Are There Different Types Of Knee Osteoarthritis
The knee has three contact zones, also known as compartments where osteoarthritis usually occurs. A common way to classify knee osteoarthritis is by which of the three compartments of are affected:
- Medial Tibiofemoral Compartment the inside part of the knee where the tibia meets the femur .
- Lateral Tibiofemoral Compartment The outside part of the knee where the tibia meets the femur .
- Patellofemoral compartment The front of the knee between the patella and femur .
Estimates of how common osteoarthritis is in each compartment of the knee vary quite widely. A study published by Oxford University found that of a group of subjects with radiographic knee osteoarthritis :
- 59% had osteoarthritis in both the patellofemoral compartment and at least one tibiofemoral compartment.
- 35% had osteoarthritis only in the patellofemoral compartment
- Only 6% had osteoarthritis in one or both of the tibiofemoral compartments.
How To Use Pain Medications Properly
There are two types of over-the-counter pain medications that can be used for osteoarthritis. Acetaminophen is a pain reliever but not an anti-inflammatory. It may help with mild knee pain.
NSAIDs can be more effective because they both relieve pain and reduce inflammation. However, they come with potential side effects and risks. NSAIDs can irritate the lining of the stomach, which may lead to an ulcer or other stomach problems. They also can impair kidney function. Some NSAIDs can increase blood pressure. And theyve been linked to an increased risk for heart disease.
Because of the risks, Dr. Day cautions against using NSAIDs regularly over long periods of time. Instead, she uses NSAIDs for her patients in two ways. First, people who have a flare-up of pain can take them regularly for three to five days and then stop. Second, they can be used over the long term, but only occasionally, maybe a couple of times a week as needed.
If youre taking NSAIDs several times a day for long periods of time, Dr. Day advises reducing their use by maximizing the other treatment strategies. She also suggests trying a topical NSAID, such as diclofenac , which has fewer potential side effects.
Opioid pain relievers are discouraged for long-term treatment of chronic knee pain. The milder narcotic tramadol might be appropriate for occasional use in some people, says Dr. Day.
Explore Supplements And Natural Remedies
Supplements for knee osteoarthritis may increase production of synovial fluid in the knee joint. This helps smooth out rough movement that could be causing knee pain. Talk to your doctor before adding these into your regimen.
Natural remedies for knee pain can also be remarkably effective. These include things like transdermal magnesium, acupuncture, and mindfulness meditation.
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How Should We Discuss The Causes Of Knee Osteoarthritis
Far too many of you are told that you wore away your cartilage. Some of you may have been told that your running caused this, or that you walked too much at work for too many years. Those theories are wrong. Osteoarthritis is often found to be less common in runners. When your healthcare providers use analogies such as a cheese grater, or sandpaper on wood, those misconceptions about the etiology or cause of your arthritis becomes your new reality.
Terms such as degeneration, aging, and wear and tear are tossed around. Words can harm. Using an inappropriate analogy can give people the wrong impression. Ive seen this movie often and the finale never changes.
Osteoarthritis does involve thinning or loss of the cartilage or cushioning on the ends of your bones. This is articular cartilage. This is different than the meniscus cartilage you hear about all the time.
For the majority of you, the cartilage was not worn away because of a mechanical process. Arthritis development is a biological process. Ill be brief here because I wrote an extensive article on osteoarthritis causation here. It turns out that our DNA, RNA, and hundreds of chemicals, protein, and hormones determine if your cartilage is going to become thinner and less resilient. Yes, this graphic below is complicated, and it should be because its meant to show you that this is a very complicated process.
What Are The Types Of Knee Osteotomy
The two main types of osteotomy are opening wedge and closing wedge.
During a closing wedge osteotomy knee surgery, the surgeon cuts a wedge of bone from the leg and brings the sides of the opening together to close the space.
In some cases, the surgeon opens up a section of bone, rather than closing the bone. This procedure is called an opening wedge osteotomy. Sometimes a graft is used to hold the space between the ends of the osteotomy gap.
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Calcium And Vitamin D
Low-fat milk, cheese, and yogurt can also provide vitamin D and calcium, which may help to strengthen the bones.
Scientists have found evidence of low vitamin D levels in people with OA.
Consuming more vitamin D through fortified dairy foods and regular, safe, exposure to sunlight may offer benefits for people with OA.
What Is Osteoarthritis Of The Knee
Osteoarthritis is the most common form of arthritis, and the knee is one of the most commonly affected joints.
Everyones joints go through a normal cycle of damage and repair during their lifetime, but sometimes the bodys process to repair our joints can cause changes in their shape or structure. When these changes happen in one or more of your joints, its known as osteoarthritis.
