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Arthritis is a general term, which means an inflammation of one or more joints, leading to pain and stiffness. The most common joints involved are the knee, hip, elbow, shoulder, and joints of the hand.
Different types of arthritis exist, each with different causes. The common causes are due to wear and tear (Osteoarthritis), inflammatory arthritis, and post injuries. Rheumatoid, Psoriasis, Gout, and Viral infection are the most common cause for inflammatory arthritis.
Osteoarthritis is not a disease, its due to degeneration (wear and tear) of cartilage within the joint. In simple, the regeneration capacity of the cartilage is reduced along with aging process. This results in asymmetrical joint space reduction leading to deformities like bow legs. Any lower limb alignment problems from childhood (bow legs) or injuries in limb may predispose to early onset osteoarthritis
Rheumatoid arthritis is an autoimmune disorder where antibodies are formed against our own body cells. It affects all systems, joints being more commonly involved. The exact cause is not known but it can run in families, with middle aged women most commonly involved. Whereas, osteoarthritis is wear and tear phenomena due to over use of joints occurring in old age.
Some known factors are:
1. Age
2. Gender (females more than males)
3. Family history
4. Previous injuries in knee or in lower limb
5. Overuse of knee joint
6. Overweight
7. Low hormone levels
8. Nutrition: low levels of Vitamin D, calcium and magnesium
Pain is the first presentation followed by swelling and stiffness. The other symptoms are:
1. Restricted range of movements
2. Limping (Antalgic gait)
3. Crepitus sound
4. Locking of knee
5. Deformity of lower limb: Varus (bow knee) , Valgus (knock knee) or Windswept
It is appropriate to consult an Orthopaedician to confirm the diagnosis of osteoarthritis. The treatment depends on the severity. Mild to moderate stage osteoarthritis can be managed non-surgically, such as
1. Weight loss
2. Lifestyle modifications
3. Nutrition and supplements
4. Physiotherapy (Knee rehabilitation and low impact exercises)
5. Medications (anti-inflammatory)
6. Injections into the joints
Knee injections can effectively reduce pain and inflammation for few months, but they are not for permanent cure. Different types of injections commonly used are Steroids, Hyaluronic acid, Platelet-rich Plasma(PRP) and Stem cell treatment. Experts around the globe don’t recommend these infections because of no proven benefits, instead they cause more harm like infection, thinning of cartilage and more damage to your knee joint. At our centre ( Bharath Orthopaedics) we don’t recommend routinely these injections.
In mild to moderate osteoarthritis, if all non-surgical options fail to improve the symptoms, a minimal invasive arthroscopy (key hole) helps to examine the joints and debridement of soft tissue with lavage. This procedure has the advantage of minimal incision, minimal bleeding, less scaring and no cutting of muscle and bone, so faster is the recovery.
Severe stage osteoarthritis with deformities is an end stage arthritis which will require a definitive procedure like Partial or Total knee replacement (SMART KNEE REPLACEMENTS)
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