You may often see older adults walking with a hobbled gait, painful knee joints when walking up and down stairs, or even an “O” shaped leg. In fact, this is a group of diseases that cause signs and symptoms associated with damage to the integrity of joint cartilage due to a variety of causes – osteoarthritis.
What is osteoarthritis?
Osteoarthritis is commonly referred to as “spurs” or “osteophytes”. Although it is characterized by “spurs,” the underlying cause is the destruction of joint cartilage, loss of elasticity and strength, and the formation of sclerosis or cystic changes in the subchondral bone and bone fragments. This results in pain and movement disorders, which can lead to severe disability of the affected limb.
Currently, the prevalence of osteoarthritis is increasing globally year by year and has become the most common joint disease in the world, with the prevalence increasing rapidly with age; more than 50% of people older than 65 years have radiographic evidence of osteoarthritis, but 25% will have symptoms, and 80% of people older than 75 years will have symptoms.
What are the causes of osteoarthritis?
The causes of osteoarthritis are still being further investigated. It is currently thought to be related to aging factors, mechanical wear and tear impingement, immune response, free radicals, increased intraosseous pressure, and cytokines, the first two of which have been identified as relevant factors. Osteoarthritis can occur in any joint. Common joints are the knee, hip, ankle, shoulder, wrist, elbow, and finger joints, but osteoarthritis of the knee is the most common.
What are the symptoms of osteoarthritis?
Osteoarthritis can occur in joints throughout the body and manifests as pain, swelling, friction sounds, deformities, and limited movement in the corresponding joints. However, the incidence of osteoarthritis of the knee is the highest. Approximately 41% of patients with osteoarthritis have osteoarthritis of the knee. This is because the knee is a joint that is heavily loaded, active, and susceptible to trauma, strain, and wind and cold stimulation.
Osteoarthritis of the hip joint accounts for 19%. Osteoarthritis joint pain is characterized by excessive activity and can be reduced after rest. Osteoarthritis of the knee joint also causes impairment of the affected limb in squatting, going up and down stairs, and inversion and flexion contracture deformity in severe cases, resulting in joint disability.
Can osteoarthritis be prevented?
Although it is not possible to prevent osteoarthritis from occurring, there are a number of measures that can be taken to reduce or delay the onset of osteoarthritis. These measures include reducing weight, avoiding high heels, protecting the joints from injury, such as avoiding repeated impact or torque on the joints, minimizing frequent ascent movements, repairing or suturing arthroscopically if there is meniscal damage, treating joint ligament damage, and surgically repositioning intra-articular fractures.
If there is deformity around the joint, surgery should be performed to correct the deformity in time. In addition, taking calcium preparations, VitA, VitC, VitE and VitD can also have a preventive effect on osteoarthritis.
Is it better to exercise or not to exercise when I have osteoarthritis?
Exercise for osteoarthritis patients should be divided into two. Proper and appropriate exercise can prevent, slow down and slow down the process of osteoarthritis. Beneficial exercises include: swimming, walking, cycling, supine straight leg raises or resistance training and non-weight bearing joint flexion and extension activities. Incorrect excessive exercise can aggravate osteoarthritis. Harmful exercises are those that increase joint torsion or overload the joint surfaces: activities such as climbing hills, stairs, or squatting and standing.
What are the treatments for osteoarthritis?
Treatment of osteoarthritis is divided into 3 phases.
The first stage is based on conservative treatment with oral Chinese medicine, anti-inflammatory and painkillers, vitamins and glucosamine, and intra-articular injections of hyaluronic acid na and other drugs. Among the above mentioned medications, vitamins and glucosamine can be used as basic and long-term medications. Anti-inflammatory painkillers can be applied for a short period of time at any time depending on the patient’s manifestations such as joint pain or swelling.
Hyaluronic acid supplementation has been shown to have good symptom improvement, functional improvement and quality of life, and can be applied for patients with indications and conditions. Although many of the above drugs are available to treat osteoarthritis, none of them can reverse and stop the course of osteoarthritis at this time. Medication can only reduce symptoms for a period of time.
The second stage of conservative treatment is aggressive surgical treatment with arthroscopy when conservative treatment does not work. Arthroscopic debridement is useful for removing or repairing cartilage fragments, meniscal fragments, and bone fragments that cause mechanical impairment of the joint, and for removing synovitis-causing inflammatory factors through intraoperative high-dose joint lavage. Arthroscopic debridement reduces symptoms by eliminating mechanical impediments and inflammatory factors. Planing of the degenerated cartilage and meniscus does not lead to their repair, so the aim of the procedure is not to have new cartilage regeneration but only to relieve the symptoms; it does not change the pathological changes and course of osteoarthritis.
In the third stage when the destruction of articular cartilage is more severe and the gap is severely narrowed, artificial joint surface replacement is recommended. As can be seen from each of the above treatments, any treatment only temporarily alleviates the symptoms, and the most effective treatment is artificial joint replacement. Artificial joints are one of the most important advances in the field of orthopedics in the twentieth century. They have enabled patients who used to rely on crutches or even amputation to walk like normal people, greatly improving their quality of life.
It has given hope to some patients with advanced osteoarthritis who have severe joint destruction, and some patients who have been bedridden for a long time have been able to regain their standing and walking functions through surgery, partially or completely restoring their ability to take care of themselves. It is now widely used as a mature treatment method both at home and abroad. At present, artificial joint replacement has become one of the main means of treating serious joint lesions, and is regarded as one of the important milestones in the history of orthopaedic development in the 20th century.
Conclusion
In summary, the treatment of osteoarthritis should focus on early diagnosis, early treatment and a long course of treatment. In other words, prevention and comprehensive treatment should be started before the patient develops symptoms, before the articular cartilage becomes obvious, before the joint space narrows, and before the bone fragments become visible, and after long-term follow-up. Early osteoarthritis can be treated with a variety of medications and can reduce symptoms over time.
However, because there are no effective measures to control the progression of osteoarthritis, osteoarthritis will continue to progress and worsen. The only effective treatment for advanced osteoarthritis is prosthetic arthroplasty. It is worth emphasizing that artificial joint replacement is now a very mature procedure that can relieve pain, improve function and enhance the quality of life in later life for patients with advanced osteoarthritis.