Knee Osteoarthritis

Knee Osteoarthritis is a condition where the protective cartilage in the knee joint wears down over time. The cartilage breaks down and becomes thinner, resulting in the bones rubbing against each other.

In this situation, the knee is expected to experience pain, stiffness, inflammation, reduced range of motion, and the development of bone spurs. Moving the knee and performing everyday activities like walking or climbing stairs is difficult.

Knee Osteoarthritis can be classified into two main categories. These include:

1. Primary Osteoarthritis: This type develops due to the natural ageing process and the gradual wear and tear of the knee joint. It is more common in individuals over 50 years old. The cartilage in the knee gradually deteriorates, leading to pain and stiffness.

2. Secondary Osteoarthritis: It results from underlying conditions such as a previous knee injury, obesity, or genetic factors. This category can occur at any age and often progresses more rapidly than primary osteoarthritis.

Apart from these the condition can also be categorised as unilateral or bilateral knee osteoarthritis, meaning it affects single knee or both knees, respectively. The patient’s quality of life can be significantly affected based on the same classification. Thus, contributing to the prognosis of disease and the choice of treatment.

Grades of Knee Osteoarthritis

Knee osteoarthritis grading is essential for determining the extent of damage caused by the disease. Additionally, it allows doctors to create unique and personalised treatment plans.

Osteoarthritis knee symptoms often develop gradually and worsen over time. Common symptoms include:

1. Pain: Especially during or after movement. It may be felt deep within the knee joint.

2. Stiffness: Most noticeable upon waking or after inactivity. The knee may feel stiff and difficult to move.

3. Tenderness: Experienced when applying pressure to the knee. The joint may be sensitive to touch.

4. Loss of flexibility: Reduced range of motion. Bending and straightening the knee may become challenging.

5. Grating sensation: Feeling or hearing a grinding sound when moving the knee. This is due to the roughened surfaces of the joints rubbing against each other.

6. Swelling: Inflammation of the soft tissues around the joint. The knee starts to appear swollen and turns tender at the touch.

"In Delhi, I treated a 58-year-old woman with advanced osteoarthritis of the knee, who had been misdiagnosed for years due to overlapping symptoms with rheumatoid arthritis. Her condition had deteriorated to the point where she could barely walk.

We performed a complex revision total knee arthroplasty involving extensive realignment and soft tissue balancing. Post-surgery, she underwent rigorous physiotherapy, and within six months, she could walk independently."

- Dr Prince Gupta
Joint Replacement Surgeon, Orthopedic Doctor

The primary cause of osteoarthritis of the knee is the gradual breakdown of cartilage, the protective tissue at the ends of bones. This breakdown causes bones to rub against each other, causing pain and inflammation. 

Risk Factors of Knee Osteoarthritis

There are a variety of factors that can contribute towards the development of this condition. These include:

1. Age: With age, the overall wear and tear to the joints increases the risk of the condition.

2. Gender: Females are more prone to develop knee osteoarthritis. Hormonal differences and biomechanics may play a crucial role.

3. Obesity: Excess body weight adds stress to knee joints.

4. Previous Knee Injury: Injuries from sports, accidents, or surgeries can lead to the disease.

5. Genetics: A family history of osteoarthritis can make individuals prone to the condition as the gene variation can affect joint structure.

6. Occupation: Jobs that involve repetitive knee stress, such as prolonged standing, squatting, lifting, and kneeling.

7. Sports Participation: High-impact games and activities that put excessive force on the knees. For example, badminton, weight lifting, wrestling, etc.

How to prevent knee osteoarthritis?

Preventing osteoarthritis of the knee involves several lifestyle changes and proactive measures. Here are some effective strategies:

1. Maintain a Healthy Weight: Excess body fat stresses knee joints, accelerating cartilage wear and tear. 

2. Osteoarthritis Knee Exercises: Engage in low-impact activities like swimming, cycling, and walking. Performing these will strengthen the muscles around the knee, improve flexibility, and reduce stiffness. 

