The cartilage gradually roughens and becomes thin exposing the underlying bone. The wear is more common on the inner side of the knee.
Osteoarthritis of the knee joint produces:
· Bone wear leading to asymmetric shape and movements
· Weak ligaments, and
· Changes to articular cartilage and tears of the menisci.
Risk factors :
1. Sportsmen who played contact sports.
2. Previous injury to the knee.
3. Obese people with Body Mass Index>30
4. Occupations involving prolonged squatting or kneeling, carrying heavy weights regularly, repetitive strain to knees.
5. Crystal Deposits such as uric acid in the joint is a chemical risk factor and may damage the joint fast.
Symptoms: Develops slowly over several years.
*In the beginning there may be some discomfort after a long walk or exertion. *Later stages: Stiffness after rest / sitting for some time and early in the mornings.
*Swelling of the joint
*Clicks or grinding noises from joint
*As the condition progresses, pain can interfere with simple daily activities and can disturb sleep.
* Muscles may become weak and thin. *Patient may also develop bow legs or knock knees.
Treatment Options:
Treatment depends up on the stage of the OA. It cannot be cured at once but one should not consider this as a disease. We can slow down the progression of the disease and to make life more comfortable:
· Knee Supports/Braces – Some splints provide pain relief with external support but can be uncomfortable to wear
· Assistive Devices – Such as cane or walker can be used to help in walking
· Medications – To control pain and to nourish cartilage (dietary supplements).
· Topical Creams/gels - Topical creams provide an alternative to oral medications.
· Heat and Cold Treatments - Local application of heat or cold can help with relief from pain and inflammation after exercise.
· Weight Loss - Weight loss can have a significant effect on slowing the disease progression.
· Exercise Program - A specific exercise program can help to maintain healthy cartilage and range of motion of the joint. In addition, keeping the attaching muscles and tendons conditioned and strong will aid in the joint's stability. If exercising is difficult, hydrotherapy may be useful to reduce the stress on the joints.
· Viscosupplementation - A ‘joint lubricant’ can be administered as an injection. This substance helps to lubricate and nourish the knee joint and can decrease the amount of inflammation.
· Arthroscopy – This procedure takes care of locking symptoms.
· Knee Replacement Surgery- Has proven it’s place and is hugely successful all over the world in relieving the symptoms from advanced osteoarthritic knees.
Exercise Program:
1. Heel slides: sit or lie on your back and gradually bend your knee by sliding the heel on the mattress.
2. Static quadriceps exercises: Sit with your legs straight and keep a rolled towel under your knee. Press the knee against the towel while tightening the thigh muscles. Hold this for count of 5 to 10.
3. Hamstring strengthening exercises: Sit with your legs straight and keep a rolled towel under your heel. Press the heel against the towel while pressing the knee to the ground. Hold this for count of 5 to 10.
4. Hamstring stretching exercises: Sit on a chair with your back straight. Lift the foot up by pulling it towards you and straighten the knee. Hold this for count of 5 to 10.
NOTE: Each exercise should be repeated atleast 10- 20 times and should be done within your pain limits.