I saw a 65 year old female patient in the clinic this morning with moderate knee arthritis, she had seen many places and spent a lot of money. I forgot to ask if the 20,000 was all out of pocket or if it was also covered by medical insurance, but I felt it was quite expensive. If you are in pain, you are in a hurry, especially when some simple methods do not work (such as rest, hot compresses, oral and topical medications), it is easy to rush to the doctor. But what I want to say is that the words of regular doctors in regular hospitals must be listened to in full and heard in the heart. At least we are following the guidelines, following evidence-based medicine in the medical treatment, will not be mixed with too much self-interest. For example, in this woman’s case, if your conservative treatment is not working, you can consider joint injections and minimally invasive arthroscopic surgery. This is objective, scientific, and the most time- and money-saving and correct path for you. You have to listen to some unscientific things: “Surgery is horrible”, “Will the anesthesia in the operating room make me stupid?”, “I’m over 60, how can I do surgery” …… The most important thing is to choose a treatment that is advertised to be very effective, which often ends up delaying the disease, wasting money, and finally going around in circles, only to understand that you still have to listen to the specialist. So I think that science is really quite important. Many times, doctors feel that this is very simple and everyone should understand. But the fact is that the practice is like a mountain, not to mention the old ladies, many young people are not very clear about some basic medical knowledge. The Internet is so rich in information, but also mixed, many mixed with the commercial interests of the propaganda on the clamor. So I hope that doctors and friends will do more public service science propaganda, so that more and more correct voices can be heard …… The following are answers to some frequently asked questions about osteoarthritis of the knee, not necessarily very comprehensive, and may not be popular enough, but I will try to answer in a concise and easy to understand way. I. What is osteoarthritis of the knee? Osteoarthritis is also called degenerative arthritis and age-related arthritis. Osteoarthritis of the knee is common in the middle-aged and elderly population. It refers to a disease that causes pain, limited movement and even limping of the knee joint due to obesity and other causes of wear and tear of the knee cartilage as we grow older. Second, what are the reasons? 1, obesity lower limb joints are weight-bearing joints, the increase in weight is proportional to the onset of osteoarthritis of the hip and knee. Therefore, for early osteoarthritis, weight control is the first medical advice. 2, overuse of joints Articular cartilage refers to a layer of “brittle bone” on the surface of both ends of the bone near the joint, and this cartilage basically cannot regenerate itself. Therefore, just like the bearings of a machine will wear out, the chances of osteoarthritis are higher in people who work long hours or exercise excessively. 3, abnormal lower limb force line Due to congenital reasons, or childhood trauma, resulting in the lower limb stress transmission deviated from the normal axis, appearing ectropion or inversion, which will be more often than normal people appear cartilage wear. 4. Meniscal injury in youth 5. Inappropriate exercise III. 1. Knee pain is mild at first, but will gradually increase if not diagnosed and treated. 2. Knee swelling Occurs from time to time. 3.Limited knee movement In severe cases, there may be fixed knee deformity. 4. Deformity and limp As the symptoms worsen, the internal and external knee deformity will increase, accompanied by limp. In severe cases, the knee can not walk continuously for 15 minutes, the walking distance is less than 500 meters, it is difficult to go up and down stairs, and it is hard to stand up from squatting. IV. What department? Orthopedics V. Diagnostic criteria? The following conditions: 1. Recurrent knee pain within the past 1 month; 2. X-ray shows narrowing of the knee joint space, subchondral bone sclerosis or cystic changes, periarticular bone formation; 3. Clear and viscous joint fluid (at least 2 times), white blood cells less than 2000/ml; 4. Middle-aged and elderly patients (greater than or equal to 40 years old); 5. Morning stiffness less than or equal to 30 minutes; 6. Friction sound (sensation) when moving. If 1+2 or 1+3+5+6 or 1+4+5+6 are met, osteoarthritis of the knee can be diagnosed. VI. Differential diagnosis? Rheumatoid arthritis is a systemic autoimmune disease that first often presents with swelling and pain, limited movement or deformation of the wrist and hand. It erodes the synovial membrane and cartilage of the joint. There is often severe valgus deformity of the knee joint and severe osteoporosis. Traumatic arthritis A history of previous fractures around the joint (e.g., tibial plateau fracture) and unevenness of the cartilage surfaces predispose to arthritis at a younger age. VII. What are the x-ray findings? Narrowing of the knee joint space, subchondral bone sclerosis or cystic changes, periarticular bone formation. What are the complications? Knee inversion and osteoporosis are often combined. Knee valgus is most often seen in rheumatoid arthritis, but there are also patients who have had all of their lateral meniscus removed at a young age who develop arthritis combined with knee valgus. What drugs should I take? 1. Non-steroidal anti-inflammatory and analgesic drugs are commonly known as “painkillers”. It can counteract sterile inflammatory response and relieve pain. Note that patients with gastric ulcer is prohibited, take after meals. 2.Glucosamine can supplement the synthesis of proteoglycans in chondrocytes, reduce the damage of chondrocytes, and delay the course of arthritis. X. How to treat? Stepwise treatment plan. 1.When the symptoms are mild: weight control; oral medication or (and) topical creams; proper exercise; regular physical therapy. 2.Ineffective medication for 2 months: consider intra-articular drug injection therapy. 3, Poor conservative treatment: arthroscopic arthroplasty or chondroplasty of the knee. 4, Combined knee inversion, early cases of medial compartment arthritis only: high tibial osteotomy. 5. When symptoms are severe and have a greater impact on daily life: artificial knee surface replacement surgery; some cases may be suitable for unicondylar replacement. XI. What is the prognosis? Early diagnosis, early treatment, “save your money”. If there is already more than one compartment (the knee has three compartments: medial, lateral and patellofemoral), joint replacement surgery is often required, depending on how much the arthritis affects your daily life. The “life expectancy” of the artificial joint itself is about 20 years. 12. How do I care for my knee? The knee can be lowered to the ground the day after surgery, but will need a walker for two weeks, and then gradually walk normally. Knee flexion and extension exercises and thigh muscle exercises are required. Postoperative wound pain will gradually recover. XIII. What are the functional exercise methods? The main exercises include active and passive flexion and extension of the knee joint and exercise of the quadriceps muscle. Generally, orthopedic wards and outpatient clinics are equipped with professional rehabilitation physiotherapists.