ByBeatrice Nakibuuka
What you need to know:
- As we commemorate World Autoimmune Arthritis Day on May 20, it is important to note that Osteoarthritis of the knee is a degenerative wear-and-tear type of arthritis that occurs most often in people above the age of 50.
- However, it can also occur in younger people.
Osteoarthritis is the most commonly diagnosed type of joint arthritis disease, which can affect the hands, knees and hips. With this type of arthritis, the cartilage in the knee joint gradually wears away.
According to Dr Moses Kakyama, an orthopaedic surgeon at CoRSU Rehabilitation Hospital in Kisubi, as the cartilage wears away, it becomes frayed, rough and the protective space between the bones decreases. This can result in bone rubbing on bone and painful bony out growths (osteophytes) that come as a result of joint damage associated with the degenerative process.
Types
The major types of knee osteoarthritis depend on the cause; inflammation, posttraumatic or degenerative due to age.
“Inflammatory (rheumatoid) osteoarthritis is an auto immune and chronic condition that attacks multiple joints throughout the body, including the knee joint. It usually affects the same joint on both sides of the body,” Dr Kakyama says. He adds that here, the synovial membrane that covers the knee joint begins to swell, causing knee pain and stiffness.
Posttraumatic osteoarthritis develops after an injury to the knee. For example, a broken bone if not managed well may damage the joint surface and lead to arthritis years after the injury.
Meniscal tears, which are common in athletes usually take place when an athlete twists or turns their upper leg while their foot is planted and their knee is bent.
“Many of such tears do not heal without treatment and often progress into osteoarthritis. Ligament injuries can also cause instability and additional wear on the knee joints. Over time, these can result in arthritis and this is the reason most athletes will eventually quit sports,” Dr Kakyama warns.
Related
- Osteoarthritis: It is not just old age
- PRIMEObesity cases on the rise globally
Risk factors
Dr Kakyama says more women than men suffer from osteoarthritis of the knee and it is a common occurrence among elderly women (above 50 years).
“This is because they have reduced estrogen levels due to menopause. About 27 percent of people who need knee replacement are elderly women,” he adds.
According to Dr Godfrey Basoita, a physiotherapist at Mulago National Referral Hospital, trauma in the joint, injury or overuse such as knee bending and repetitive stress on a joint can damage it which increases the risk of osteoarthritis in that joint.
As we carry on with our daily activitis, Dr Basoita notes, about three to six times our body weight is spread to the knees. Therefore, for every extra kilogramme of weight gained, about five kilogrammes of the weight is transmitted to the knee joints. This puts more stress on joints, particularly weight-bearing joints such as the hips and knees, which increases the risk of osteoarthritis.
Also, due to genetics, those who have family members with osteoarthritis are more likely to develop the condition.
Dr Kakyama also points out that some inflammatory conditions such as septic arthritis that is poorly managed can cause accumulation of pus in the knee joints, which in turn causes osteoarthritis.
People whose jobs require carrying heavy loads and those on diets that are low in vitamin C and D may also develop osteoarthritis over time.
Diagnosis
Osteoarthritis usually develops slowly but the pain it causes worsens over time. The stages of this type of arthritis according to Dr Kakyama, range from mild, moderate and severe.
Although most of the patients with knee osteoarthritis report with knee pain, the stages can be determined by physical examination and an x-ray.
During the diagnosis, an orthopaedist will take your medical history, symptoms and conduct a physical examination. They may also order diagnostic tests such as X-rays or blood tests.
“An x-ray that provides a detailed picture of dense structures can help distinguish among various forms of arthritis and show a narrowing of the joint space and any changes in the bone as well as bone extensions,” Dr Kakyama says.
Occasionally, a magnetic resonance imaging (MRI) scan or a computerised tomography (CT) scan may be needed to determine the condition of the bone and soft tissues of the knee.
The best way to diagnose rheumatoid arthritis is through a blood test. After these tests and clinical presentation, the orthopaedist will be able to class the severity of the condition and recommend the best treatment.
Treatment options
There is no cure for arthritis but treatment is directed towards relieving symptoms such as pain and deformity. Depending on the stage of your arthritis, the initial treatments are usually conservative avoiding invasive procedures such as surgery. These may include giving pain killers, physiotherapy with emphasis on exercises that increase mobility of the knees.
According to Dr Basoita, one of the most important recommendations that you will receive from your doctor is lifestyle modifications that include changes in your diet, regular exercises that do not hurt the knees as well as maintaining a healthy body weight in order to protect your knee joint and slow the progress of arthritis.
“You may have to ditch some physical activities such as aerobics, climbing stairs, jogging and playing tennis and instead focus on low impact exercises such as swimming or cycling, depending on what your doctor recommends,” Dr Basoita says.
