| Osteoarthritis is the most common type of arthritis, | | | | Overweight person develops knee osteoarthritis (2) |
| occurring in up to about 10% of adults, with as many | | | | painful knees reduce mobility (3) with reduced |
| as 50% of the elderly suffering from it. It is basically | | | | mobility, more weight is gained (4) more weight |
| a degenerative form of arthritis, in which the | | | | worsens the arthritis. |
| cartilage, whose function is to cushion the joints, gets | | | | - Regular exercise - regular aerobic, strengthening and |
| worn out with age. | | | | range of motion exercises help strengthen muscles |
| This "wear-and-tear" of the cartilage over time, | | | | that stabilize the joints. |
| results in the bone surfaces becoming less protected | | | | - Adequate intake of Calcium and Vitamin D for bone |
| and increases friction between the bones during | | | | strength. |
| movement. This friction eventually results in pain, | | | | - Warm soaks and heat packs to help relief pain. |
| swelling and loss of mobility. In more advance stages, | | | | - Avoid excessive walking during periods of acute |
| the joint loses it normal shape and bony spurs may | | | | pain. |
| grow on the edges of the joint. Bits of bone or | | | | - Orthoses and walking aids - splints and braces help |
| cartilage may break off and float inside the joint | | | | with joint alignment and weight redistribution. Walking |
| space, further causing pain and loss of mobility. | | | | frames and crutches help take load away from the |
| WHAT CAUSES OSTEOARTHRITIS? | | | | arthritic knee. |
| The cause is multi-factorial, but the following would | | | | - Physiotherapy |
| increase your risk: | | | | - Acupuncture |
| - Being overweight | | | | 2. Pharmacological Measures: |
| - Getting older | | | | - Pain-killers - paracetamol-based medication, |
| - Previous injury to the joint | | | | Non-steroidal anti-inflammatory drugs (NSAIDS) etc. |
| - Mechanical stresses on the joint from high impact | | | | - Glucosamine and/or chondroitin sulfate. |
| sports, certain jobs, pathological or congenital | | | | - Topical rubs with NSAIDS or capsaicin. |
| mal-alignment of bones | | | | - Intra-articular joint injections |
| SYMPTOMS | | | | 3. Surgical Treatment: |
| Symptoms in the initial stages may include pain, | | | | - Joint lavage (wash out) and arthroscopic |
| tenderness, stiffness, creaking and locking of the | | | | debridement (clearing) |
| affected joint. As the arthritis progresses, there may | | | | - Osteotomy - a wedge of bone located near the |
| be swelling of the joint due to collection of synovial | | | | damaged joint is removed to realign the knee. This |
| fluid within the joint. In the more advanced stages, | | | | causes a shift of weight from the area of damaged |
| there is bony deformity (caused by bony spurs) and | | | | cartilage to the area where there is more healthy |
| mal-alignment of the limb (eg. "varus" deformity of | | | | cartilage. |
| the knee). Patients experience increasing pain upon | | | | - Total Joint Replacement - considered to be the last |
| weight bearing, thus limiting walking, and ultimately, | | | | resort option in which the severely arthritic joint, |
| even standing. | | | | having failed more conservative methods of therapy, |
| Osteoarthritis commonly affects the hands, feet, | | | | is replaced with a prosthetic joint. |
| spine and weight-bearing joints, such as the hips and | | | | The decision to treat as well the type of treatment |
| knees. In the smaller joints, such as in the fingers, | | | | appropriate must be individualized according to the |
| hard bony swellings called Heberden's nodes and | | | | needs of the patient. |
| Bouchard's nodes may form. These are typically not | | | | For example, young athlete with arthritis to the knee |
| painful, but they do limit joint movement. | | | | from a previous injury, will require treatment because |
| DIAGNOSIS | | | | his arthritis impacts his activities. For him, |
| Diagnosis can often be made by your doctor with | | | | conservative treatment with possible arthroscopic |
| reasonable certainty by a thorough physical | | | | lavage and debridement would be more appropriate |
| examination. X-rays are used to confirm the diagnosis | | | | than total joint replacement, in view of his young age. |
| as well as to document progressive X-ray changes | | | | In contrast, severe osteoarthritis of the knee in an |
| (thinning of cartilage, bony spurs, loose bodies, | | | | elderly gentleman, which when examined in isolation, |
| mal-alignment of joint etc) as the condition | | | | would lead one to consider total knee replacement. |
| progresses. | | | | However, if this knee belonged to a bed-bound |
| TREATMENT | | | | gentleman, then perhaps simple pain-killers would be |
| 1. Non-Pharmacological: | | | | all that is needed. |
| - Weight loss - Excess body weight puts more strain | | | | Dr Ang C.D. |
| on the knee joints. A typical vicious cycle exists: (1) | | | | SingaporeDoc. |