Arthritis is the scientific term to describe to describe inflammation of the joint.
The most common cause of arthritis is the age related wear and tear of the cartilage which is called as Osteoarthritis (OA). The second most common cause for arthritis is Rheumatoid Arthritis (RA) which is an autoimmune disorder.
Yes. Injuries or fractures that cause damage to the smooth gliding surface of the joint (cartilage) can lead to arthritis. Additionally, injuries to the supporting structures of the joint such as the ligaments, joint capsule and menisci can lead to arthritis.
Common symptoms of arthritis include pain on activity such as walking for long distances, pain on climbing up and downstairs, swelling of the knee and stiffness. During the initial stages of arthritis the pain occurs only on excessive activities but as the disease progresses the pain can occur even at rest and in the night while sleeping. The pain is usually located along the inner side of the knee and sometimes around the knee cap.
Additional features of advanced arthritis include bowing of the legs and change in the way the patient walks.
Detailed history regarding onset and progression of symptoms along with a thorough physical examination by the surgeon usually gives a clue to the diagnosis of arthritis.
X rays of the knee in standing position will show a reduction in the gap between the thigh bone (Femur) and the leg bone (Tibia). This reduction in gap signifies that the cartilage and the meniscus (disc of cartilage) between the bones has got thinned out and is no longer providing a cushioning to the bones of the joint.
Blood test may be required when rheumatoid arthritis is suspected to be the cause knee pain.
Maintaining ideal bodyweight through regular exercises and diet management can help in prevention of osteoarthritis. Exercises to strengthen the abdominal, hip and knee muscles also help in unloading of the joint and can help in preventing arthritis in the long run.
Appropriate treatment of ligamentous injuries of the kneeto restore joint stability can prevent early onset of arthritis especially in young patients.
These include pain killers and nutritional supplements.
Mild to moderate strength pain killer medications are prescribed to control symptoms of arthritis. However, such medication cannot be prescribed for longer duration as they are associated with harmful effects on the liver and the kidneys especially in elderly population suffering from arthritis.
Nutritional supplements in the form of glucosamine preparations can be helpful in early stages of osteoarthritis when joint damage is not excessive.
Glucosamine injections serve the same purpose as that of oral preparations and are effective in early stages of osteoarthritis.
Steroid injections provide short term relief of symptoms and repeated use may accelerate joint damage.
At times patients with osteoarthritis develop acute tear in their menisci (Cartilage Discs) which causes acute aggravation of pain and swelling of the knee. The loose fragments of the torn menisci can lead to locking of the joint. In such cases, arthroscopic surgery can be performed to treat the torn menisci and to remove the loose bodies. During this procedure bony spurs are removed and joint is irrigated which leads to resolution of symptoms.
This is usually the last resort when patients have tried all other treatment modalities and still experience pain and disability from arthritis.
It is a surgical procedure in which the worn out surfaces of the knee joint are removed and replaced with metallic parts which are usually fixed to the bone with special bone cement. The space in between the metallic parts is filled with a specialised polyethylene disc. If the knee cap has worn out it is replaced as well with a polyethylene button.
TKR is highly successful in resolving pain, swelling and stiffness due to arthritis in 90-95% of patients. Additionally, TKR can straighten the bowing of the legs.
Physiotherapy exercises after surgery are highly essential for the success of TKR.
Arthroscopy is a surgical procedure in which keyhole incisions are made to assess the interior of the knee joint with the help of specialised instruments.
The potential advantages of arthroscopy are:
Arthroscopy is a useful tool for reconstruction of torn ligaments, repairing of torn cartilages, removal of loose pieces of cartilage and bony spurs.