by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
Click here: Second Opinion Arthritis Treatment Kit
Osteoarthritis (OA) is the most common type of knee arthritis. This type of arthritis is also called wear-and-tear arthritis or degenerative joint disease.
OA is characterized by progressive wearing away of the cartilage of the joint.
Other varieties of arthritis that may affect the knee include: rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Reiter’s disease, Lyme disease, septic arthritis, gout, and pseudogout. These types of arthritis are more inflammatory and affect a somewhat different age group.
Knee arthritis due to OA typically affects patients past 30 years of age, although it may be symptomatic in younger people. Evidence suggests it may begin much earlier in people predisposed to the disease. It is more common in patients who are overweight. Weight loss reduces the symptoms associated with knee arthritis. There is also a genetic predisposition of this condition, meaning knee arthritis tends to run in families. Other factors that can contribute to developing knee arthritis include trauma to the knee, meniscus tears or ligament damage, and fractures to the bone around the joint.
Knee arthritis symptoms tend to progress as the condition worsens. Knee arthritis symptoms tend to wax and wane. Often patients report good months and bad months or symptom changes with weather changes. This is important to understand because comparing the symptoms of arthritis on one particular day may not accurately represent the overall progression of the condition.
The most common symptoms of knee arthritis are:
• Pain with activities
• Limited range of motion
• Stiffness of the knee
• Swelling of the joint
• Pain at night
• Tenderness along the joint
• A feeling the joint may "give out"
• Deformity of the joint (knock-knees or bow-legs)
Evaluation of a patient with knee arthritis should begin with a physical examination and imaging studies such as x-rays and MRI. These can serve as a baseline to evaluate later examinations and determine progression of the condition.
Treatment of knee arthritis should begin with the most basic steps. Not all treatments are appropriate in everyone.
Weight loss is important, yet it is often the least commonly performed of treatments. The less weight the joint has to carry, the less painful activities will be. Adipocytes (fat calls) have been shown to produce leptins, proteins that promote inflammation. All the more reason to lose weight.
Limiting certain activities may be necessary, and learning new exercise methods may be helpful. Aquatic exercise is a good option for patients who have difficulty exercising.
Use of a cane or a single crutch in the hand opposite the affected knee will help decrease the demand placed on the arthritic joint.
Strengthening of the muscles around the knee joint (the quadriceps and hamstrings) may help decrease the burden on the knee. Preventing atrophy of the muscles is an important part of maintaining functional use of the knee.
Medications including analgesics and anti-inflammatory medicines (NSAIDs) often help with pain and inflammation.
Cortisone injections may help decrease inflammation and reduce pain within a joint. They should not be given more often than 3 times per year.
Viscosupplemnts are lubricants that may be effective for pain and may also help retard progression of disease. Viscosupplements may delay the need for knee replacement surgery.
Glucosamine and chondroitin supplements appear to be safe and might be effective for treatment of knee arthritis. Research into these supplements is ongoing.
Certain new types of braces are able to “unload” the narrowed compartment in patients with knee arthritis. This helps reduce pain and allow easier and less painful walking.
Knee Osteotomy- cutting a wedge of bone out of the tibia to align the leg better- may be an alternative to more invasive surgery. While most patients are not good candidates for this alternative to knee replacement, it can be effective for young patients with limited arthritis.
Total Knee Replacement Surgery is a procedure where the cartilage is removed and a metal & plastic implant is placed in the knee.
Partial Knee Replacement Surgery is also called a unicompartmental knee replacement. This is replacement of one part of the knee. It is a surgical option for the treatment of limited knee arthritis.
The latest and most promising treatment is the use of autologous stem cell therapy and platelet rich plasma using the guided mesenchymal layering technique to help regrow cartilage. For more information:
Stem Cells for Osteoarthritis
Also, call the Arthritis Treatment Center at 301 694 5800 or contact them at www.arthritistreatmentcenter.com
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Second Opinion Arthritis Treatment Kit
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