Osteoarthritis (OA) is a chronic joint disease characterized by degeneration and destruction of articular cartilage and osteophytes. The disease is more prevalent after middle age. Preliminary domestic surveys show that the overall prevalence of osteoarthritis is about 15%, with a prevalence of 10%-17% in people aged 40 years and 50% in people aged 60 years or older, while 80% of people aged 75 years or older suffer from osteoarthritis. The ultimate disability rate of the disease is 53%. Clinically, swollen and painful joints, osteophytes and limited mobility are most common. There are no geographical or racial differences in the development of osteoarthritis. Age, obesity, inflammation, trauma, and genetic factors may be associated with the development of the disease.
Clinical manifestations
1. Symptoms and signs: Osteoarthritis is mainly characterized by pain, swelling, morning stiffness, joint effusion and bony hypertrophy of the affected joints, which may be accompanied by bone rubbing sounds, dysfunction or deformity during activities.
(1) Joint pain and pressure pain: The most common manifestation of this disease is localized pain and pressure pain in the joints. The weight-bearing joints and hands are most likely to be involved. It is usually mild or moderate intermittent pain in the early stage, which improves with rest and worsens with activity. There may be localized pressure pain in the joints, which is especially obvious when accompanied by joint swelling.
(2) Joint swelling: In the early stage, there is limited swelling around the joint, but as the disease progresses, there may be diffuse joint swelling, bursal thickening or joint effusion. In the later stage, bony bulge may be palpable around the joint.
(3) Morning stiffness: Patients may experience joint stiffness and adhesion in the morning, which may be relieved after activity. The duration of morning stiffness in this disease is relatively short, usually a few minutes to ten minutes, and rarely exceeds half an hour.
(4) Joint friction sound: mainly seen in osteoarthritis of the knee joint. Due to the destruction of cartilage, the joint surface is rough and there is a bone rubbing sound (sensation) or twisting sensation when the joint is moved, or it is accompanied by local pain in the joint.
Osteoarthritis of the knee joint is a common disease in the elderly, usually called “osteophytes” and “knee degeneration” in China. A recent study by the American Academy of Orthopaedic Surgeons (AAOS) concluded that some of the treatments commonly used in the treatment of osteoarthritis of the knee (OA) lacked a strong scientific basis, and based on evidence-based medicine, the AAOS released 22 treatment recommendations in December 2008 for patients with osteoarthritis of the knee who do not yet have enough time for joint replacement.
I. The guidelines recommend effective treatments for knee OA
1. Patients with a body mass index (weight/height squared) of more than 25 should lose at least 5% of their body weight.
2. Aerobic low-intensity adaptive exercise.
3. Use acetaminophen (no more than 4 g/d) or non-steroidal anti-inflammatory drugs to relieve pain. In addition, topical NSAIDs, or oral gastroprotective agents and COX-2 inhibitors can be used for patients at high risk of gastrointestinal distress.
4, For short-term pain relief can be intra-articular injection of glucocorticoids.
5.Arthroscopic surgery can be performed in case of meniscal injury or free body.
6. Patellar support band for short term pain relief.
II. This guideline does not recommend the following treatment measures for knee OA
1. Puncture irrigation.
2. Glucosamine or (and) chondroitin sulfate (hydrochloride).
3. Foot orthopedic brace.
4. Arthroscopic washout in the absence of free body or meniscal damage as an indeterminate result.
III. Treatment of unspecified treatment measures
1, Intra-articular sodium hyaluronate injection for mild and moderate OA.
2, Bracing.
3.Acupuncture.
Of course, serious conditions and non-surgical treatment is ineffective to consider artificial joint replacement.
Attachment: height and body mass index.
BMI (Body Mass Index, also known as Body Mass Index, or BMI for short) is a number derived by dividing the number of kilograms of body weight by the square of the number of meters of height, which is a standard commonly used internationally to measure the degree of fatness and thinness of the human body and whether it is healthy. BMI is a neutral and reliable indicator when we need to compare and analyze the health effects of a person’s weight on people of different heights.
Body Mass Index
This concept was first introduced by Kettler, a Belgian generalist in the mid-19th century. It is defined as follows.
Body Mass Index (BMI) = weight (kg)/height (m) squared.
Statistical significance of BMI values
The BMI was originally designed as a statistical tool for public health research. When we needed to know whether obesity was the cause of a disease, we could convert a patient’s height and weight into BMI and find out if there was a linear correlation between the value and the incidence of the disease. However, with the advancement of technology, the BMI value is now only a reference value. To truly measure whether the patient is obese, it is necessary to use microelectricity to measure the patient’s impedance in order to deduce the thickness of the patient’s fat. Therefore, the role of BMI is slowly changing, from medical use to general public slimming indicator.
BMI values for adults
Body mass index, male, female
Underweight, below 20, below 19
Moderate, 20-25, 19-24
Overweight, 26-30, 25-29
Obese, 30-35, 29-34
Very obese, above 35, above 34
Experts say that the ideal body mass index is 22
Because of the error, BMI can only be used as one of several criteria to assess an individual’s weight and health status. The National Institutes of Health (NIH) recommends that physicians assess whether a patient is overweight by looking at three factors
BMI Waist circumference – a measure of abdominal fat and risk factors for obesity-related diseases such as high blood pressure, high LDL (“malignant”) cholesterol, low HDL (“benign”) cholesterol hyperglycemia, and smoking.
Because BMI does not take into account a person’s fat percentage, a person with an overweight BMI may not actually be obese. For example, a person who practices fitness will have a BMI over 30 because they have a heavy percentage of muscle. if they have a low percentage of body fat, then they do not need to lose weight.
Asian standards
The traditional WHO adult obesity standard is less than 30, but the Asian adult indicator has recently been changed to 27.5. an Asian adult with a BMI of 23 is now considered overweight, while the ideal index is 18.5 to 22.9. the official indicator for Singapore.
BMI values for children
BMI values do not apply to adults alone. For growing children, we can also use their BMI values to figure out if they are overweight. The above BMI formula also applies to people between the ages of 2 and 20, but their overweight and underweight indicators are not determined by a fixed BMI value. This is because children in different regions have different growth rates, and if a fixed value is used, it is easy to make a wrong judgment.
Many countries and regions have annual height and weight statistics for their children. These statistics can be converted into BMI values, and then the distribution of BMI values of local children can be calculated. Based on this distribution, local health authorities can project the overweight and underweight indicators of local children. Generally, the average BMI and its standard deviation values are used to calculate the highest 5% and lowest 5% of the normal distribution as the overweight and underweight indicators. On the other hand, children with a BMI in the range of 85%-95% of the normal distribution are at risk of being overweight.