Osteoarthritis of Knee

Osteoarthritis is also known as degenerative arthritis, and is one of the most common forms of arthritis affecting an estimated 20 million people in the United States alone. This is a condition that is mainly brought about by wear and tear, and can affect the hands, hips, neck, lower back and knees. Of these, osteoarthritis of the knee is the most common. Although this is a condition that is thought to be brought about by age, and does most often affect people above the age of 50, it can develop in younger people as well. Osteoarthritis is called degenerative because it gradually worsens over time, and currently there exists no known cure. This type of arthritis is associated with degradation of the joints which can also be brought about by means of injury or other joint problems. The following are some of the details relating to the causes, symptoms and treatment of this condition.

Causes
The main cause of this condition is the breakdown of the cartilage that lines the joints, serving as a cushion between the bones. The knee joint, where the femur and tibia meet, is the largest in the body, and also the strongest, since it is this joint that needs to bear the weight of the body and withstand stress when running, as well as lock in position to allow the body to stand. In a normal healthy person, the meeting point of the two bones is lined with cartilage, which allows movement without friction or actual contact between the bones. The knees also have two additional rings of cartilage called menisci, which contribute additional protection by functioning as shock absorbers. This cartilage is nourished by a thick viscous synovial fluid which also provides lubrication to the joint and promotes smooth movement.

The primary cause of osteoarthritis is aging, wherein the water content of the cartilage increases and the proteins of which it is made, begin to degenerate. Continuous use of the joints irritates the cartilage further, which may cause flaking or the formation of tiny crevices; at times, the cartilage may also get inflamed, which can stimulate tiny new growths around the joint, called bone spurs. This loss of cartilage causes friction between the bones, which leads to joint pain and swelling. Osteoarthritis of the knee which is caused as a result of preexisting condition is known as secondary osteoarthritis. This can be caused by -

• Obesity, which places excessive stress on the joints
• Trauma or injury
• Congenital defects
• Gout
• Diabetes
• Marfan's syndrome

Symptoms
The primary symptom of osteoarthritis in the knee is joint pain, which can range from mild, to moderate or severe. This may be accompanied by knee joint effusion or swelling, caused by a build up of fluid around the affected joint. A classic symptom of osteoarthritis in the knee is discomfort when the joint is in use, which disappears once at rest. The pain and inflammation may also be accompanied by stiffness in the joints, along with an awkward gait, muscle cramps or spasms, and a worsening of these symptoms when the weather is cold or wet. These symptoms may get progressively worse as the degeneration continues. The joint may feel tender when light pressure is applied, and loss of flexibility may be experienced. There may also be a grating or crackling sound called crepitus, when the joint is in use.

Treatment
There currently exists no known cure for osteoarthritis, and treatment options focus on reducing discomfort and relieving knee pain, as well as increasing the scope of movement, and reducing stiffness. Medication can help in relief, which is why analgesics are often prescribed for pain management. In some cases, especially if there is effusion or joint swelling, aspiration, or draining of the surrounding fluid can help. Some patients may also benefit from the use of NSAIDS (or Non steroidal anti-inflammatory drugs), such as ibuprofen, localized corticosteroid injections or COX-2 selective inhibitors. Osteoarthritis knee exercises also exist which are performed as part of a physiotherapy rehabilitation system to help in reducing restriction of movement without adding to the pain. In some cases, knee braces may also help in providing support and compresses can aid in immediate relief. Topical creams or ointments may also be prescribed. If medication is ineffective, knee replacement surgery may be considered.

It is untrue that osteoarthritis of the knee inevitably signifies a crippling and disabling condition. The symptoms and severity will differ from person to person, and with care and management, it need not have a marked detrimental effect on the quality of life. With early diagnosis and advancements in pain management, living with osteoarthritis can be a success story. Good luck!