Osteoarthritis of the Knee

knee_osteoarth_intro01-300x300Post middle age, a common problem that most of us face is Osteoarthritis (OA). It is also commonly known as wear and tear or degenerative, arthritis and mostly has an effect on the knee joint. Earlier it was thought to have no solution but today doctors have come up with various ways to treat this problem. This ensures that you have better movement with less pain and in turn an enhanced life quality.

Discussed below are few topics that will give you a better picture of

  • Development of OA
  • Problems caused by OA of the knee
  • Treatment provided for OA

Anatomy

Parts of the knee that get affected by OA

OA is associated with the degeneration of articular cartilage. At the knee joint the ends of the leg bones are covered by a smooth lining known as the articular cartilage that helps to reduce friction thus enabling freedom of movement to the joint. Below the articular cartilage is present a layer of bone known as the subchondral bone.

The degeneration   or wear and tear of the articular cartilage may expose the bone underneath and may cause it to rub against the bone. The knee joint may contain small outgrowths called osteophytes  or bone spurs.

Causes for knee OA

A knee injury long back could be one of the causes for knee OA.  Years of repeated stress on the knee could also be a major reason. Abnormal alignment or movement of the joint surfaces may be caused due to joint surface fractures, meniscal injuries or ligament tears which in turn leads to wearing away of joint surfaces. Studies reveal that  a  prior injury cannot be always accounted for all cases of knee OA. Studies reveal that some people are more prone to degenerative arthritis.  Yet another cause for knee OA is obesity.

Research shows that articular cartilage may undergo changes triggered by  problems in the subchondral bone. Usually, the articular  cartilage forms a protective layer on the subchondral bone but in certain cases the subchondral bone may become too soft or hard thus changing the manner the cartilage cushions and absorbs joint shocks.  

Symptoms

Developed over a period of several years, knee OA is characterized by swelling, pain and knee stiffening. Physical activity such as walking etc may worsen the pain. In the initial stages, you may feel fairly good while walking but notice knee stiffness and pain on sitting for some time. This pain may interfere with your daily activities too once the condition starts progressing. Pain may become continuous and have an effect on the sleep patterns too in the advanced stages.

Diagnosis

Initial history and physical examination forms the basis of initial diagnosis of OA. In majority of cases, X-rays may help in the diagnosis.  Knee pain from a torn meniscus or a knee cap problem may be confused with that of knee OA which can be easily be ruled out with the help of X-rays. In certain cases, X-rays may not show the estimated results due to OA being in its initial stages.

In order to have a closer look at the knee MRI (Magnetic resonance imaging ) scan may be recommended.  It is a special type of radiological test that is painless and does not require dye or needles. Magnetic waves are used to capture pictures resembling slices of the knee. It provides a clear picture of the articular cartilage, ligaments, bones and the menisci.

In case of an imprecise diagnosis, arthroscopy is done to look inside the knee and to determine if the joint surfaces are showing wear and tear. It is a surgical procedure in which a small incision is made and a very small fiberoptic camera is inserted into the joint.  By moving the camera inside the joint, the surgeon can view images on a TV screen and perform the surgery.  Other surgical instruments are inserted into the joint through several other small incisions and can be used to pull out or poke any of the internal structures to check for damages.

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