KNEE OSTEOARTHRITIS

Osteoarthritis is the wearing down of joint cartilage and the underlying bone. It is the commonest disease of joint worldwide with knee osteoarthritis being the most common. Osteoarthritis is the degeneration of joint cartilage and the underlying bone. Mostly affects people above the 45yrs. Women more affected than men.

The knee is the largest and strongest joint in the body. It is made of the lower end of the thigh bone, the upper end of the shin bone and the knee cap. The ends of these bones are covered by cartilage, a slippery tissue which provides a smooth surface for joint motion. Cartilage also acts as a cushion between the bones.

It can broadly be classified as primary (no known cause) and secondary (cause of the articular degeneration is known).
Risk factors for knee osteoarthritis include:
1) Age: ability of cartilage to heal itself decreases with aging.
2) Obesity weight increases the load on the joints especially the knee joints.
3) Gender women more at risk than men especially above 55yrs. This may be due to changes in hormonal levels after menopause.
4) Trauma knee injuries sustained during sports or accidents predisposes to osteoarthritis later in life. Osteoarthritis in this group tends to occur earlier and with more severe symptoms.
5) Repetitive stress injuries minor trauma which ordinarily would not cause injury, when it occurs repetitively may accumulate to cause serious injury to the knee, leading to osteoarthritis subsequently.
6) Bone deformities Genu valgum (k –leg) or Genu varum (bow leg)

Patients with knee osteoarthritis may present with any of this symptoms:
°Pain during or after movements
°Stiffness: commonly after awakening or after a period of inactivity.
°Grating sensation may be felt on moving the knee. Popping or crackling sound may be heard.
° Swelling around the knee, this may be constant or activity related.

Knee osteoarthritis is a clinical diagnosis and but be confirmed by relevant radiographs. Other investigations may be requested to identify predisposing factors.
Treatment can be non surgical or surgical.
Non surgical treatment is usually the first line treatment. It can be non pharmacologic or pharmacologic(use of medications) treatment.
Non pharmacologic treatment include
• Lifestyle modification
°Minimize activities that aggravates the condition e.g climbing stairs
°Avoid high impart activities e.g jogging or tennis. Swimming or cycling will put less stress on the knee.
°Losing weight reduces stress on the knee resulting in less pain.
• Physiotherapy
Helps increases range of motion and flexibility and also help strengthen the muscles around the knee.
°Assistive device
Using cane, wearing a brace can be helpful by taking off load from the knee or redirecting load passing through the knee.
°Application of heat or ice may soothe acute pain
° Elastic bandage: provide support to the knee.
Pharmacologic treatment
There are many arrays of medications available to manage arthritis. These include analgesics, anti inflammatory agents and other medications which may alter the viscosity of the joint.
Surgical treatment:
Usually a last resort if conservative measures fails or is no longer effective. Surgery can relieve pain, correct deformity and improve range of knee motion.

If you have any of these symptoms or you suspect you have knee osteoarthritis, you will need to consult a doctor. Prompt diagnosis and institution of treatment will prevent progression of symptoms and result in a better outcome.

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