What is Arthritis of the Knee?
Arthritis of the knee is a disease which wears away the cartilage between the femur (thigh bone) and the tibia (shin bone) causing the two bones to scrape against each other, raw bone on raw bone. When this happens, the joint becomes pitted, eroded and uneven. The result is pain, stiffness and instability. In some cases, motion of the leg may be greatly restricted.
Osteoarthritis, which is the most common form of arthritis in the United States, is degenerative and, although it most often occurs in patients over the age of 50, it can occur at any age, especially if the joint is in some way damaged.
It is usually confined to the large weight-bearing joints of the lower extremities, including the hips and knees, but may affect the spine and upper extremity joints, too. Patients with osteoarthritis often develop large bone spurs, or osteophytes, around the joint, further limiting motion.
Unlike osteoarthritis, which is a "wear and tear" phenomenon, rheumatoid arthritis is a chronic inflammatory disease that results in joint pain, stiffness and swelling. The disease process leads to severe, and at times rapid, deterioration of multiple joints, resulting in severe pain and loss of function.
Knee Surgery – Know Your Options
Non-surgical Options for Knee Pain
Knee pain doesn't necessarily mean knee surgery. There are many options for you to discuss with your doctor to help alleviate knee pain.
Exercise and Weight Control - Research shows that exercise is one of the best treatments for osteoarthritis. Exercise may help decrease pain, improve flexibility and maintain weight. A healthy diet can facilitate weight loss resulting in reduced stress on weight-bearing joints and limiting further injury.
Physical Therapy - Your doctor may prescribe physical therapy as a course of treatment. It is important for you to work with your physical therapist and learn proper technique of your exercises. These exercises are specifically designed for your condition and may prove effective in building supporting muscles and loosening stiff muscles that cause pain.
Bracing - Your doctor may also suggest bracing or other assistive devices to add external stability to your knee or to improve your stability while walking.
Medication - Heat and Cold are non-drug ways that may relieve pain. A warm bath, hot packs or cold packs are simple techniques that may help with pain. Medicines commonly used in treating osteoarthritis include: acetaminophen, NSAIDs (nonsteroidal anti-inflammatory drugs), topical pain-relieving creams and sprays, narcotic painkillers , corticosteroids, and hyaluronic acid. Many medicines used to treat OA have side effects, so it is important for patients to learn about the medicines they take. Consult your doctor before using medications for pain relief.
Injections - Steroid injections may provide relief from knee pain. Your doctor will advise you on the efficacy of this treatment and monitor how effective this course of treatment is for you.
Joint Fluid Therapy (hyaluronic acid) - Joint Fluid Therapy is a treatment to help treat the pain of osteoarthritis of the knee. It provides long-lasting relief from arthritis pain for many patients. Joint Fluid Therapy involves injecting a substance called hyaluronic acid into the knee. This substance is similar to the fluid that occurs naturally in the knee, synovial fluid, which helps to lubricate the knee, reducing friction and protecting from pain.
There are many other options promoted for relief of pain, and while some may be effective, others could be potentially harmful. Always consult your doctor before embarking on any course of care to ensure you will get the maximum benefit for your condition.
What is Total Knee Replacement?
Is Total Knee Replacement Surgery for You?
The good news is that if you are considering total knee replacement surgery, you're not alone. According to the American Academy of Orthopaedic Surgeons, more than 600,000 such procedures are performed in the US each year.1 Even better news is that the US Department of Health and Human services considers total knee replacement to be one of the most successful and cost effective interventions in medicine. In fact, the success rate for knee replacements 10 years after surgery is 90-95%.
Of course, the decision to have knee replacement surgery should be a cooperative one made by you, your family, your primary care doctor, and your orthopaedic surgeon. The process of making this decision typically begins with a referral by your primary care doctor to an orthopaedic surgeon for an initial evaluation.
How is Knee Replacement Surgery Performed?
During knee replacement surgery, the surgeon surgically removes the damaged bone and cartilage of the joint and replaces it with smooth, artificial implants - thereby eliminating painful bone-on-bone contact.
Almost all knee replacement implants consist of a four-part system:
- The tibial (shin) side has two elements and replaces the top of the shin bone. This portion of the implant is made up of a metal tray attached directly to the bone and a plastic spacer that provides the lower half of the new joint's bearing surface.
- The femoral (thigh bone) side is a single element that replaces the bottom of the thigh bone and provides the top half of the new joint's bearing surface. This component also replaces the groove where the patella, or kneecap, sits.
- Finally, the patellar component replaces the surface of the kneecap, which rubs against the femur. The patella protects the joint, and the newly resurfaced patellar button will slide smoothly on the front of the joint.
When is Knee Surgery Recommended?
How Do I Know When It's Time to Consider Surgery?
There are several reasons why your doctor may recommend knee replacement surgery. People who benefit from knee replacement surgery often have:
- Knee pain that limits everyday activities, such as walking or bending
- Knee pain that continues while resting, either day or night
- Stiffness in a knee that limits the ability to move or bend the leg
- Inadequate pain relief from anti-inflammatory drugs, physical therapy, or walking supports
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