By Dr. George Ballantyne
Osteoarthritis of the knee is a degenerative condition that develops when cartilage breaks down. Factors that contribute to the development of osteoarthritis include joint injury, overuse, excess body weight, inactivity, heredity, and unfortunately the natural process of aging. Symptoms of osteoarthritis include pain, stiffness, and joint swelling or enlargement.
Diagnosis of osteoarthritis of the knee is usually based on a medical history coupled with a physical exam and radiographs. X-ray will detect joint space narrowing or spur formation. Unlike in rheumatoid arthritis, blood test would be normal.
Treatment includes proper exercise, weight control, heat and cold therapy, pain medication, injection into the joint or surgery. Common medications include Tylenol and non steroidal anti-inflammatory drugs (NSAIDS). NSAIDS reduce inflammation and pain but are a double edge sword as they can cause GI upsets. Recent prescription creams are being used to relieve pain by massaging directly into the skin over the knee.
Corticosteroid injections can be used to relieve inflammatory symptoms, but must be used sparingly as these injections can lead to increased degradation of the joint cartilage. Viscosupplementation injections using hyaluronic acid may provide relief for up to 12 months, but unfortunately do not alter the progression of arthritis.
Surgery, while providing relief to millions of people, is the last line of defense against osteoarthritis of the knee. Surgical options include osteotomy, arthroscopic debridement and microfracture, and partial or total joint replacement. Your orthopaedic surgeon, working in conjunction with your family physician, can provide you with these treatment options which can help you enjoy an active lifestyle well into your golden years.