3. Avoid Repetitive Stress: Modify the tasks that strain the knees excessively. Use proper techniques and equipment to reduce the risk of injury. Avoid repetitive motions that can lead to joint overuse.

4. Protect Your Knees: Wear knee pads while kneeling, and buy proper shoes that fit well and provide balance.

5. Healthy Diet: Ensure adequate intake of nutrients that support joint health. Include anti-inflammatory foods like fruits, vegetables, and omega-3 fatty acids.

6. Control Blood Sugar: High glucose levels can speed up cartilage deterioration. Controlling diabetes can help prevent the disease.

7. Prevent Injuries: Warm up before exercise, use proper techniques, and wear protective gear. Treat any joint injuries promptly to prevent further damage.

Accurate diagnosis of the diseases involves a combination of clinical evaluation and imaging tests. Here is a list:

1. Medical history: Discussing symptoms and any previous knee injuries. The healthcare expert will inquire about the onset, duration, and severity of indications.

2. Physical examination: Checking for pain, swelling, and range of motion to assess the stability and alignment of the knee.

3. Osteoarthritis Knee X-ray: To reveal joint space narrowing, bone spurs, and other changes. These cans can depict the accurate extent of cartilage loss and bone damage.

4. MRI: For providing detailed images of soft tissues. These scans can detect early changes in the cartilage and other structures.

5. Special test for knee osteoarthritis: These may include joint aspiration to analyse synovial fluid. This test can help rule out other conditions like infections or gout.

How to prepare for a doctor consultation?

Preparing for a consultation about Knee osteoarthritis involves various steps. These are:

1. List symptoms: Note when they occur and their severity. Keep a diary of the indications to provide detailed information to the doctor.

2. Medical history: Include previous injuries and family history of osteoarthritis. 

3. Questions: Prepare a questionnaire about diagnosis, treatment options, and lifestyle changes. Write down concerns and priorities to discuss with the doctor.

Questions to Ask the Doctor

When consulting an orthopaedic doctor about knee osteoarthritis, it is essential to rule out doubts and confusion. Some common questions to ask are as follows:

1. What is the severity of my knee osteoarthritis?

2. What treatment options are available?

3. Are there any lifestyle changes I should make?

4. How can I manage pain and improve mobility?

5. What are the potential side effects of treatments?

There are several options of Osteoarthritis knee treatment that can help with managing the disease optimally. These options can be broadly categorised into non-surgical and surgical methods.

1. Homoeopathic treatments: It is a complementary therapy that uses highly diluted substances to stimulate the natural healing processes. Patients often try methods like:

   • Individualised remedies: Common medicines for hip osteoarthritis include Rhus toxicodendron, Bryonia, and Calcarea carbonica.

   • Combination preparations: Some studies suggest that homoeopathic combination remedies containing multiple ingredients, such as Rhus toxicodendron, Arnica montana, and Solanum dulcamara, may be effective in reducing pain and improving function.

2. Ayurvedic treatments: Ayurveda is a traditional Indian system of medicine that focuses on balancing the body. Some commonly used procedures are:
   

   • Herbal remedies: Herbs like Boswellia serrata, turmeric, ashwagandha, and Shallaki are used to reduce inflammation.

   • Panchakarma therapy: This detoxification therapy involves five different treatments, including massage and herbal enemas, to help remove toxins from the body.

3. Non-Surgical Treatments: These options for osteoarthritis aim to reduce pain, improve function, and slow disease progression. They are:
   

   • Medications: Pain relievers like acetaminophen and NSAIDs are commonly used. For more severe pain, doctors may prescribe stronger medicines.

   • Injections: Corticosteroid injections are proven to reduce inflammation and pain in the joint. Hyaluronic acid injections provide lubrication to the joint. 

   • Bracing and Orthotics: Knee braces, especially unloader braces, allow weight to be redistributed away from the damaged part of the knee. Orthotic devices like shoe inserts can also provide additional support.