These will not only enable you to be active while putting less stress on your knees but also help increase your balance, flexibility agility and coordination.
Walking devices such as a cane, brace or knee sleeve can help increase your stability and function, especially if the arthritis is on one side of the knee. Wearing elastic bandages can also provide support to the knee and some relief from pain.
Some orthopaedists recommend using an aspiration needle to inject painkilling drugs (steroids) or hyaluronic acid, which mimics synovial fluids into the knee joint to enhance lubrication and reduce inflammation. This is usually given as the patient prepares for a knee replacement surgery.
Dr Kakyama says most of the cases he receives are those that have exhausted all other conservative options and have not been successful and have increased deformity. These often need a knee replacement; a surgery that involves replacement of parts of the injured or worn-out knee joints. The surgery is meant to ease pain and make the knee better.
Surgery
A successful surgery according to Dr Kakyama can last up to 12 years or longer.
The conventional thinking is that you are better with your natural knee but sometimes, instead of keeping the patient on pain killers that might damage their kidneys we choose to manage the pain through surgery.
He adds that the conservative therapies are usually to buy the patient some time so that one does not have more than one surgery. Since there is no cure, arthritis usually progresses and the pain worsens with time and the only option is surgery.
A revision knee replacement surgery is usually complicated. We prefer that one has the first surgery at least after 50 years so that it can take them through up to 15 years or more. Having another surgery after this time is complicated.
If left untreated, knee osteoarthritis can progress causing deformities, increased pain, reduced function of the knee joint as well as restricted movement.
Symptoms
The commonest symptom of a knee joint affected by osteoarthritis is pain that develops over time. The pain is usually worse in the morning and flares up after vigorous activity.
Stiffness and swelling, redness and tenderness of the joint making it difficult to bend or straighten the knee.
There is also loss of range of motion for the joint because the loose fragments of cartilage and other tissue can interfere with the smooth motion of joints.
The knee may lock during movement making a click, snap, or grinding noise.
Pain may cause a feeling of weakness or buckling as if bending and giving way under a weight in the knee.
FAQs
Osteoarthritis is not just old age? ›
While older people do develop arthritis, children and teenagers can get certain forms of the condition, Klippel said. The Arthritis Foundation reports two-thirds of people with doctor-diagnosed arthritis are under age 65.
Is osteoarthritis a normal part of aging? ›Anyone can get osteoarthritis, but it is more common as people age. Women are more likely than men to have osteoarthritis, especially after age 50. Other factors that may make it more likely to develop osteoarthritis include: Overweight or obesity.
What can cause osteoarthritis other than old age? ›In addition to age and secondary causes such as inflammatory arthritis and prior injury/ trauma, several other risk factors increase the chance of developing osteoarthritis including obesity, diabetes, elevated cholesterol, sex, and genetics.
What age is osteoarthritis most common? ›Age—The risk of developing OA increases with age. Gender—Women are more likely to develop OA than men, especially after age 50. Obesity—Extra weight puts more stress on joints, particularly weight-bearing joints like the hips and knees. This stress increases the risk of OA in that joint.
Does everyone over 60 have osteoarthritis? ›While arthritis is more common among older adults, arthritis develops in younger people too1: Among adults aged 65 and older, 50% report ever having been diagnosed with arthritis. Among adults aged 45 to 65 years, 31% report ever having been diagnosed with arthritis.
Can you stop progression of osteoarthritis? ›There's no cure for osteoarthritis, but there is a lot you can do to slow its progression, reduce pain, and maintain or improve function. Losing weight can be particularly helpful if you're overweight or obese.
Does osteoarthritis ever get better? ›Osteoarthritis is a long-term condition and cannot be cured, but it doesn't necessarily get any worse over time and it can sometimes gradually improve. A number of treatments are also available to reduce the symptoms. Mild symptoms can sometimes be managed with simple measures, including: regular exercise.
Why do I suddenly have osteoarthritis? ›The most common triggers of an OA flare are overdoing an activity or trauma to the joint. Other triggers can include bone spurs, stress, repetitive motions, cold weather, a change in barometric pressure, an infection or weight gain.
What triggers osteoarthritis? ›Overuse from repetitive movements of the joint. Joints that do not form correctly. Family history of osteoarthritis.
What exercise is best for osteoarthritis? ›“Low-impact exercises, like walking, cycling or using an elliptical machine are smart choices,” says Dr. Zikria. “If you run, play basketball or do other high-impact activities, avoid hard surfaces and don't do it every day.” Multiple studies show that mild to moderate exercise is beneficial for people with arthritis.
Can you live a normal life with osteoarthritis? ›
With the right support, you can lead a healthy, active life with osteoarthritis. The condition does not necessarily get worse.
How quickly does osteoarthritis progress? ›How quickly does OA progress? Experts confirm that once OA starts, it may take years to reach a severe stage. However, in extreme cases, OA progresses rapidly to complete the destruction of the cartilage within a few months.
