What Is Knee Osteoarthritis?
Osteoarthritis is a condition of the knee whereby there is wear or degeneration of the knee cartilage due to repetitive stress to the cartilage.
What Are The Symptoms Of Knee Osteoarthritis?
Patients with osteoarthritis suffer from painful and stiff knees that can disturb their quality of life.
Who Are At Risk?
Knee osteoarthritis tends to be more common in women than men.
Risk factors of developing knee osteoarthritis include:
- Excessive stress to the knees
- Old age, after the age of 55-60 years
- People with knee ligament injuries that are not properly treated
Can Knee Osteoarthritis Be Avoided?
Cartilage breakdown and wear is inevitable as we age. However, we can take certain steps to reduce knee pain and to prevent stiffness arising from osteoarthritis.
- Control of body weight
Being obese or overweight worsens the cartilage wear due to the extra stress on the cartilage. Reducing weight will slow down the progression of osteoarthritis.
- Regular exercise
Exercising our joints, especially our knees, helps to strengthen the muscles around the joints. Strong muscles that result from regular exercise protect our knees and absorb part of the stress exerted to the knee. Exercising also helps prevent stiffness to the joints. Exercises beneficial for the knees include cycling, swimming etc.
- Prevent knee injuries
Knee injuries put the cartilage at a higher risk of developing osteoarthritis. Hence, adequate warm-up before exercising and wearing protective gear such as a knee guard helps to prevent knee injury. If you have developed any sports injuries to the knees, get them treated early by an orthopaedic surgeon.
We should take these preventive measures while our knees are still healthy. However, even if we develop mild or early knee osteoarthritis, we can still practice these measures to maintain good knee function and to prevent the osteoarthritis from worsening.
What Is The Treatment For Knee Osteoarthritis?
Mild or early osteoarthritis
- Anti-inflammatory medicines
- Physiotherapy and modification of activity
Depending on the extent of the knee condition, some mild or early osteoarthritis can be treated with non-operative treatment such as radiofrequency ablation (RFA), platelet-rich plasma (PRP), hyaluronic acid (HA) injections and stem cells.
Radiofrequency ablation stops the nerves that bring pain sensation to the knee by specifically coagulating it at 3 specific points of the knee. The advantage of this procedure is that the patient can be awake during the procedure and the procedure only takes around 20 minutes. It is a cheaper option compared to surgery and the patient can walk immediately after. Radiofrequency ablation of the knee can be done as a day care procedure.
Mild cases of knee pain can be treated by taking glucosamine either alone or in combination with chondroitin. Doctors also recommend injections of hyaluronic acid into the knee. Hyaluronic acid injections help mild to moderate osteoarthritis by providing lubrication as well as pain-relief to the arthritic knee. These injections generally provide symptom relief for about 6 months to 1 year.
Platelet-rich plasma (PRP) injection is a procedure where we extract the patient’s own blood which is centrifudged, obtaining a small amount of pure PRP, and injecting it into the knee. The advantage of this procedure is that no surgery is required, it is cheaper than surgery and it can even be done in the outpatient clinic.
Through the treatment options above, we aim to have a pain-free knee for the patient, as well as to delay the need for knee replacement and the progression of osteoarthritis.
If all the above treatments fail to work or if the disease is too severe, the only option is surgery. Total knee replacement surgery is the best option for these patients.
For patients who are 65 years and above with severe osteoarthritis, total knee replacement surgery offers the best solution to relieve pain and to improve the patient’s function and quality of life.
Knee replacement surgery offers very high success with minimal risks. The knee replacement can last 15 to 20 years and beyond if the operation is done accurately. Perfect accuracy in total knee replacement surgeries can now be consistently achieved by using computer-assisted surgery (CAS). CAS is the latest technology in knee replacement surgery that yields more accurate results compared to conventional knee replacement surgery.
Knee replacement surgery is the best surgery for severe osteoarthritis of the knee. However, it should be done only after trying all the other treatment options available. It should be reserved as a salvage procedure when all other treatment options fail. Some drawbacks of knee replacement surgery include:
- It is a major operation requiring a long time to recover
- The implant lasts for only 15-20 years
- Limitation of activities post-operation such as unable to kneel, squat, sit cross legged
Newer surgical options such as proximal fibula osteomy (PFO) are gaining popularity. In this procedure, a small portion of the fibula bone of the leg is removed and this naturally restores the mechanical axis of the affected knee. Removal of a small section of the fibula bone does not cause any functional limitation to the knee or the leg. The advantages of PFO are:
- Short surgery duration (15-20 mins)
- Cost effective
- Able to walk the same or next day itself
- No metal implant in the body
Orthopaedic & Trauma Surgery