What is osteoarthritis?

Osteoarthritis is a type of arthritis that is caused by the breakdown and eventual loss of the cartilage of joint. Cartilage acts as a "cushion" between the bones of the joint. It also absorbs shock of physical movement. Osteoarthritis is the most common type of arthritis and it occurs as we age, Osteoarthritis commonly affects the large weight-bearing joints, such as the hips and knees. Osteoarthritis can also be caused by another disease or condition. Conditions that can lead to secondary osteoarthritis include obesity, repeated trauma or surgery to the joint structures, abnormal joints at birth, gout, diabetes. Next to ageing, obesity is the most powerful risk factor for osteoarthritis of the knees.

What are symptoms of osteoarthritis?

Common symptom is pain in joint after repetitive use. Joint pain is usually worse later in the day. There can be swelling, warmth, and creaking sound of the affected joints. Pain and stiffness of the joints can also occur after periods of inactivity, for example, sitting in a theater. In severe osteoarthritis, complete loss of cartilage cushion causes friction between bones, causing pain at rest with limited motion.

How do you know if you have osteoarthritis?

Early in the disease, the joint may ache after physical work or exercise. Later on, joint pain may become more persistent. Knees: The knees are among the joints most commonly affected by osteoarthritis. Symptoms of knee osteoarthritis include stiffness, swelling, and pain, which make it difficult to walk, climb stairs, and get in and out of chairs and bathtubs. Hips: As with knee osteoarthritis, symptoms of hip osteoarthritis are pain and stiffness of the joint. Sometimes pain is felt in the groin, inner thigh, buttocks, or even the knees. Osteoarthritis of the hip may limit walking, sitting and bending, making daily activities such as dressing and putting on shoes and socks, a challenge.

Stage of osteoarthritis

Stage I: In this stage there is mild swelling of the joint and person feels pain on exertion and overuse. Stage II: Person feels pain at lesser effort and there may be instability of the joint. Stage III: The joint gets deformed and walking distance is greatly decreased and there is a feeling of instability. Stage IV: In this advanced stage of disease, person may house bound and joints are markedly deformed.

Self-Care

Get yourself educated about the disease. Do regular physical activity. Eat well and maintain your body weight. Get plenty of sleep. Use assistive devices like walking stick to take weight off your knee or hip as you walk. Maintain good posture. Use your strongest muscles and favour large joints.

What are the common causes of joint pains?

The most common cause of joint pains is osteoarthritis which is a degenerative joint disorder that occurs as a result of age related wear and tear of joints. Osteoarthritis mainly affects knee and hip joints. Other diseases that can cause joint pains in younger age group are rheumatoid arthritis, ankylosing spondylitis and similar conditions.

When should one consult a specialist?

One should consult a specialist in case of significant pain in the knees affecting the quality of life. Other warning signals include swelling around the joints, stiffness or inability to bend or straighten knees fully, or gradually developing deformity.

Is there any non-surgical treatment modality for osteoarthritis?

In early stages, osteoarthritis is treated by means of exercises and life style modifications that include avoiding strenuous activities like squatting, crosslegged sitting and minimizing the use of stairs.

When should one seriously consider surgery?

Surgery in the form of joint replacement is required when the disease becomes advanced enough to lead to loss of quality of life. In case the non-surgical means of treatment have failed to provide adequate relief, and one has to depend upon analgesics daily to get some relief, or if the deformity becomes obvious, then I think one should seriously consider joint replacement surgery.

How successful is a joint replacement surgery?

Joint replacement surgery is one of the most successful procedures in orthopaedics. Infact, joint replacement has been termed as the greatest orthopaedic invention of the twentieth century. A joint replacement performed by experienced surgeon, can improve the quality of life tremendously by making the patient free of pain, deformity and giving physical dependence. Patients sometimes go to the extent of telling that they are an entirely different person after surgery since they have a new life, a life full of motion, and free of agony.

Is it a lifetime solution?

Mostly joint replacements last lifetime, if performed around sixty years of age or later. In younger patients suffering from advanced rheumatoid arthritis or other crippling disorders like ankylosing spondylitis, the artificial implants last as much as 15-20 years depending upon the lifestyle and activity profile of the patient. In such cases, another surgery is required to remove the worn out implants and put new implants again. The new implants then function normally as a new joint.

Your knee your life

The Knee Joint is the largest joint in body. A normal knee has painless movement. Arthritis of any cause can damage the joint and surrounding ligaments. This produces pain. Swelling and limits walking. An advanced stage of the disease also causes bowing of the legs with stiffness. In early stages disease can be controlled by regular exercise and occasional medication. Change in lifestyle like walking with a cane will help off-loading the joint and reduce pain. To tide over severe pain, injecting local steroid in the joint (with adequate precaution) can prove beneficial. If however, the symptoms persists after these simple measures and the disease is affecting the daily lifestyle then your surgeon might suggest a knee replacement to relieve the symptoms and deformity.

Knee replacement benefits people who have:

What is a knee replacement?

Knee replacement surgery is usually performed for persons who are 60 years and above. Patients who are younger may also require it if the knee has been previously damaged by trauma or disease like rheumatoid arthritis. Traditionally Knee replacement surgery consists of replacing the damaged joint with In essence, it replaces all the surfaces of the joint, therefore the name Total Knee replacement. These implants are placed securely in the joint with bone cement.

Advances in Knee Replacement

Conventional knee replacements allow up to about 100 degrees of knee bending. Over the year's development in the design and technology have produced prostheses which allow increased knee bending with freedom to enjoy more recreational and day to day activities after a knee replacement.

 

High Flex Knees is used in selected patients who have good knee bending before the operation. High flexion rotating platform knee replacement allows knee bending to, as much as 155 degrees.

Gender-Knee in female are slender as compared to their male counterpart. To match their knees Few companies have made female specific knees which have thinner profile and this is called Gender Knee.

Unicompartmental Knee Replacement

If only part of the knee joint is damaged (eihter the medial or lateral compartment), that compartment may be replaced with partial or unicompartmental knee implant.

Indications for total knee replacement

The rehabilitation outline

Short term goal during inpatient rehabilitation includes:

Exercise