Arthritis is inflammation of one or more of your joints. Read on to find out more about your treatment options
25 July 2018| Last updated on 25 July 2018
Pain, Swelling, and stiffness are the primary symptoms of arthritis. Knee arthritis can make it hard to do many everyday activities, such as walking, stair climbing and even praying.
The knee is the largest and strongest joint in your body. It is made up of the lower end of the femur (thighbone), the upper end of the tibia (shinbone), and the patella (kneecap). The ends of the three bones are covered with articular cartilage, a smooth, slippery substance that protects and cushions the bones as you bend and straighten your knee.
Two wedge-shaped pieces of cartilage called meniscus act as "shock absorbers" between your thighbone and shinbone. Four major ligaments give support and stability to your knee joint.
Osteoarthritis is the most common form of arthritis in the knee. It is a degenerative, "wear-and-tear" type of arthritis that occurs most often in people 50 years of age and older, but may occur in young people, too.
In osteoarthritis, the cartilage in the knee joint gradually wears away. As the cartilage wears away, it becomes frayed and rough, and the protective space between the bones decreases.
This can result in bone rubbing on bone, and produce painful bone spurs. Osteoarthritis develops slowly and the pain it causes worsens over time.
A knee joint affected by arthritis maybe painful and inflamed. The joint may become stiff and swollen, making it difficult to bend or straighten the knee. Pain and swelling may be worse in the morning or after sitting or resting.
Vigorous activities may cause the pain to flare up. The knee may pop, lock, stick, click, snap, or make a grinding noise. Even though the symptoms develop gradually, sudden onset is also possible.
These imaging tests create a detailed pictures of the bones. X-ray of an arthritic knee may show a narrowing of the joint space, changes in the bone and the formation of bone spurs. When it is possible, a weight bearing (standing) x-ray is more preferable.
Although the most important test in diagnosis of osteoarthritis is plain x-ray; occasionally, MRI scan, CT scan and blood tests may be needed to rule out other causes of knee pain. These tests are only needed if the plain x-rays fails to confirm the diagnosis.
There is no cure for arthritis, but there are a number of treatments that may help relieve the pain and disability it can cause.
As with other arthritic conditions, the initial treatment of arthritis of the knee is non surgical. Some changes in your daily life can protect your knee joint and slow the progress of arthritis.
Avoiding high impact activities such as running and jumping; and increasing low impact activities such as swimming and cycling will put less stress on your knees. Losing weight can also reduce the stress on the knee joint. For every one kilogram of weight loss, you will reduce the stress on the knees by three kilograms.
Using assistive devices such as a cane will also reduce the stress on the knees. Several types of drugs are useful in treating the symptoms of arthritis, specifically non steroidal anti-inflammatory medications such as Ibuprofen and Celecoxib. However, chronic use of medications does have additional side effects on the kidneys, liver and stomach.
Corticosteroid (also known as cortisone) are powerful anti-inflammatory agents that can be injected into the joint. These injections provide pain relief and reduce inflammation; however, the effect will not last indefinitely. Because of possible the side effects, your doctor may limit the injections not to more than 3-4 times per year.
Viscosupplement gel ( Hyalouronic acid) injections may improve the quality of the joint fluid but their efficacy have not been proven.
Platelet Rich Plasma(PRP) is a term used to describe concentrates of platelets prepared from your blood. Platelets contain numerous proteins called growth factors that are important in healing of injuries. Unfortunately, at this time we do not know which growth factor is useful for which condition. Therefore, even though, PRP can be helpful, there is no scientific study that supports its use.
Stem cells are unspecialized cells that have the ability to differentiate into multiple different cell types and replicate themselves; hence, regenerating the diseased cells. Unfortunately, like PRP, their function and utility remains poorly understood and controversial.
If the non-surgical treatment does not help, and you have limitations of your daily activities, and cannot live with your pain, then you may consider surgical treatment.
Knee replacement surgery is one of the most successful procedures in all of medicine.
Your doctor will remove the damaged cartilage and bone and then position new metal and plastic surfaces to restore the function of your knee. In most cases; surgery will relieve pain, make it possible to perform daily activities more easily, and improve the quality of life. However, like any other surgical procedure, there are specific risks, and there is no guarantee in the final outcome.
Dr. Kevin Shamlou