There is an old Chinese saying that people get old before their legs. Many people begin to experience knee pain around the age of 50. Some people start with pain when going down steps, and gradually develop pain even when walking on a flat road. Some people have pain when they first start walking and then stop after a while. Others have pain after walking more. Some people get up in the morning and have stiff joints, but they get better after a few minutes of movement. Some people have swollen, deformed joints. These are all different manifestations of different stages of osteoarthritis. Osteoarthritis is actually a sign of degeneration in old age. The underlying change is the degeneration of joint cartilage. The normal surface of our joints has a layer of cartilage, which is smooth and flexible, and has a low coefficient of friction due to the action of joint fluid. With age, trauma, inappropriate exercise, strain and other factors, the cartilage gradually loses its original function. It starts to soften, then the surface starts to become hairy, then it cracks, and finally it falls off. Without the protection of cartilage, the rougher bones are directly exposed and rubbed, resulting in various symptoms such as pain. Bone spurs, as they are often called, are also caused by the loss of cartilage and joint instability. It should be noted that bone spurs do not necessarily produce symptoms, but rather the root cause of pain is the degeneration of cartilage. Since osteoarthritis is a manifestation of aging, is it impossible to change it. The answer is no. The key is early treatment. The key is early treatment, and different treatment options are available depending on the stage of arthritis progression. For patients who have just developed joint pain, which is not very severe and is fine when walking on flat roads but painful only when walking up and down stairs, if there is no feeling of joint jamming, then a relatively conservative treatment plan can be adopted. The first step is to reduce weight, do not lift heavy objects, reduce going up and down stairs, and avoid climbing and squatting. Swimming and cycling are better ways to exercise. Straight leg lifts and static stance can increase quadriceps strength, increase joint stability and reduce the burden on the bones, and can be done as often as possible each day. These methods are applicable to all patients with osteoarthritis. On top of this, you can take some oral medications that nourish joint cartilage. Although Beijing health insurance requires that these drugs be reimbursed for severe osteoarthritis, in my experience, such drugs are only effective for mild to moderate cases, and are not effective when the disease is really severe. Chinese fumigation of the joints, ointment external application, dialectical use of some liver and kidney, blood circulation, wind and dampness are effective. If the above methods are not effective, intra-articular injection of sodium vitrate can also be chosen to lubricate the joints and reduce the wear and tear of cartilage. The above methods, when used in combination, work well for osteoarthritis in the early to middle stages. Arthroscopic surgery is a better option for patients with longer periods of unrelieved pain, clicking and clacking sounds in the joints, limited joint flexion and extension, and sometimes jamming. The above symptoms indicate that there is detached cartilage, joint free bodies or broken meniscus in the joint. All of these things can greatly accelerate the rate of degeneration of the joint. Oral medications, or joint injections, will have a hard time helping. These foreign bodies must be removed as soon as possible for symptoms to be relieved. Arthroscopy requires only 2-3 small 1 cm long openings in the joint surface, one of which is used to access a camera that projects the inside of the joint on a monitor. The surgeon then uses specially designed instruments through the other small opening to remove the detached cartilage and free bodies, trim the torn meniscus, and grind away the symptom-causing bone fragments. For cartilage that has degenerated and become uneven, radiofrequency techniques can also be used to restore it to as flat as possible. Arthroscopic surgery is less invasive and has fewer complications. Only one stitch is needed to close each incision, and you can be out of bed the day after surgery and have your stitches removed in a week. The hospital stay is about one week. Meniscal injuries, joint free bodies, some synovial lesions, and cruciate ligament injuries are all indications for arthroscopy. Although arthroscopy is less invasive, it has its own limitations – low power. For patients who already have joint deformity, significantly limited joint movement, and significant narrowing of the joint space on X-ray with loss of extension, arthroscopy will be difficult to achieve satisfactory results. If conservative treatment does not work, joint replacement is the more radical treatment option. In layman’s terms, joint replacement is the removal of bone and cartilage from the surface of the diseased joint and a metal cover over the surface, so that the surface of the joint is smooth again and the line of negative gravity can be corrected at the same time. The symptoms can be completely treated.