What is the earliest symptom of osteoarthritis? ›Joint Stiffness: Similar to joint pain, joint stiffness is commonly an early sign of osteoarthritis. Stiffness is common after sitting or laying for long periods of time. That sluggish, slow-to-move start in the morning could be an early sign of osteoarthritis.
Why do some people get osteoarthritis and others don t? ›People who are overweight or obese are more likely to get knee osteoarthritis than people who are not overweight. Excess weight can also make knee osteoarthritis worse. Extra weight puts more stress on joints, particularly weight-bearing joints like the hips and knees. What you can do: Maintain a healthy weight.
What are the worst symptoms of osteoarthritis? ›The main symptoms of osteoarthritis are pain and sometimes stiffness in the affected joints. The pain tends to be worse when you move the joint or at the end of the day. Your joints may feel stiff after rest, but this usually wears off fairly quickly once you get moving. Symptoms may vary for no obvious reason.
What slows down osteoarthritis? ›Physical activity is the best available treatment for OA. It's also one of the best ways to keep joints healthy in the first place. As little as 30 minutes of moderately intense exercise five times a week helps joints stay limber and strengthens the muscles that support and stabilize your hips and knees.
Can anything reverse osteoarthritis? ›You can't reverse osteoarthritis, but there are things you can do to manage your pain and improve your symptoms. Osteoarthritis occurs when the protective cartilage that acts as cushioning between your bones starts to fray and wear down over time.
What makes osteoarthritis worse? ›Carrying extra body weight contributes to osteoarthritis in several ways, and the more you weigh, the greater your risk. Increased weight adds stress to weight-bearing joints, such as your hips and knees. Also, fat tissue produces proteins that can cause harmful inflammation in and around your joints. Joint injuries.
Can osteoarthritis go into remission? ›While remission is possible in RA and, in fact, is the goal of RA treatment, OA is generally not discussed in terms of “remission,” primarily because there are no treatments to date that can halt the disease progression. How fast the disease progresses differs from person to person.
Can you lift weights with osteoarthritis? ›Although it may seem like the opposite would be true, weightlifting is actually healthy for those diagnosed with osteoarthritis, because strong muscles support the joints. Weightlifting can also ease joint pain and stiffness, boost bone strength, and maintain a healthy weight.
What exercises should you avoid with osteoarthritis in the back? ›
People with osteoarthritis in the lumbar spine may want to avoid deep bending at the waist or deep twisting. People with cervical spine osteoarthritis should avoid putting extra pressure on the head and neck, such as doing as headstands in yoga classes.
How do you stop osteoarthritis flare ups? ›- heat therapy to ease stiffness.
- cold compresses for pain relief.
- activities to reduce stress, such as yoga and tai chi.
- cane or walker to help with balance.
- braces, kinesiology tape, and other forms of joint support.
- rest between activities.
- acupuncture.
...
High-impact activities that can worsen symptoms of osteoarthritis in your hips or knees include:
- Running.
- Jumping.
- Deep squatting and bending.
- Stair climbing.
- Hiking.
- Prolonged standing.
If you have been recently diagnosed with arthritis, or have lived with it for some time, you may be unsure as to whether your arthritis may spread from one part of your body to another. Arthritis can develop and become worse, spreading from affected areas. However, arthritis is not contagious.
What is lacking in osteoarthritis? ›Osteoarthritic joints have low levels of aggrecan, proteoglycan, type-II collagen, and runt-related transcription factor 1(RUNX1).
Is osteoarthritis caused by stress? ›The more stress you're under, the more destructive your inflammation and arthritis can become. Even people with the most common form of arthritis, osteoarthritis, find that stress compounds their discomfort. Stress can cause you to tense up muscles, which only increases your joint pain.
What is the most common treatment for osteoarthritis? ›Nonsteroidal anti-inflammatory drugs (NSAIDs).
Over-the-counter NSAIDs , such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), taken at the recommended doses, typically relieve osteoarthritis pain. Stronger NSAIDs are available by prescription.
Glucosamine and chondroitin are two of the most commonly used supplements for arthritis. They're components of cartilage—the substance that cushions the joints. Research on these supplements has been mixed, in part because studies have used varying designs and supplement types.
What is the newest treatment for osteoarthritis? ›The new drug and how it could help
“Talarozole is a retinoic acid metabolism blocking agent (RAMBA) that works by blocking the breakdown of all-trans retinoic acid, which results in an increase in their levels,” explained Louie.
Pushing through pain is not the thing to do. If your joints are hot or swollen, exercise can increase the damage and cause more pain. Remember, arthritis pain and pain from a strenuous workout are not the same. A little soreness a day or two after a workout is OK.
