Osteoarthritis Management

Osteoarthritis, also called degenerative joint disease is the most common form of arthritis. It occurs most often in older people. This disease affects the tissue covering the ends of bones in a joint (cartilage). Osteoarthritis is characterized by damaged articular cartilage, cartilage lining the knee joint. Advanced age is one of the most common reasons for osteoarthritis of knee. You may also develop osteoarthritis if you had a knee injury or fracture in the past, if you have family history of osteoarthritis, suffering from knee diseases such as avascular necrosis and other congenital or developmental knee diseases.

The characteristic symptoms and diagnostic test helps in diagnosing the condition. You will experience severe pain in the knee, morning stiffness and limited range of motion. Based on the symptoms your orthopedic surgeon will perform physical examination, X-rays and other scans, and also some blood tests to rule out the other conditions that may cause similar symptoms.

Management of Osteoarthritis

The objective of the treatment is to reduce pain, improve joint movement, and prevent further damage to joint.

Non-surgical Treatment

 The non-surgical treatment of osteoarthritis involves:

• Medications: Pain-relieving medications such as NSAIDs, COX-2 inhibitors and opioids may be prescribed. Topical medications such as ointments can be applied over the skin where there is pain.
• Steroid injection: These injections of steroids are given directly into the affected joint for severe pain when use of NSAIDs does not bring much relief. Steroids are very strong anti-inflammatory drugs and if used orally cause various side effects on other body systems. Local analgesics that prevent the sensation of pain are sometimes given along with steroids in the same shot to bring relief quickly.
• Lifestyle modifications: Some of the lifestyle modifications include:
  • A moderate exercise program
  • Use of Heat or cold treatments
  • Eating a healthy and well balanced diet
  • Get adequate rest
  • Lose weight
  • Protect your joints with the use of assistive devices such as splints or braces to support the weakened joints
• Physical therapy: Your physical therapist will teach you exercises to keep joints flexible and improve muscle strength.

Surgical Treatment

Surgery is usually considered if nonsurgical treatment fails to provide relief. There are different surgical procedures that can be used and may include:

• Arthroscopy: Arthroscopy, also referred to as keyhole surgery or minimally invasive surgery, is performed through very small incisions to evaluate and treat a variety of knee conditions.  Arthroscopy is a surgical procedure in which an arthroscope is inserted into a joint. Arthroscope is a pencil-sized instrument that has a small lens and lighting system at its one end. Arthroscope magnifies and illuminates the structures inside the body with the light that is transmitted through fibre optics. It is attached to a television camera and the internal structures are seen on the television monitor. It has a number of indications in knee injury, but its use in arthritis is limited, and doesn’t help in the treatment of arthritis itself. It can be of use with secondary issues such as loose bodies and locking of the knee
• Total Knee Replacement: is the definitive treatment of severe arthritis in the knee. This is discussed in detail under the Total Knee Replacement section
  

Your surgeon will discuss the options and help you decide which type of surgery is the most appropriate for you.