Osteoarthritis is the most common arthritis form that affects millions of people across the globe. While OA can affect any joint, it often damages the knees, hands, spine, and hips. Also known as wear and tear arthritis, the condition develops when the protective cartilage cushioning the ends of the bone in a joint wears away over time. Joints are parts of the body where two or more bones meet. These parts include your knee, hip, hands, backbone (any part of the body that you can bend has a joint).
The ends of the bones in a joint have a smooth, slippery surface referred to as the cartilage. This protective covering allows the bones to rub against each other without friction. Osteoarthritis causes the wear and tear of the cartilage between the bones, making the joint rough. The increased resistance at the joint causes stiffness, pain, swelling, and decreased ability to move.
While various treatments help in managing the OA symptoms, damaged joints are not reversible. Maintaining a healthy weight and staying active c will also help in slowing the disease progression. Although OA can affect both men and women at any age, individuals aged over 45 years are at an increased risk. Based on the research done by the Arthritis Foundation, osteoarthritis affects more than 27 million people in the USA alone, with the knee being the most susceptible part. Research also shows that women are at an increased risk of developing OA than men.
The most common cause of knee pain is knee osteoarthritis. The pain may come and go, become worse over time, or come accompanied by other symptoms, including knee stiffness. The condition develops due to degeneration of the cartilage. While the cartilage does not contain any nerves, damage or missing cartilage in the knee causes friction between bones and bone tissue changes, leading to pain. For example, damaged cartilage can lead to various bone changes such as:
Bone spurs, also known as osteophytes, are abnormal bony growth at the knee joints with damaged cartilage. The joint bones produce the bone spurs to compensate for missing or deteriorated cartilage. Bone spurs have an irregular shape that creates more friction in the knee joint, causing discomfort and pain.
Due to undistributed weight loads, the tibia and femur surfaces, which lie beneath the cartilage, can change in composition, making it harden.
Missing or deteriorated knee cartilage can also lead to cysts development and bone marrow lesions (areas of abnormal swelling). These cysts and lesions lead to knee discomfort and pain.
For most people, the knee osteoarthritis symptoms come and go, worsening over time. While it is easy to dismiss early knee OA signs and symptoms, the symptoms become worse if left untreated, causing mobility issues. Some of the common OA signs and symptoms include:
Knee pain is the most reported OA symptom. The pain description often varies from one person to the other depending on their condition and situation. Sometimes the pain may come and go, while the person may experience chronic low levels of pain with intermittent intense pain flare-ups. On the other hand, you may experience a dull, aching. Most often, knee OA pain gets worse, especially when doing activities that put a strain on the knee, such as walking upstairs or squatting.
Damaged cartilage causes the femur and tibia bones to rub together, leading to irritation. The irritation forces the body to produce excess fluid at the joint, making the knee swell.
The swelling and friction in the knee make the joint stiff. You may often experience 30 minutes of stiffness after sitting for an extended period or early in the morning. Knee stiffness can also be accompanied by reduced motion range and visible swelling.
The irritation develops when the knee joint’s bones rub each other causing the skin over the knee to become warm and red. These signs could also indicate an infection that requires medical attention.
The swelling in the knee limits your range of motion. Mild to moderate knee OA makes it hard for you to bend or straighten the knee completely.
Your knees tend to become stiff after long periods of sitting or sleeping. In most cases, you will notice pain and stiffness after waking up in the morning or sitting for long hours.
A popping or crunching sound when bending your knee indicates knee joint friction.
People with moderate to severe knee OA can also cause a sensation of knee-buckling. The sensation develops when there are uneven flaps or grooves, or cartilage breaks off and sticks in the joint.
Although Knee OA affects as many as 45 percent of people in their lifetime, the exact cause is unknown. However, medical practitioners have discovered several risks that increase the chances of developing knee osteoarthritis. These include:
Your susceptibility to developing OA increases with age. As you grow old, the cartilage in the knee joint wears down, making it prone to damage and thinning. According to research done by the Arthritis Foundation, about 19 percent of people over 45 years have knee OA. The research further indicates that 37 percent of people over 60 years have the condition, although not all will have the symptoms.
The knees support the weight from the thighs upwards. Obese people are at two times more risk of developing knee arthritis than individuals who are not.
Surgery, a broken bone, or severe injuries that affect the knee joint can also lead to knee OA. These symptoms may not be present immediately after the injuries but may reveal years later.
Hereditary genes also play a crucial role in the susceptibility of knee arthritis. For instance, if your mother had knee OA, you are more likely to develop the condition than people with no family history of the condition are.
Septic arthritis, gout, poor bone alignment, congenital conditions, and metabolic disorder can also increase your susceptibility to contracting knee arthritis.
Individuals whose daily activities involve heavy lifting while standing, crawling, or squatting tend to experience mini-traumas. These mini traumas can lead to knee osteoarthritis over time—bodybuilders and other athletes who participate in high-impact sports are prone to knee OA development.
