IF you have a sedentary lifestyle and your work forces you to sit for more than eight hours a day then you are at a high risk for developing knee arthritis. Knee arthritis typically affects people above the age of 45 years but is most commonly seen in overweight females above the age of 50 years not doing knee exercises regularly. Knee pain typically affects 10 per cent of people between the age of 35-45 years, 30 per cent between 45-55 years and almost 70 per cent of population after 55 years. However, knee arthritis is a preventable problem and the need for knee replacement surgery can be avoided by few simple precautions and measures.
What causes knee arthritis?
With increasing age the natural cushioning between joints of the knee slowly wears away. Due to this, the surface of the knee-joint start rubbing against each another leading to loss of cartilage layer in early stages and ultimately leading to bone rubbing and instability in knee in later stages. In advanced stages there is lot of extra bone formation and fluid secretion within the joint leading to swelling.
What are the symptoms of arthritis?
In the early stages of arthritis patient often complain of pain around knee in morning, while climbing stairs or kneeling. In the second stage the pain becomes more persistent and is accompanied by swelling around the knee. In the third stage stiffness settles in, making walking or folding the knee difficult. Finally, in the fourth stage the pain is sever accompanied by bowing of legs, locking, poor range of motion, cracking noise and grinding sensation within the knee.
How to prevent arthritis?
The answer is simple, few lifestyle modifications and exercises. Few important measures are:
- Reduce Weight: Overweight people are more prone to develop knee arthritis. Simple way is to keep your weight always under control.
- Avoid sitting cross legged or squatting on floor (avoid Indian type of toilet seat, switch to European type).
- Avoid climbing stairs (if possible).
- Regular knee exercises (10 minutes daily).
- Avoid walking on concrete roads or hard surfaces. Treadmill walking or garden walking is preferred.
- Always wear good shoes while walking/running.
What to do if early arthritis is developed?
If you have early knee arthritis and you want to avoid a surgery in future, follow these simple steps:
- Wear a knee cap while walking or standing. A special type of brace is also available for patients with severe pain (called off-loader brace).
- Use dietary supplements like glucosamine and chondroitin sulphate.
- Start supervised physiotherapy for your knee.
- Use of occasional painkiller is allowed, preferably like crocin or aspirin. Avoid using strong painkillers which can affect kidneys.
When to see a doctor?
You should consult a doctor when knee pain starts troubling during day-to-day activities or you feel like taking a painkiller often. He might ask you to get an x-ray along with few blood tests done to understand the stage of your arthritis.
What are the options in case of severe arthritis?
In later stages of knee arthritis, options include:
- Giving injections in the knee joint. These injections may be of lubricating fluid (hyaluronic acid) or anti-inflammatories like steroids or platelet rich plasma (PRP). Typically, these injections give relief from symptoms ranging from 3 months to 1 year. They can be repeated as and when required.
- Cleaning the joint using a telescope (called arthroscope). This typically gives relief from 6 months to 1.5 years.
- Knee Replacement Surgery: Depending upon your condition your doctor may advise you half or full knee replacement surgery. Nowadays knee implants are available with life up to 30 years.
(The writer is Senior Consultant Orthopaedic Surgeon, Artemis Hosital, Gurgaon; MC.h Orthopaedics (University of Edinburg, UK), Joint Replacement Fellowship, FNB Spine Surgery, DNB Orthopaedics.)