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Osteoarthritis of the Knee

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Osteoarthritis occurs most often in knees, hips and hands. Other joints, particularly the shoulders, can also be affected. The pain and stiffness of osteoarthritis can make it difficult to carry out daily activities including one’s job, play sports or even get around with ease.

Signs and Symptoms
Joints affected by osteoarthritis ache or become painful or stiff first thing in the morning, or during or after use. They may also be stiff after periods of inactivity. Exercise keeps joints moving, which helps them stay lubricated. It also builds strength in the muscles surrounding the affected joint, so they can support it.

Treatment Options
There are a wide range of treatment options for osteoarthritis of the knee – and it should be a joint decision between the patient and the physician. In its early stages, arthritis of the knee is treated with nonsurgical measures. Nonsurgical treatments fall into four major groups: lifestyle modifications; exercise; supportive devices and other methods.

Lifestyle Modification – like losing weight, switching from running or jumping exercises to swimming or cycling, and minimizing activities that aggravate the condition, such as climbing stairs. Many, but not all, people with osteoarthritis of the knee are overweight. Simple weight loss can reduce stress on weight bearing joints, such as the knee. Losing weight can result in reduced pain and increased function, particularly in walking.

Exercise – it can help increase range of motion and flexibility as well as help strengthen the muscles in the leg. Physical therapy and exercise are often effective in reducing pain and improving function.

Supportive Devices – such as a cane, wearing energy-absorbing shoes or inserts, or wearing a brace or knee sleeve can be helpful. Some research studies have focused on the use of knee braces for treatment of osteoarthritis of the knee. They may be especially helpful if the arthritis is centered on one side of the knee. A brace can assist with stability and function. There are two types of braces that are often used. An “unloader” brace shifts load away from the affected portion of the knee. A “support” brace helps support the entire knee load. In most studies, the knee symptoms improved, with a decrease in pain on weightbearing and a general ability to walk longer distances.

Other methods may include applications of heat or ice, water exercises, liniments or elastic bandages.

Drug Treatment
Several types of drugs can be used in treating arthritis of the knee. Anti-inflammatory medications such as aspirin, acetaminophen or ibuprofen help reduce swelling in the joint.

A more potent type of pain reliever is a nonsteroidal anti-inflammatory drug or NSAID. These drugs, which include brands such as Motrin, Advil and Aleve, are available in both over-the-counter and prescription forms. Like all pain relievers, NSAIDs can cause side effects including changes in kidney and liver function as well as a reduction in the ability of blood to clot. These effects are usually reversible when the medication is discontinued.

A COX-2 inhibitor is a special type of NSAID that is often prescribed if knee pain is moderate to severe. Common brand names of COX-2 inhibitors include Celebrex and Vioxx. It should be noted that Vioxx was recently withdrawn from the market by its manufacturer. COX-2 inhibitors reduce pain and inflammation, but should not be used with a traditional NSAID (prescription or over-the-counter).

Glucosamine and Chondroitin
Glucosamine and chondroitin (kon-dro’-i-tin) sulfate are oral supplements may relieve the pain of osteoarthritis. These are two large molecules that are found in the cartilage of our joints. Supplements sold over-the-counter are usually made from synthetic or animal products.

Glucosamine and/or chondroitin sulfate may be particularly helpful in the early stages of osteoarthritis of the knee, provided they are used as directed on package inserts and with caution.

Corticosteroids
Corticosteroids are powerful anti-inflammatory agents that can be injected into the joint. They are given for moderate to severe pain. They can be very useful if there is significant swelling, but are not very helpful if the arthritis affects the joint mechanics and there are side-effects too.

Viscosupplementation with Hyaluronic Acid
Viscosupplementation involves injecting substances into the joint to improve the quality of the joint fluid.

Gold Salt Injections
Special medical treatments for rheumatoid arthritis include gold salt injections and other disease-modifying drugs.

Alternative Therapies
Alternative therapies include the use of acupuncture and magnetic pulse therapy. Many forms of therapy are unproven, but reasonable to try. Magnetic pulse therapy is painless and works by applying a pulsed signal to the knee, which is placed in an electromagnetic field. Like many alternative therapies, magnetic pulse therapy has yet to be proven.

Surgical Treatment
If osteoarthritis does not respond to these nonsurgical treatments, one may need to have surgery.

There are a number of surgical options, including the following:

  • Arthroscopic surgery to enable the surgeon to see inside the joint and clean it of debris or repair torn cartilage.
  • An osteotomy to cut the shinbone (tibia) or the thighbone (femur) to improve the alignment of the knee joint.
  • A total or partial knee arthroplasty replacing the severely damaged knee joint cartilage with metal and plastic.
  • Cartilage grafting, if possible, with limited or contained cartilage loss from trauma or arthritis.

Current research is focusing on new drugs as well as on cartilage transplants and other ways to help slow the progress of arthritis.

About Arthritis Center

This web site is run by an Arthritis Specialist based in Dubai, United Arab Emirates. On this site you will find news about the latest in arthritis, information about research results in the field, tips and information and diet and exercise, and much more.

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This web site is run by an Arthritis Specialist based in Dubai, United Arab Emirates. On this site you will find news about the latest in arthritis, information about research results in the field, tips and information and diet and exercise, and much more.

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