Knee Osteoarthritis: Not Just For The Grey Nomads

What Is Knee Osteoarthritis?

Osteoarthritis (OA) is often referred to as a “wear and tear” arthritis. Knee osteoarthritis is a condition where your articular knee cartilage (the natural cushioning between joints) wears away. The knee is one of the most commonly affected areas with regard to osteoarthritis and can result in pain, swelling, stiffness, and a decreased function and ability to move. With osteoarthritis age is considered a major risk factor with the number of cases rising in the over 55 population. However this is not to say that young people under this 55 yr old age bracket can’t also suffer with knee osteoarthritis.

Risk Factors For Osteoarthritis Of The Knee

Beyond age there are other factors that play a role in someone’s risk of developing knee osteoarthritis, such factors include:

• • Being female, women are more likely than their male counterparts to suffer with osteoarthritis in many areas of the body including the hand, knee and hip.
  • Heredity factors where there are abnormalities in the knee, altering biomechanics and therefore placing additional stress at specific areas of the knee.
  • Injury Or Repetitive Stress, as a result of work, hobbies, or physical activity choices someone may expose their knees to more stress via injury, or repetitive loading such as squatting, lifting and kneeling activities.
  • Weight, Carrying excess weight places more stress on the knee and subsequently increases someone’s risk of developing knee osteoarthritis.

Interesting Fact: Data from the National Health and Nutrition Examination Survey (HANES I) indicated that obese women had nearly 4 times the risk of knee OA as compared with non-obese women and for obese men, the risk was nearly 5 times greater.

Treatment For OA Of The Knee

Once the arthritic process has started it can never be halted, or reversed but the rate of progression of the disease process can be slowed. Commonly there are non-surgical as well as surgical options for the treatment of osteoarthritis of the knee. Once all other treatment options have been exhausted having a total knee replacement (TKR) remains the final step to relieve the pain of knee osteoarthritis.
Following having a TKR it is not recommended that you every run on the prosthesis. There is around a 90% survival rate of TKR hardware lasting 10-15 years following surgery. This survival rate of the hardware is a major reason why managing younger patients with osteoarthritis can be more challenging. Having a total knee replacement as a treatment approach for knee osteoarthritis works very well in the older population with osteoarthritis, however because of the typically greater demands placed on their knees by younger patients a TKR is very much a last resort in this population. Yet in saying this all patients need to manage their loading following a TKR and need to be realistic about their goals, but this is especially relevant for the younger patient.

Non-Surgical Treatment Of Knee OA

Research suggests that non-surgical treatment of osteoarthritis of the knee can improve symptoms, typical conservative knee OA management may include:

• Anti-inflammatory medication – some patients can use these safely to good effect for a very long time, however others will suffer side effects from either short or longer term use.
• Supplements including glucoasmine and fish oil have limited research proving their benefit but substantial anecdotal evidence of benefit.
• Footwear adjustments and bracing options can work with some knee OA patients. Helping to support the joint, improve biomechanics and reduce load on the knee. This can work to both reduce pain and improve function, however any benefits are lost when the brace/footwear adjustments are not being used.
• Activity modification and targeted exercises – Activity modification works to reduce loading stress to the joint and target exercises like muscle strengthening can help restore any functional losses.
• General exercise and weight management – appropriate exercise has been shown to reduce pain and improve function in patients with early knee OA. For the obese patient losing weight will also improve any associated knee OA symptoms.

Worth Noting: Unfortunately any beneficial effects of exercise are lost six months after the exercise/training has stopped, therefore it is important with osteoarthritis of the knee that the management is consistent. Changes shoulder be a long term lifestyle change, not just a short term fix/focus.

• Injections – Injection of hyaluronic acid, as well as cortisone injections have been used to good effect for short term relief of knee OA. This approach is more typically are used when someone is having an acute flare up of their symptoms rather than used as part of an ongoing management regime.

Surgical Management Options For Osteoarthritis Of The Knee

• Surgical management as previously mentioned is typically engaged only once all other treatment options have failed to achieve a satisfactory result.
• Surgical treatments can offer a good solution for osteoarthritis of the knee and even allow for a return to some athletic activities.
• Surgical management may include an arthroscope / debridement (basically like a clean up and wash out of the joint) a partial or unicompartmental knee replacement, and a total knee replacement (TKR).

Disclaimer: This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific medical advice or assistance on Knee Osteoarthritis: Not Just For The Grey Nomads should consult his or her general practitioner, physiotherapist, orthopaedic surgeon or otherwise appropriately skilled practitioner.