Osteoarthritis (O.A.) of the Knee is a diagnosis that affects approximately 80% of Americans over the age of 50. This condition is when the cartilage at the bone ends deteriorates with in the knee joint, the inside or medial joint is most common. This allows the bones to rub together during weight bearing activities such as standing from a seat, walking up stairs, in some cases just walking at all. The current treatments for O.A. of the knee include physical therapy, anti inflammatory medicine, pain pills, exercise, weight loss, surgery, or bracing for the knee. When we view these treatments we should not consider one of them to be the answer for all people. We should more think of a combination treatment.
When a doctor tells a patient with O.A. to loose weight in order to reduce the strain on their knees, they must consider the pain that will be experienced and choose an exercise that the patient can tolerate. Walking for weight loss usually leads to greater pain and increased swelling of the knee. This in turn leads to a patient becoming noncompliant in their exercise program. Therapist work through stretching and strengthening the affected areas of the body, they also teach patients proper alignment. When therapists encounter O.A. of the knee that is considered to be moderate or severe it limits their approach to provide help. With every weight bearing exercise there is pain and increased swelling. We have to understand that this condition is skeletal based not muscle. There is not a lot that can be done unless you affect the skeletal alignment first.
Anti-inflammatory medicine is a treatment option that confirms the presence of O.A. (if it helps, but the problem still persist when the medication is discontinued) Many times Anti-inflammatory medications will mask the pain and the patient feels much better, many consider this a good thing. One of the problems with anti inflammatories in the treatment of O.A. of the knee is that they do not do anything to remove the bone on bone. With the pain being decreased the patient continues in the activities that lead to more deterioration of the joint. So, could masking the pain actually cause the joint to deteriorate faster? Anti-inflammatory medicine is also harsh on the stomach and can lead to peptic ulcers with long-term use. This usually results in the patient being transferred to another drug that is Tylenol based such as Lortab, hydrocodone, or oxycontin. These are very addictive but also have side effects that are reduced by lying down or resting! Do you see a problem with this? The best treatment for arthritis is motion. These drugs influence sedentary lifestyles. Sedentary lifestyles increase the risk of obesity, thereby placing more stress on the joints of the body.
Surgery is an option for some patients, but is very invasive. The surgery requires a great deal of recovery time and pain tolerance in its own right. The surgical candidate is seen as someone at or over the age of 65. The surgery can be seen at www.orlive.com in the search bar, type in "Total Knee Replacement." As the old saying goes, the difference in surgery and major surgery is that surgery is only surgery when it is on somebody else. When the surgery is on me, it is MAJOR surgery! Think of your knee as you watch the video. For many patients surgery is the only option, I am not speaking out against surgery, it has its place. The patients that suffer with bilateral (both inside and outside) joint erosion are left with very few options for treatment.