Osteoarthritis (OA) of the knee is a common and frequent disease characterized by degeneration and destruction of articular cartilage, and is one of the most important causes of knee pain in elderly patients, usually due to degeneration of articular cartilage from age and overuse. I would like to tell you my personal experience in the treatment of this disease in the hope that it will be helpful to the majority of patients. Symptoms A feeling of knee stiffness is the initial symptom in most patients, causing pain during prolonged sitting and squatting and standing up, or difficulty in straightening the knee joint. Usually, the pain occurs when the patient stands up from a seat, but gradually disappears after walking and is characterized by pain again after a longer period of walking. The pain is mostly on the medial side of the knee joint, around the kneecap, and in some cases, the s-fossa is the main source of the pain. The pain is obvious when walking up and down stairs and on slopes. This is due to the degeneration and destruction of the meniscus, synovial hyperplasia, or free bodies embedded in the joint space. Some female patients also have venous aneurysms of the lower extremities, resulting in circulatory abnormalities that may be associated with nocturnal flow. Continued progression of the lesion will result in deformity of the knee joint, most patients have an inversion deformity. Most patients require a Rosenberg radiograph and an axial patellar radiograph, which show mainly joint space narrowing and periarticular osteophytes. Some doctors give MRIs to patients, and it is a misconception that MRIs are so expensive that they must be better than X-rays. In the case of osteoarthritis of the knee, X-rays are the best and superior to MRIs. Therefore, I believe that MRIs for osteoarthritis of the knee are not necessary. Conservative treatment The treatment of this disease cannot simply rely on medications. Most of the patients I come in contact with do not have a proper understanding of the disease, and all their hopes are pinned on medications. In fact, this is a misconception and the main starting point for me to write this article. I would like to tell patients with osteoarthritis of the knee that the treatment of this disease is “3 parts medicine and 7 parts nutrition”. The main goal of conservative treatment is to slow down or stop the progression of joint destruction and to reduce pain. Only treatment on the basis of “nourishment” can have good results. The main treatment includes taking oral non-steroidal anti-inflammatory and analgesic drugs, crutches (which can reduce the load by 30%), avoiding fast walking and walking slowly instead, avoiding sprains, avoiding excessive squatting, and always standing up slowly with both hands on the armrest when standing up from the seat. Another very important treatment is to strengthen the muscle strength around the knee joint. The main ones are straight leg raise exercises and bicycle exercise machines. In addition, intra-articular injections of sodium vitreous acid are also very effective.
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