Is coffee good for osteoarthritis? ›
For some forms of arthritis, coffee seems to hold some benefits, particularly for reducing inflammation and uric acid levels. However, other research suggests that coffee may increase the risk for developing specific types of arthritis, such as rheumatoid and osteoarthritis.
Is caffeine bad for osteoarthritis? ›Osteoarthritis – Excess caffeine intake can negatively affect the growth of bone and cartilage, which can increase the risk of developing osteoarthritis.
What is the drug of choice for osteoarthritis? ›NSAIDs are the most effective oral medicines for OA. They include ibuprofen (Motrin, Advil) naproxen (Aleve) and diclofenac (Voltaren, others). All work by blocking enzymes that cause pain and swelling.
Is osteoarthritis worse than regular arthritis? ›OA usually affects fewer joints, and its symptoms are generally limited to the joints. The progression of RA is more difficult to predict, and it can cause more widespread symptoms. The outlook for people with RA has greatly improved due to advances in research and therapies.
Should I be worried about osteoarthritis? ›Osteoarthritis is a degenerative condition. If left untreated, it'll get worse with time. Although death from OA is rare, it's a significant cause of disability among adults. It's important to talk to your doctor if OA is impacting your quality of life.
Can you end up in a wheelchair with osteoarthritis? ›Severe Osteoarthritis and mobility
Sadly for some Osteoarthritis can lead to need to using a wheelchair. The pain while often manageable with drugs can combine with joint stiffness and loss of dexterity to require the use of a wheelchair to help alleviate the conditions.
People with arthritis often experience more severe pain and stiffness first thing in the morning, Dr Christine Haseler, a GP with a special interest in arthritis says: “Joints affected by osteoarthritis often stiffen up in the mornings and can make nights uncomfortable and restless.
Will osteoarthritis show up on xray? ›Regardless of the joint that is affected, osteoarthritis is revealed on conventional radiographs (X-rays) by characteristics that are distinct from other joint disorders, such as rheumatoid arthritis.
What does osteoarthritis flare up feel like? ›Some of the typical symptoms include increased joint pain, stiffness, swelling of the affected area, and reduced range of motion of the affected joint. You may also experience fatigue if the pain disrupts your sleeping pattern.
Does osteoarthritis hurt everyday? ›Pain from arthritis can be constant or it may come and go. It may occur when at rest or while moving. Pain may be in one part of the body or in many different parts.
Is osteoarthritis an autoimmune disease? ›
The difference between osteoarthritis (OA) and rheumatoid arthritis (RA) is in the way these diseases harm the body. While OA is a degenerative disease caused by a physical breakdown of the cartilage, and eventually the bones, RA is an autoimmune disease caused by a reaction in the immune system.
How fast does osteoarthritis worsen? ›Osteoarthritis is generally a slowly progressive disorder. However, at least 1 in 7 people with incident knee osteoarthritis develop an abrupt progression to advanced-stage radiographic disease, many within 12 months.
What are the symptoms of end stage osteoarthritis? ›Stage 4 OA is considered severe. People in stage 4 OA of the knee experience great pain and discomfort when they walk or move the joint. That's because the joint space between bones is dramatically reduced. The cartilage is almost completely gone, leaving the joint stiff and possibly immobile.
What conditions mimic osteoarthritis? ›Osteoarthritis and rheumatoid arthritis (RA) — the two most common forms of arthritis — closely resemble each other when symptoms arise.
What conditions are similar to osteoarthritis? ›The most common types include osteoarthritis (OA), rheumatoid arthritis (RA), psoriatic arthritis (PsA), fibromyalgia and gout. Arthritis and related diseases can cause debilitating, life-changing pain in different ways.
Is osteoarthritis an auto immune disease? ›The difference between osteoarthritis (OA) and rheumatoid arthritis (RA) is in the way these diseases harm the body. While OA is a degenerative disease caused by a physical breakdown of the cartilage, and eventually the bones, RA is an autoimmune disease caused by a reaction in the immune system.
Is osteoarthritis always degenerative? ›Osteoarthritis is sometimes referred to as degenerative arthritis or degenerative joint disease. It is the most common type of arthritis because it's often caused by the wear and tear on a joint over a lifetime.
Is osteoarthritis inflammatory or degenerative? ›Degenerative arthritis is also known as osteoarthritis, and it's caused by wear and tear in a joint.
Is coffee bad for osteoarthritis? ›Osteoarthritis – Excess caffeine intake can negatively affect the growth of bone and cartilage, which can increase the risk of developing osteoarthritis.
What is the number 1 inflammatory food? ›- Red meat and processed meats, including bacon, hot dogs, lunch meats and cured meats.
- Refined grains, including white bread, white rice, pasta and breakfast cereals.
- Snack foods, including chips, cookies, crackers and pastries.
- Sodas and other sweetened drinks.