A joint is a part of the body where two or more bones meet in your knee, its the thigh and shin bones. There is also a small bone at the front of the knee called the patella or kneecap.
The ends of our bones are covered in a smooth and slippery surface, known as cartilage . This allows the bones to move against each other without friction, and protects your joint from stress.
Your knee also has two other rings of a different type of cartilage known as menisci or meniscus, which help to share weight evenly across your knee joint, and theres also cartilage underneath your kneecap.
Osteoarthritis causes the cartilage in your knee joint to thin and the surfaces of the joint to become rougher, which means that the knee doesnt move as smoothly as it should, and it might feel painful and stiff.
Osteoarthritis can affect anyone at any age, but its more common in women over 50.
Injuries or other joint problems, such as gout, can make people more likely to get osteoarthritis. The genes we inherit from our parents can also increase the risk of the condition developing.
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Osteoarthritis And Knee Replacement
Osteoarthritis is a common condition in adults. In the US, the incidence of OA is projected to increase to 3.5 million per year by 2030. In the knee, osteoarthritis is apparent in up to 50% in people over the age of 75 one third suffer from symptoms caused by knee osteoarthritis.
Knee replacement is the only curative procedure for osteoarthritis. In fact, 94-97% of knee replacements take place due to osteoarthritis, with the most common being end-stage osteoarthritis. Knee replacement cures arthritis because it removes the portion of the knee joint that is affected by the condition. Of all the people over the age of 55, only 1.5% of them have radiographic evidence of severe knee OA that is painful. Mild to moderate knee OA impacts 10% of the population over the age of 55. While this research suggests that most people with severe OA may not experience pain symptoms, end-stage OA commonly requires knee replacement to relieve pain and improve knee function. Knee replacement provides positive outcomes for people in terms of improving knee function, relieving pain, avoiding a repeat implant, and reducing costs associated with continuing treatment of OA. However it may not be the best treatment option for everyone.
How Can I Manage Oa And Improve My Quality Of Life
CDCs Arthritis Program recommends five self-management strategies for managing arthritis and its symptoms.
- Learn self-management skills. Join a self-management education class, which helps people with arthritis and other chronic conditionsincluding OAunderstand how arthritis affects their lives and increase their confidence in controlling their symptoms and living well. Learn more about the CDC-recommended self-management education programs.
- Get physically active. Experts recommend that adults engage in 150 minutes per week of at least moderate physical activity. Every minute of activity counts, and any activity is better than none. Moderate, low impact activities recommended include walking, swimming, or biking. Regular physical activity can also reduce the risk of developing other chronic diseases such as heart disease, stroke, and diabetes. Learn more about physical activity for arthritis.
- Go to effective physical activity programs. For people who worry that physical activity may make OA worse or are unsure how to exercise safely, participation in physical activity programs can help reduce pain and disability related to arthritis and improve mood and the ability to move. Classes take place at local Ys, parks, and community centers. These classes can help people with OA feel better. Learn more about CDC-recommended physical activity programs.
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How To Practice Walking Or Running Up Stairs
Although walking up and down stairs may hurt, it can be a good strengthening exercise for your leg and hip muscles.
Theres another benefit to exercise, and thats having a protective effect on joint or articular cartilage. This is extremely important for slowing the onset of osteoarthritis.
Think of articular cartilage as a protective covering for your joints.
Articular cartilage functions as a shock absorber and also reduces friction between bones where they meet at joints. As a person ages, this cartilage can wear away, leading to joint pain and swelling, or osteoarthritis.
Research shows that loading of the articular cartilage maintains the health of the cartilage and that avoidance of loading, aka exercise, results in atrophy, or thinning of the articular cartilage.
To safely climb steps:
- Take your time. A slow and steady approach can help you maintain your stability.
- Use the railing for support. If you currently use a cane, talk to your physical therapist about how to best use it while on stairs.
For a low-impact alternative, try using a stair stepper machine. When using a stair stepper, keep the following in mind:
- Start with a shorter workout and increase the duration over time. Doing too much too quickly can be harmful.
- Adjust the height of the rise to suit your needs. Bell advises that you start small and gradually work your way up to a higher step.
- Use the railing for support, as needed. Be careful not to lean on the rails.
What Conditions Does Knee Arthroscopy Treat
You may need knee arthroscopy if you have:
- Soft tissue injuries: Soft tissues include ligaments and tendons . Some of the most common knee injuries are bursitis, torn meniscus, patellar tendonitis, anterior cruciate ligament tear and tears of the medial collateral ligament .
