OSTEOARTHRITIS OF KNEE

The knee is the commonest of the large joints to be affected by osteoarthritis. Often there is a predisposing factor: injury to the articular surface, a torn meniscus and ligamentous instability or pre existing deformity of the hip or knee, to mention a few. However in many cases no obvious cause can be found. 

                                                            IN OTHER WORDS

Osteoarthritis, commonly known as wear and tear arthritis, is a condition in which the natural cushioning between joints -- cartilage -- wears away. When this happens, the bones of the joints rub more closely against one another with less of the shock-absorbing benefits of cartilage. The rubbing results in pain, swelling, stiffness, decreased ability to move and, sometimes, the formation of bone spurs.

                  

   ANATOMY OF KNEE JOINT (STRUCTURE)

The knee is the largest joint in the body. Normal knee function is required to perform most everyday activities. The knee is made up of the lower end of the thighbone (femur), which rotates on the upper end of the shin bone (tibia), and the kneecap (patella), which slides in a groove on the end of the femur. Large ligaments attach to the femur and tibia to provide stability.

The joint surfaces where these three bones touch are covered with articular cartilage, a smooth substance that cushions the bones and enables them to move easily.

All remaining surfaces of the knee are covered by a thin, smooth tissue liner called the synovial membrane. This membrane releases a special fluid that lubricates the knee, reducing friction to nearly zero in a healthy knee.

Normally, all of these components work in harmony. But disease or injury can disrupt this harmony, resulting in pain, muscle weakness, and reduced function.

                                                   PATHOPHYSIOLOGY

Cartilage breakdown usually starts in an area of excessive loading. Thus, with long-standing varus the changes are most marked in the medial compartment. the characteristic features of cartilage fibrillation sclerosis of the subchondral bone and peripheral osteophyte formation are usually present in advanced cases the articular surface may be denuded of cartilage and underlying bone may eventually crumble.

   Chondrocalcinosis is common, but whether this is cause or effect- or quite unrelated- remains unknown.

                             WHO ARE EFFECTED BY OSTEOARTHRITIS?  

Osteoarthritis is the most common type of arthritis. While it can occur even in young people, the chance of developing osteoarthritis goes up after age 45. According to the Arthritis Foundation, more than 27 million people in the U.S. have osteoarthritis, with the knee being one of the most commonly affected areas. Women are more likely to have osteoarthritis than men.

                            HOW TO KNOW IF U HAVE OSTEOARTHRITIS ?

        

• Patients are usually 50 years old
•  If the person is overweight
•  Having bow leg deformity
•  If pain is leading symptom 
•  The joint feels stiff after rest and takes some time to get going
•  Swelling is common and locking of knee may occur.

                                                          DIAGNOSIS  

A careful history taking and physical examination by a doctor or physical therapist may reveal the early judgment of knee OA. However, taking x-ray images confirm the diagnosis with reduced space between the two big bones and presence of bone spurs.

RADIOGRAPHS SHOWING ARTHRITIC CHANGES 

TREATMENT OF KNEE OSTEOARTHRITIS

If the symptoms are not severe treatment is conservative. joint loading is lessened by using a walking stick. Quadriceps exercises are important. Analgesics are prescribed for pain and warmth (e.g. radiant heat or short wave diathermy ) is soothing. Wearing knee supports and bands is helpful in assisting proprioception for an unstable joint. Intra articular corticosteroid injection may relieve pain but its not good in long run.

If the symptoms are severe then some surgical interventions can be used these are-

• arthoscopic washout
• patellectomy
• realignment osteotomy
• replacement arthroplasty
• arthrodesis                                                                                                                                      

In my upcoming blogs i will post about these surgeries and best conservative treatment of Knee OA i have been practicing from long.

I am a new blogger please give your valuable feed back in comments if u like it or not.

                            

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AGING PROCESS OF JOINTS

Osteoarthritis is a chronic progressive age related disorder. This effects a large population of the world giving pain swelling and disability to the old mostly effected are knee, hip, lumbar and cervical intervertibral joints. and the wrong thing is, most treatment does not seem to work.