As the population ages, the proportion of middle-aged and elderly patients with osteoarthrosis is increasing. Many of the middle-aged and elderly patients I see often do not know much about their joint disease, and many of them are confused about the treatments and medications available in society for knee and joint diseases. I would like to summarize the most common problems I have encountered in my clinical work over the years and give a brief explanation in the hope that it will help you in your treatment. Why do I have “osteoarthritis of the knee” when there is no “inflammation” in my joints? Can I be cured by hanging “anti-inflammatory water”? There is a misconception to be cleared up here. Many people immediately think that “inflammation” is “inflammation” when they hear “inflammation” and that they need to use “anti-inflammatory drugs” or even “saline”. “hanging saline”. This misconception is very common, especially in remote and rural areas. In fact, osteoarthritis of the knee is a pathological phenomenon caused by aging, metamorphosis, and increased wear and tear of the joints. In layman’s terms, it is a condition in which the joints are repeatedly swollen, painful, unable to move or impaired in movement, and in severe cases, the joints may even become waterlogged, hot, and unable to walk. There is no correlation with bacterial infections, and it is certainly not necessary to use “anti-inflammatory drugs”. However, if osteoarthritis is combined with intra-articular synovitis or even infection, the necessary anti-inflammatory drugs are appropriate, but this is a very rare occurrence in osteoarthritis of the knee. Second, I am still young, not even 50 years old, how can my doctor say I have osteoarthritis of the knee? It’s not a disease only for the elderly, right? According to the standards published by the World Health Organization, people under the age of 59 can only be called middle-aged, 60-69 years old are called low-aged elderly, and over 70 years old are called senior citizens. It is true that in the past, most people with osteoarthritis did not have the opportunity to go to the hospital because of factors such as low standard of living, limited medical science, and difficulty in accessing medical care, and even some orthopedic surgeons would say, “You are old, your joints are not flexible, so do less and enjoy more. However, with the improvement of the social and economic level, especially the cultural quality of the majority of the patient group and the improvement of their own care, more and more middle-aged people, even people in their 30s, will have clinical manifestations of “osteoarthritis”. These patients may ask me reluctantly, “Why do I have this disease at such a young age? Will I be crippled?” On the other hand, with the development of science and technology, especially magnetic resonance technology, it is difficult to miss patients with early osteoarthritis (mainly cartilage damage), and those who take X-rays and say, “There’s nothing wrong with the film Patients who take X-rays and say, “There’s nothing wrong on the film,” are often found to have cartilage damage on MRI of the knee. There is no reason to be overly nervous. In fact, early detection of early manifestations of osteoarthritis of the knee and early treatment can instead slow or even reverse the aging process of the joint and reduce the possibility of medium- and long-term disability. In some patients who have suffered a traumatic injury during adolescence or at a young age, or who have not been treated correctly and in a timely manner, damage to the articular cartilage also occurs early, a condition we call “traumatic arthritis”. For example, I saw a judo athlete who was only 26 years old but already had clinical signs of osteoarthritis of the knee. Third, I exercise every day, but why are my knee osteoarthritis symptoms getting worse? ”Life is about exercise”. This is one of the most familiar slogans for all patients with poor health, especially the middle-aged and elderly. In fact, for patients with osteoarthritis of the knee, I often have to say one more thing: “Do you know how to exercise properly?” . Inappropriate physical activity is not only unhelpful to the recovery of osteoarthritis of the knee, it can even be harmful. As mentioned above, the essence of osteoarthritis of the knee is excessive wear and tear and aging of the joints, as evidenced by the exfoliation of articular cartilage, the proliferation of bone fragments and the thickening of synovial membranes within the joints, resulting in joint swelling, deformation, fluid accumulation, pain and limited movement. In this pathological environment, you still “walk more than ten kilometers a day, jumping gymnastics, boxing, climbing, long-distance running, cycling” and other exercises can only aggravate the already serious wear and tear of the joint metamorphosis, adding insult to injury. There are also some middle-aged and elderly people who want to improve their quality of life through physical exercise because of factors such as “three highs”, obesity and poor sleep, but after a period of persistence, they often “do not lose much weight, but their joints hurt first”. In layman’s terms, this is the “hardware” that consumes joint cartilage in exchange for “blood pressure drop, blood sugar stabilization, weight loss, sleep and appetite improvement” and other “software” enhancements brought about by Misconceptions. Once again, we recommend that when you have lower extremity knee discomfort, do not engage in physical activity that is primarily weight-bearing on the lower extremity joints or that requires pace. Do more upper extremity-based or non-lower extremity weight-bearing exercises. You can get specific and professional guidance from the sports medicine department or the rehabilitation department or the physical therapy department of a regular hospital, so I won’t go into the details here. What kind of medicine is available for