   • Alternative Therapies: Some patients find relief with acupuncture or topical creams containing capsaicin.
     
     

4. Surgical Treatments: When all other remedies fail to provide adequate relief or the osteoarthritis is severe, surgery becomes important. The main surgical procedures for knee osteoarthritis include:
   

   • Arthroscopy: This minimally invasive procedure uses a small camera to view the inside of the knee and remove damaged cartilage or loose particles. It is often used for younger patients to delay more extensive surgery.

   • Osteotomy: The surgery involves cutting and reshaping the bones to improve knee alignment. It is typically recommended for patients with damage confined to one part of the knee.

   • Joint Replacement (Arthroplasty): In severe cases, partial or total knee replacement surgery may be necessary. This is the replacement of damaged joint surfaces with artificial parts made with metal and plastic. It can significantly improve pain and function but may require revision in the future.

Cost of the Treatment for Osteoarthritis of the Knee

The total cost of treating the disease in India is variable based on the procedure which suits the patient. It can also differ majorly based on the hospital, the complexity of the case, and the surgeon's experience. The average expense for knee replacement surgery in India is ₹3,50,000.

Delaying treatment for osteoarthritis of the knee can lead to several serious complications. The common scenarios include:

1. Increased Joint Damage: A longer delay can lead to increased cartilage deterioration. The damage may lead to increased bone loss and joint deformity.

2. Muscle Weakness: Limited mobility and constant inflammation weaken the surrounding muscles. This makes post-operative rehabilitation more challenging.

3. Constant Pain Management: Delaying treatment often requires more pain medication and can severely affect the quality of life.

4. Joint Stiffness: Progression of arthritis reduces joint mobility. This can eventually result in stiffness and contraction of soft tissues around the joint.

5. Bad Posture: Poor form due to knee pain can lead to additional strain on the knees and other body parts.

6. Risk of Injury: Improper movement and restricted mobility can increase the risk of injuring the other knee or losing stability.

7. Surgical Complications: Avoiding surgery can make the procedure more complex and longer. This increases the risks and recovery period.

8. Overall Health Decline: Reduced physical activity due to knee pain can lead to weight gain, cardiovascular issues, and other health problems.

When to call a doctor?

It is important to seek help if the knee osteoarthritis symptoms occur more frequently. The patient must contact a doctor in the below-mentioned cases:

1. Persistent Pain: Tenderness or stiffness in one or more joints that lasts for three days or more.

2. Swelling: Swollen joints, especially after extended activity.

3. Limited Range of Motion: Difficulty moving a joint or performing common daily activities.

4. Redness and Warmth: Joints that are red or warm to the touch, which could indicate inflammation or infection.

5. Sounds: A clicking or cracking sound when a joint bends.

6. Symptoms of Sickness: If you have a fever along with knee pain.

A healthy diet can support joint health and help manage the condition. Here are some dietary recommendations:

1. Fruits: Berries, cherries, and oranges.

2. Vegetables: Leafy greens like spinach, kale, and broccoli.

3. Omega-3 Fatty Acids: Salmon, mackerel, and sardines, as well as flaxseeds and walnuts.

4. Lean Proteins: Chicken, turkey, tofu, and legumes.

5. Healthy Fats: Olive oil, avocado, and nuts.

6. Dairy: Milk, yoghurt, and cheese.

7. Hydration: Drink plenty of water to maintain joint lubrication and overall health.

8. Spices and Herbs: Anti-inflammatory spices like turmeric and ginger.

Osteoarthritis of the knee is a common condition that affects millions of people worldwide. By staying informed and proactive, you can take steps to alleviate pain and improve your quality of life.

If the symptoms have just started, incorporating osteoarthritis knee exercises into your daily routine can significantly help maintain joint health. For more information and personalised advice, consider consulting with our team at HexaHealth. We offer expert guidance and support for managing the disease with the most suitable treatment option.