Many people gradually develop knee stiffness as they get older, have difficulty getting up and down stairs, cannot get in and out of cars, and in some cases cannot even walk. Some people can’t even walk. They have just retired and can enjoy their lives, but going for a walk has become a luxury. This is actually a medical condition called “degenerative disease” of the knee joint, also known as osteoarthritis of the knee. The common people call it a bone spur in the joint.
What are “bone spurs”? When people enter old age, all the organs of the body have to age according to the laws of nature, and the natural wear and tear of the bones and joints is especially strong, especially in obese and heavy people. Degenerative changes are reflected in x-rays as joint space narrowing and bone growth around the joints, as if there are “spurs” on the bones. This is why the people call it “long bone spurs”.
1. How do I know I have osteoarthritis of the knee?
Osteoarthritis of the knee usually occurs slowly, and many patients cannot say exactly when. Its clinical manifestations are many and are combined as follows.
Pain: Because the joint is so worn down, the cartilage, the protective membrane on the surface of the bones in the joint, has worn through, so the bones are directly exposed and can produce pain. This occurs more obviously when walking for a slightly longer period of time. Some patients develop beaten up legs, which are more likely to occur when walking up and down stairs and on uneven paths.
Walking stiffness and poor knee movement: This is due to the development of many “bone spurs” around the joint, which can interfere with normal knee movement and prevent the joint from moving as freely as it once did. In addition, some patients are afraid to walk due to prolonged pain, which causes the soft tissues around the knee to lose their previous elasticity and no longer contract freely, or “stiffen”.
In fact, the clinical manifestations and symptoms are different for each person, but generally follow the following pattern.
The first is stiffness of the knee early in the morning at the onset of activity. The knee feels stiff, heavy, sluggish and a little painful, usually within 4-5 minutes of walking a distance of 100-200 steps. Or the inside of the knee may always feel astringent. This knee stiffness is only felt within 4-5 minutes of the start of activity in the early morning, and most people do not feel any discomfort during the day. As a result, the patient does not care. The length of this phase varies from person to person, and may last 1-2 months in some cases, or several years in others.
Later on, the knee joint starts to feel pain gradually, which sometimes occurs when changing positions, for example, from sitting to standing. But it only hurts for a little while. Then gradually the pain became longer in duration and had to be relieved by resting or using some treatment.
As the condition worsened, the knee pain could no longer be relieved by rest, and sometimes it was so bad that I could not sit or squat in any position. It is also very painful when going up and down stairs, especially when going up than down. Usually, I could only walk with my legs dragging.
Finally, the joints swell and deform, and many people become “rotund legs” type legs, not only painful when moving, there will be a sound. In the end, they can’t do all kinds of activities of normal people, and they can’t take care of themselves.
2.What should I do if I have osteoarthritis in my knee joint?
First of all, it should be clear that “bone spur” is an irresistible process of natural aging of the human body, which is a normal repair reaction of the human body. At the current level of medicine, it is not possible to treat the disease completely, which means that the joint surface cannot be restored to its original state. However, it does not mean that there is no cure, just like a broken tire that can be repaired and used.
Most of the medications available today are mainly for pain relief, not for the elimination of bone spurs. Medication is limited to those patients whose symptoms are mild and do not require surgery. However, it is important to know that medication can only treat the symptoms, not the root cause. In other words, it can only make the knee joint painless, not slow down the process of knee degeneration, much less turn the degenerated joint back into a good one.
In general, for patients with early-stage osteoarthritis, their pain is not obvious and does not last long enough to require surgical treatment. The main thing is to take medication to prevent pain, physical therapy, weight loss for those who are overweight, and rest is very necessary. However, this rest is not immobilization every day, but rather, according to the doctor’s recommendations, appropriate exercise every day, and then scientific rest.
For patients whose joint lesions are not very serious, but whose pain cannot be reduced by the methods mentioned above, some surgical treatment is required. Arthroscopic treatment is usually performed by placing a special mirror inside the joint to treat the lesion in a localized manner, which can relieve pain and improve the function of the joint. For patients with severe joint damage that cannot be solved with the above methods, joint replacement surgery is required.
3.What is joint replacement surgery?
Artificial joint replacement is one of the most important advances in orthopedics in the late last century, and is an effective means of overcoming disease with the development of modern technology. Some people think that joint replacement is the replacement of prosthetic limbs, and others think that artificial joint replacement is like replacing the bearings of a car, removing the diseased joint and replacing it with an artificially manufactured metal joint. In fact, all of these perceptions are biased towards joint replacement surgery. It is simply the removal of a worn and damaged joint surface and the “insertion” of an artificial joint made of advanced biomaterials into the repaired joint surface.
This is like fitting a set of “braces” to a bad tooth. It has been used to treat disorders of the shoulder, elbow, wrist, finger, hip, knee and ankle, but artificial hip and knee replacements are the most common. Over the past few decades, the material design and installation techniques of artificial joint prosthesis have become more perfect, and modern anesthesia techniques, aseptic techniques and surgical operation techniques and modern surgical instruments have provided a comprehensive guarantee for the success of the surgery, which has greatly improved the treatment effect of artificial joint surgery.
Artificial joint replacement surgery is now internationally recognized as the most effective and reliable method of managing severe joint disease. Globally, more than one million patients undergo this type of surgery each year, with success rates of over 90%. In the United States, over the past fifteen years, the percentage of the hip population has increased by 15% and the knee by nearly 50%.
Artificial joints made with today’s high-tech concepts and materials should theoretically have a life expectancy of more than 20 years if they are properly fitted and used. But artificial joints are like the shoes we wear, we need to pay attention to the protective use, the more attention to protection, the longer we can use. More than 90 percent of patients who had their artificial joints replaced more than a decade ago are still using them.
Some patients with knee disease are reluctant to undergo replacement surgery because they have concerns about the procedure and forgo the treatment that is best for you. In fact, artificial knee replacement is a mature procedure that has been performed in millions of cases worldwide to date, with low risk and high success rates. If you need a replacement and do not want to have it, you may miss the best opportunity to return to your normal life. Not only will it be more difficult to perform the surgery later on, but the patient’s quality of life will be significantly reduced. Please consult an experienced physician to choose the right time and make the right choice under the guidance of the physician, taking into account your own situation.
4.What should I do if I have to replace the joint?
The artificial joint is a highly technical surgery, it has strict requirements for many aspects, only when these requirements are met, the life of the artificial joint can be guaranteed. These requirements include: the sterility of the operating room, the experience of the surgeon in knee replacement, the quality of the knee joint used, and the patient’s own preoperative and postoperative cooperation with the surgeon.
The artificial joint is a foreign body to the human body, so it requires very demanding surgical conditions. Therefore, when you choose to do joint replacement, you should choose a regular large hospital, so that there is a good guarantee in the surgical environment, and it is best that the hospital is already very experienced in doing joint replacement, so that the whole operation will be more smooth and the operation time will be short. Anhui Provincial Hospital is currently able to perform a variety of complex artificial joint replacements, and the level of knee replacement can be compared to other major cities.
Since artificial joints have their own set of strict operating procedures, the experience and skill requirements for the surgeon are also higher. When choosing a surgeon, it is important to pay attention to whether the surgeon has sufficient experience in this type of surgery (if he or she has done it, it is best to consider the surgeon carefully) and whether he or she is very sure about the operation.
The patient’s own cooperation with the surgery is also a very important aspect. Since the joint is designed to restore normal movement, it is important to actively cooperate with the post-operative surgeon’s rehabilitation recommendations, otherwise the post-operative results will not be ideal.