Knee pain is a common problem in Asia, especially in individuals above the age of 40. The most common cause of knee pain is degenerative osteoarthritis.
Women are more prone to osteoarthritis. It is characterized by mild to debilitating pain. The treatment ranges from physiotherapy, medication, injection and surgery. Once the condition is diagnosed, it is important to choose the treatment according to the individual’s age, and severity of the symptoms.
What is osteoarthritis?
Osteoarthritis is a common problem for many people after middle age. Osteoarthritis is sometimes referred to as degenerative, or wear and tear arthritis, and is the most common form of arthritis. The disease causes cartilage breakdown found in joints, which removes the buffer between bones and the resulting bone against bone friction causes pain. Bone spurs may also form around the joint as the body’s response.
The symptoms of osteoarthritis are mainly pain, swelling, and stiffening of the knee. Osteoarthritis develops slowly, but one may be presented with sudden attacks of knee pain. The pain of osteoarthritis is usually worse after engaging in an activity. Some patients may even feel pain and stiffness when standing after a prolong period of sitting. Activities such as squatting and climbing of stairs my become painful. In the late stages of the condition, the patient may even feel the pain worsening with walking.
How do you get Osteoarthritis?
There are a wide array of factors that cause the development and progression of the disease. These risk factors may include:
- Obesity issues
- Joint injuries from sporting activities, work or accidents
- Genetical makeup
How can osteoarthritis be diagnosed?
Osteoarthritis can be diagnosed by an orthopaedic surgeon, who conducts a full physical examination of the symptoms. The physician may also recommend X-ray investigations to confirm the presence of the condition. In some cases of early osteoarthritis, the X-ray examination may not show changes that are typical of osteoarthritis. In such cases where the diagnosis is unclear, arthroscopy may be conducted to look inside the knee, to investigate if the joint surfaces are beginning to develop changes from wear and tear.
Arthroscopy is a surgical procedure where a small fibre-optic television camera is inserted into the knee joint through a very small incision, which is about 5mm. The orthopaedic surgeon then directs the camera around the joint while viewing the pictures on a TV screen. The structures inside the joint can then be examined with small surgical instruments to see if there is any damage.
Treatment of Osteoarthritis
- Weight management to relieve stress on weight-bearing joints
- Glucosamine Sulphate 1500mg per day
- Anti-inflammatory drugs and analgesics
- Injection of lubricants into the knee
- Arthroscopy to wash away the inflamed fluid, debris and loose fragments inside the joint. Abrasive-therapy to stimulate cartilage growth
- Osteotomy to straighten the leg to reduce the stress acting on the bad part of the knee
- Partial knee replacements (unicompartmental knee replacement replaces only the diseased portion of the joint)
- Total knee replacement (used when severe osteoarthritis is present)
Today’s guest post on understanding osteoarthritis is by Dr Kevin Yip, Orthopaedic Surgeon, with over 20 years of experience. Dr Yip´s main areas of interest are knee and shoulder surgeries. He also treats various conditions related to neck and back, and to upper and lower limbs.
Dr Yip obtained his medical degree from St. Thomas’ Hospital London, England. He completed his post-graduate training in London, obtained his Fellowship of the Royal College of Surgeons in 1990, and worked in several hospital units in England before moving to Hong Kong. After leaving Hong Kong in 1998, he joined Gleneagles Hospital as a Consultant Orthopaedic Surgeon.