What does degeneration of the knee joint mean? How is it treated? Knee degeneration, also known as osteoarthritis, osteoarthrosis, degenerative joint disease, proliferative arthritis disease, hypertrophic arthritis, and age-related arthritis, is the most common type of chronic, progressive joint disease. Its pathology is characterized by degeneration and destruction of articular cartilage, sclerosis of subchondral bone, reactive hyperplasia of joint edges and subchondral bone, and formation of bone redundancy. The clinical manifestations are swelling of the knee joint, pain, difficulty walking, difficulty going up and down stairs, difficulty squatting while standing, and inability to stand up while squatting, which is very painful for the patient. Although the disease progresses slowly and each patient’s performance is different, the final outcome is the same – loss of knee walking function. Studies have found that in the early 20s, gravity can cause the cartilage in the knee to degenerate, which is the main reason why many people have trouble with their legs as they get older. There are “4 stages” of joint degeneration and the incidence of osteoarthritis in people over 50 is 50%! The prevalence of osteoarthritis in people over 55 years old is 80%! The incidence of arthritis in China is more than 100 million people, and gradually younger. How to take care of joints is an essential course for everyone, and the first and foremost, is to understand the process of knee joint pathology. The first stage: the growth phase The growth phase of the joint is before the age of 18. There are two main types of pain during this stage: growing pains from bone development and joint damage from excessive activity. Stage 2: The Golden Age At the age of 18 to 30, the joints are in their golden age. Although the joints in their “peak state” have a strong ability to repair themselves, this is also the period when people are the busiest and use their joints most frequently. Stage 3: Vulnerability By the age of 30 to 45, joint cartilage produces early and mild wear and tear, and the frequency of aches and pains increases as the joint enters a period of vulnerability. For example, cartilage wear can affect joint movement, and the debris from grinding down may also stimulate the structures around the joint; women who often wear high-heeled shoes also tend to be more prone to injury in the knee joint. Stage 4: Degeneration Assuming 10,000 steps per day, the knee joint will experience mechanical wear and tear more than 100 million times after the age of 45. The more debris that accumulates in the joint, the more degeneration the joint will experience. During this period, bone loss begins to occur and the joint becomes less strong. As the joint continues to degenerate after middle age, the slightest irritation can lead to a range of conditions. What are the symptoms of knee degeneration? Pain is characterized by an increase in pain with activity, a decrease in pain at rest, and pain that is still present or even worse when moving again. It is especially difficult to go up and down the stairs, and one can only use the good leg or the less symptomatic leg to ascend and descend the stairs one by one, but not alternate between the two legs like normal people, and often it is more difficult to descend the stairs than to ascend them. Joint sprains, cold, and overwork can often trigger or aggravate joint pain. If the pain is severe, the leg cannot move and sleep is disrupted. Joint swelling Joint swelling is caused by synovial hyperplasia and intra-articular fluid accumulation, which often occurs initially due to sprains and cold, and later becomes persistent swelling. There is a rubbing sensation or a popping sound when the joint is moved. Knee tenderness is also known as weak leg. It is the phenomenon of sudden weakness of the knee joint during walking and the desire to kneel or fall, which may be accompanied by severe pain. The “gluing” phenomenon: After the joint has been stationary for a long time in a certain position, it is very painful when moving again and cannot be flexed or extended, and must be moved slowly and gradually for a while before the “gluing” phenomenon disappears and the knee joint can be flexed or extended. For example, when riding a bus, the patient has to stand up and move the joint one stop early in order to get off the bus. Strangulation Strangulation is when the knee joint is suddenly locked in a certain position during movement such as walking and cannot move, as if something is “stuck” in the joint, often requiring the joint to be swayed and flexed, often after feeling a “thump” before the joint resumes its original movement. The joint often resumes its original motion only after a “thump” is felt. Free bodies and ruptured menisci are common causes of joint locking due to articular cartilage debridement. Joint dysfunction: Due to cartilage destruction, bone fragmentation and synovial hyperplasia, the knee joint cannot be fully straightened and flexed, and cannot squat or hold weight, and even has difficulty sitting and defecating. Joint deformity: As the disease progresses, the knee joint becomes thicker and more deformed, such as an “O” shaped leg. What should I do about knee degeneration? Is there any good treatment? The conventional treatment for degenerative knee osteoarthritis is pain relief and anti-inflammatory drugs, acupuncture and ointment, etc. These treatments can reduce swelling and pain, invigorate blood circulation and remove blood stasis, relieve joint stiffness, pain and swelling, and restore knee joint movement. However, it should be noted that although these treatments can temporarily relieve the symptoms and achieve better results, they cannot prevent the deterioration of the disease, and when the disease becomes more serious, this treatment will not achieve satisfactory results. Degenerative osteoarthritis of the knee should be recognized and taken seriously. Early detection, diagnosis and treatment are undoubtedly necessary for patients. Generally speaking, it is still recommended that comprehensive treatment, combined with medication and rehabilitation, along with exercise and protection in daily life, enhance muscle strength, maintain joint stability and mobility, and finally consider surgery. However, for combined joint deformities, early correction, such as the orthopedic correction of “rotund legs”, should be carried out to prevent further development of the lesion, so as not to delay the treatment and affect the efficacy. Physiotherapy: Physiotherapy is the use of cold compresses, heat therapy and exercise to reduce the pain of the affected area, while enhancing the strength of the muscles around the joint and expanding the range of motion to increase the mobility of the joint and restore the function of the joint. 2.Exercise therapy: Increase joint mobility and muscle strength and stability through appropriate exercises: quadriceps strength exercise, knee mobility therapy, knee strengthening therapy, etc. It is important to note that many patients want to “wear out” the joint by repeatedly squatting and other more strenuous movements, not knowing that this pathological state of “wear and tear” aggravates the wear and tear of the joint, but exacerbates the progress of the disease. 3.Medication: The first line of medication for arthritis is “non-steroidal anti-inflammatory pain medication (NSAIDS)”, but many patients often have gastrointestinal discomfort and other symptoms when taking these drugs, and even gastrointestinal ulcers, bleeding or perforation. 4.Surgery: Generally speaking, if the condition of degenerative arthritis of the knee is serious and is not well controlled by traditional rehabilitation, physical therapy and medication, and if it continues to deteriorate, it is recommended that patients undergo surgery. For patients with degenerative arthritis of the knee at different times and with different needs, there are different surgical options available. 5.Arthroscopic surgery: the microscopic cleaning and repair of degenerated articular cartilage, meniscus and synovium, and removal of intra-articular free bodies. The surgery is less invasive, quick recovery, and you can go down to the ground in a few days after the surgery. It is suitable for degenerative arthritis of the knee joint which is not heavily deformed and has mainly mild to moderate degeneration. 6. Artificial joint replacement surgery: There are two types of joint replacement: unicondylar replacement and total knee replacement. The unicondylar replacement is mainly for patients with medial tibiofemoral joint lesions with minor deformities; while total knee replacement is the last salvage surgery, and the current surgical techniques and prosthesis design can achieve more satisfactory treatment results.