osteoarthritis of the knee? Does it work? Will it come back? Is there any “addiction”? Currently, the most prescribed medications for patients with osteoarthritis of the knee are painkillers, drugs to reduce swelling and improve blood circulation, Chinese medicine (most of which are also known as “blood circulation and microcirculation” drugs), and cartilage nutrients. The first two of these drugs are only a kind of “symptomatic treatment”, that is to say, “where to treat discomfort”, and can not reverse the development of the disease process, and can not be taken for a long time. The Chinese medicines are not generalizable due to their complex composition, but they are generally considered to have only an ameliorative effect on the symptoms of the disease, and we recommend that patients try them for a short period of time, but not for a long time. As for cartilage medications, the most commonly used are various “glucosamine” and “chondroitin sulfate”, “hyaluronic acid” and so on, which theoretically can provide raw materials for cartilage repair and have almost no side effects. However, the disadvantage is that some patients have serious cartilage damage in their joints, and even if this “raw material” is provided, the damaged cartilage cannot be “repaired” or “partially repaired”. “. Fifth, I just have poor walking and climbing, why would a doctor ask me to operate? Is this expanding the indications for treatment? In our clinical work, we have encountered many patients who report that their knee discomfort is “not very serious”, “just heavy work”, “can get better with some medication”, etc. This is often when the body is still in a state of discomfort with the knee. This is often the time when the body is still tolerating the discomfort of osteoarthritis of the knee, and during this time the patient feels “fine” or “intermittently good and bad”. However, the wear and tear of the articular cartilage continues to develop and even worsens, and some patients do show severe articular cartilage loss on x-rays or MRIs, making them eligible for knee replacement surgery. However, if you recognize the disease, treat it early, and improve your lifestyle, behavior, and inappropriate exercise regimen, you have a good chance of avoiding or delaying the surgery. Being told by your doctor that you need surgery is not only to let you know the state of your disease, but in a sense it is also a “yellow card warning” that you really need to take your joint disease seriously! Sixth, the doctor said that my knee joint must be replaced, is there no way to save it? Do I have to have an artificial knee? The artificial knee joint is an important achievement in recent years in the development of joint surgery technology. It is true that there are risks of surgery and anesthesia, poor post-operative recovery, infection and other complications and risks, but it is really the only treatment for patients with severe knee osteoarthritis, especially those who “can’t even walk or squat on the toilet because of the pain”. It is also a very well established procedure and remains a safe and efficient treatment overall. However, because osteoarthritis of the knee is not a life-threatening disease, and the purpose of surgery is to improve quality of life rather than to save lives, and at this stage, artificial knee replacement surgery is still unable to absolutely avoid and minimize certain surgical complications and complications, I believe that a doctor who tells you that “the cure is guaranteed” will not give you peace of mind. I don’t think a doctor who says he can fix your knee is going to make you feel comfortable enough to give him your knee. The patient’s willingness to be treated is very important, otherwise we would not be able to arrange this surgery for you easily. 7. Can minimally invasive arthroscopic surgery cure osteoarthritis of the knee? What are the after-effects? For some patients who have osteoarthritis of the knee and do not have significant results from conservative treatment, or who are very young and are afraid of the risks of artificial joint replacement surgery, we can try arthroscopic debridement of the knee cavity if the patient has only early osteoarthritis and the overall condition of the joint is acceptable and there is no significant deformity. This can be done by removing the hyperplastic synovial membrane and the bone fragments that produce articular cartilage wear, removing intra-articular free bodies, and “welding” and “flattening” some of the articular cartilage that is close to exfoliation using a technique called “low temperature plasma ablation”. “This can significantly slow down the process of osteoarthritis, and a significant number of patients recover well after surgery. However, we must be fully aware that arthroscopic clearance of the joint cavity is only a limited treatment, and the results are uncertain for patients with moderate to severe osteoarthritis, with some patients even being ineffective and having to undergo second-stage knee replacement surgery. Arthroscopic surgery is a very safe procedure, and there are usually no serious risks or complications after surgery. I do have osteoarthritis of the knee, but I don’t want to have surgery and I don’t want to take medication for a long time, is there really no other way? For this group of patients I tend to say “I respect your choice, but please also respect the laws of natural science”. The right lifestyle is far more important than injections and medication. Reduce unnecessary life behaviors and labor, give up some exercise, don’t be afraid to wear a knee brace, hold a crutch or use a walker. These methods are often more effective, although more troublesome. Finally, I would like to remind you that you should be careful about “puncturing and pumping” the knee cavity, or “using closed needles” or “applying plasters” as a last resort. Such treatments are often not curative, and there is a risk of intra-articular infection.