- Fracture: Bones can break or chip off inside of your knee. Sometimes, pieces of cartilage can break off when your bone fractures.
- Inflammation: The synovium inside a joint can become inflamed . Synovium is soft tissue on the inside of a joint. Healthcare providers call this condition synovitis.
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Dealing With Knee Arthritis At Home
Is The Pain Continuous
Gout, OA, post-traumatic, reactive, and infectious arthritis can cause continual discomfort during the acute phase of the flare or attack. However, symptoms may be worse on some days than others.
Other forms of arthritis may have symptoms alternating between flare-ups and periods of remission where symptoms improve, such as:
- rheumatoid arthritis
- arthritis due to lupus
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What Are The Signs And Symptoms Of Arthritis Of The Knee
There are many signs and symptoms of arthritis of the knee:
- Creaking, clicking, grinding or snapping noises .
- Difficulty walking.
- Joint pain that changes depending on the weather.
- Joint stiffness.
- Knee joint pain that progresses slowly or pain that happens suddenly.
- Your knee locks or sticks when its trying to move.
Pain and swelling are the most common symptoms of arthritis of the knee. Some treatments might reduce the severity of your symptoms or even stall the progression. See your healthcare provider if you have symptoms of knee arthritis.
What Kinds Of Arthritis Can Occur In The Knee
In the case of knee pain, one of the most common culprits is arthritis. There are three types of arthritis that can occur in the knee, and it is not unheard for patients to have multiple arthritic conditions present at the same time. The three kinds of arthritis that often develop in the knees include:
- Osteoarthritis : A slow-acting, progressive wear-and-tear process that deteriorates joint cartilage. Middle-aged and older patients are the most likely group to develop OA.
- Rheumatoid arthritis : RA can occur at any age. This inflammatory process can be marked by painful swelling in the joints.
- Post-traumatic arthritis: Patients who have a significant knee injury, such as a fracture, torn ligament, or torn meniscus, may develop post-traumatic arthritis. This can occur many years after the injury itself.
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Knee Arthritis Treatment Options
If you have knee arthritis, you know it can be painful and require you to restrict normal activities. The pain associated with inflammatory arthritis can be treated with anti-inflammatory medications like ibuprofen or naproxen, but those medications treat the symptom, not your actual arthritis, said Dr. Rosen. You should avoid extended use of these medications because if taken in excess they can cause kidney failure, stomach bleeding, or liver disease.
Inflammatory arthritis of the knee can be treated with disease-modifying antirheumatic drugs which slow down the progression of the arthritis and can help prevent joint deformities. Other treatment options for inflammatory arthritis include corticosteroid injections or hyaluronic acid injections.
In addition to the above treatment options, your doctor will likely give you tips to help you self-manage your knee arthritis, including remaining active, maintaining a healthy weight, and protecting your joints by avoiding repeat activities with the affected joint.
There is no treatment for osteoarthritis of the knee, so your doctor will treat your symptoms, likely with a combination of therapies including having you increase your level of physical activity, doing exercises to strengthen the affected muscle, physical therapy, losing weight, recommending over-the-counter or prescription medication, using aids like crutches or canes, or surgery.
Exercise And Other Knee Arthritis Remedies
For both OA and inflammatory knee arthritis patients, exercise is a key component of treatment, particularly if youre overweight or obese
Physical therapy may be a necessary first step for some to strengthen the muscles surrounding your knee joint and improve range of motion. Low-impact exercises walking, cycling, or swimming are usually best for those with arthritis of the knee, but you may be able to do higher-impact exercises if dont have much joint damage.
To help make activity more comfortable, your doctor may recommend using assistive devices such as a cane or a knee brace or sleeve. Wearing well-cushioned, shock-absorbing shoes or inserts is also key unsupportive styles such as flip-flops and flimsy flats only exacerbate knee joint pain. High heels, which throw off your alignment and place added stress on your knees, should also be avoided.
Its also a good idea to talk to your doctor about how to get more rest, since many people with arthritis experience sleep disturbances that studies suggest can lead to pain, depression, and greater disability. Simply practicing good sleep hygiene sticking to a regular bedtime, keeping your bedroom quiet and dark, exercising during the day, etc. can help in many cases.
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Cracking Or Popping Sounds
When you bend or straighten your knee, you may feel a grinding sensation or hear cracking or popping sounds. Doctors call this crepitus.
These symptoms can occur when youve lost some of the cartilage that helps with smooth range of motion. Both OA and RA can result in cartilage damage.
When cartilage is damaged, rough surfaces and bone spurs develop. As you move your joints, these rub against each other.