Although putting too much stress on your knee joint can lead to arthritis, lack of exercise can also cause OA. Exercise helps in boosting the cartilage’s health and repair. Additionally, the knee joints contain fluid-rich nutrients that need to be circulated in the knee joint capsule. Regular exercise promotes proper circulation of the joint fluid.
Poor hamstring, calf, and quadriceps muscle development can put more stress on the knee’s bones and cartilage, causing knee osteoarthritis.
Research shows that women are about 40 percent more likely to develop knee arthritis than men are.
The diagnosis process for knee osteoarthritis starts with a thorough physical examination by a qualified doctor. Your physician will also collect your medical history and ask you about any symptoms you may be experiencing. Ensure that you explain your symptoms in detail and point out what makes the pain better or well. It is also essential to find out if other members of your family have knee arthritis.
Besides collecting the information and performing a physical examination, your doctor may also request additional testing such as x-rays and MRI scans. The X-ray imaging shows the extent of the cartilage damage and any presence of bone spurs. Magnetic resonance imaging (MRI) scans are more precise and detailed and help the doctor see the bones, cartilage, and other joint tissue damage. The doctor may also request blood tests that will help him to rule out other conditions that may be causing the knee pain.
Like most other diseases, addressing the symptoms of knee OA from early stages helps prevent the condition from worsening. Various treatments are available for knee arthritis. As mentioned, this treatment’s primary aim is to stop the condition’s progression since damaged joints are not reversible. The main types of knee osteoarthritis include medications, non-surgical treatments, surgeries, and injections.
Your doctor will choose the right approach depending on your general wellbeing and the condition progression level. Like other arthritic conditions, lifestyle modifications can help protect your knee health and slow the progression of knee arthritis. Your physician may recommend following the following lifestyle changes.
Several types of medications and injections help in treating knee arthritis. However, since people respond to different medications, your physician will work closely to determine the right drugs and injections that are effective for you. Your doctor may recommend taking pain-relieving drugs to help ease the knee arthritis pain. These drugs include
Drugs such as acetaminophen are effective in relieving the pain associated with knee osteoarthritis. Anti-inflammatory drugs such as ibuprofen, aspirin, and naproxen can help relieve pain and inflammation.
If over-the-counter medications do not work, your doctor will prescribe more potent painkillers such as ibuprofen, naproxen, and COX-2 inhibitors.
This medication comes in both over-the-counter and prescription formulas. They are usually creams that you can apply onto the skin over the knee joint skin. Unlike oral medications, topical analgesics do not carry risks such as dependency and stomach upsets.
Injections are also effective in treating knee OA symptoms. Some of the joint injections for knee arthritis include;
Hyaluronic acid injections– Also referred to as visco-supplementation-provide the lubricating fluid needed to reduce friction in the knee joint.
Platelet-rich therapy (PRP) injections – These injections help in boosting tissue repair and healing.
Stem cell injections –The injections contain cells harvested from your fat or bone marrow. When injected into the knee joint, these cells will promote new tissue growth.
Prolotherapy- this therapy form involves injecting several irritant injections to help restart the body’s natural healing process.
Physical therapy programs include specific exercises such as stretching, strengthening, and aerobics to help strengthen the muscles and increase your range of motion. Your physical therapist will develop a personalized program that addresses the issues that may be contributing to your knee pain and discomfort.
The exercises will help strengthen the knees’ muscles and stretch the inflexible, tight muscles such as your hamstring. Additionally, physical therapy programs will also include aerobic exercise that encourages proper circulation of fluids and nutrients in the body. Physical therapy also involves gait and posture training. Restoring the proper posture can help eliminate the stress on the knee that may be causing the pain and discomfort.
Most people suffering from knee osteoarthritis will never undergo surgeries. However, people experiencing severe symptoms or who do not respond to other treatments may only have surgery left as their best option.
Arthroscopy – This is a minimally invasive surgery that helps relieve pain and discomfort in the knee. The procedure involves making a small incision in the knee and using thin instruments to treat the problem.
Cartilage grafting- The procedure involves taking healthy cartilage tissue from another part of the body and filling the damaged cartilage in the knee joint. This surgery is appropriate for young patients with minimal cartilage damage.
Osteotomy – The surgery involves cutting and reshaping either femur or tibia bone, relieving the pressure on the knee joint. The procedure is often performed for people with mild OA, which has damaged only one side of the knee joint. By balancing the weight in the joint, the procedure will help relieve pain and slow the condition’s progression.
Arthroplasty – This procedure is performed for people with severe cartilage damage. The surgeon usually cuts the damaged cartilage and bone and then replaces them with plastic or metal surfaces, restoring your knee function.
Geniculate Artery Embolization (GAE), also known as genicular artery embolization, is a new and advanced minimally invasive procedure that provides immediate and long-term pain relief for patients suffering from osteoarthritis (OA). The procedure reduces the flow of blood to the synovium (the lining of the knee). By blocking these arteries, the inflammation that is associated with osteoarthritis reduces significantly, eliminating knee pain. Is GAE suitable for me? What benefits does it have over traditional OA treatments? Before answering these questions, let us first discuss what osteoarthritis is and its effect on our wellbeing.