osteophytes over the bones, further exacerbating the problem.
The main causes are wear and tear related to age, overweight and in some cases, genetic predisposition.
Signs and Symptoms
The earliest symptom is pain in the joints, initially on movement and later persisting with rest.
Later there may be swelling in joints followed by stiffness and lastly decreased range of motion along with deformity in the joints.
Prevention
Regular exercises and strengthening of the muscles around the knee joints help to keep one fit and free from Osteoarthritis. Additionally keeping the weight in check is a very useful measure to prevent knee OA from developing.
Treatment for Knee OA
Treatment of Knee OA depends upon the stage of the disease. Detailed history taking, clinical examination and a few bedside clinical tests help in establishing the diagnosis, further confirmed by and X-Ray of the affected knee joint. Some patients, especially those above 65 years of age and some other symptoms such as instability of gait while walking may require additional tests like a DEXA Scan and an MRI of the Knee Joint.
Once the stage of the disease is known, the patient with early disease may be offered physical therapy consisting of knee strengthening exercises, and some painkillers like NSAIDs for short-term relief. Those with ongoing disease for a few years may benefit from regenerative techniques like PRP or GFC injections into the knee or prolotherapy of the knee joint. Patients with advanced age and deformities in the knees benefit the best from surgery. Some patients, however, are not willing for surgery and are offered nerve blocks and Radiofrequency ablation of the nerves surrounding the knee joint for pain relief to enable them to lead a pain-free life.
Regenerative Therapy
It consists of PRP or GFC injections into the knee joints. These products are prepared from autologous blood from the patient. The PRP or GFC is injected into the knee joint and helps repair the cartilage and reduce the inflammatory markers causing pain in the knees. These have the best results when administered early in the course of the disease and can help prevent the need for knee joint replacement (TKR).
Nerve Blocks
Some sensory nerves carry the sensation of pain from the knee joints to the brain and blocking these nerves either with drugs or using low-dose electrical current can help ameliorate the pain symptoms. These procedures are beneficial in patients with advanced age, advanced disease, and limited activity mostly restricted to households.