Many middle-aged and elderly people have had the experience of gradual swelling and pain in the knee, not caring much at first, but over time, the swelling and pain became more and more intense, especially uncomfortable when squatting, squatting up to hold the side of something, in serious cases, even lifting the leg to walk is a problem, and then went to the hospital after examination was diagnosed as “osteoarthritis of the knee”. I. What is osteoarthritis of the knee? Osteoarthritis of the knee is a degenerative change (aging) of the knee cartilage and secondary osteophytes (bone spurs). Under the effect of local injury, inflammation and chronic strain on the knee joint, the cartilage of the joint surface degenerates and the subchondral bone plate reacts to bone loss, which eventually leads to a series of symptoms and signs in the knee joint. This is like a car tire, a normal tire is set on the hub so that the car can run normally, while a ruptured tire has no elasticity and support, only the hub rubbing hard against the ground, which is bound to cause damage to the vehicle itself. A normal joint surface is covered by smooth cartilage with “low friction”, just like a brand new car tire, which slides easily and improves the mobility of the entire joint. In osteoarthritis of the knee, the cartilage is lost, the bone is exposed, and the nerve endings are exposed, just like a worn car tire, the hard hub rubs directly against the ground, and the more it wears, the worse it gets. Second, what are the osteoarthritis of the knee being? Pain: The most dominant symptom, usually tingling-like, burning-like. In the early stage, the pain is sporadic and inconspicuous; in the middle stage, the pain increases when squatting, walking up stairs, walking on flat ground, and still improves after rest; in the late stage, the pain persists, and when the pain occurs even during sleep, it indicates a serious condition. Swelling: In the middle stage of osteoarthritis, the joint surface wears out and sheds debris, which causes inflammation of the synovial membrane, causing swelling, pain and discomfort in the joint. Joint deformation and restricted movement: As the symptoms of the disease worsen, the knee joint swells and grows, eventually deforming into an O-leg or X-leg. The effective range of motion of the joint is significantly reduced and the joint cannot be fully flexed or straightened. If the disease progresses further, the knee joint may lose its function completely. What are the conservative treatment methods for osteoarthritis of the knee? All medication is only “symptomatic treatment” to temporarily relieve the pain, but it is not “root treatment”, and there is no specific medicine that can cure the disease. Osteoarthritis of the knee is a degenerative process in the human physiology and there is no medication that can reverse it (just like there is no elixir of immortality). (1) Oral drug therapy Non-steroidal anti-inflammatory drugs (NSAIDs) can effectively reduce the inflammatory response and relieve the symptoms, and the COX-2 inhibitors are commonly used with small gastrointestinal side effects and high safety. (2) Intra-articular injection therapy Some patients with osteoarthritis can have pain relief by intra-articular injection of hormones and sodium glacialate, but it is not possible to regenerate the degenerated cartilage. For most patients, the therapeutic effect of intra-articular injections is limited, and the efficacy is not maintained for a long time, and repeated injections may accelerate joint degeneration. The latest AAOS guidelines for the treatment of osteoarthritis do not recommend intra-articular sodium glacial injections for patients with osteoarthritis. Intra-articular injections need to be used under the guidance of a professional joint surgeon. Excessive use can aggravate joint damage and accelerate joint degeneration, and there is a risk of infection, so their use should be strictly controlled. What are the surgical treatment methods for osteoarthritis of the knee? If the knee pain is not controlled after a series of conservative treatments, and if the symptoms persist and mobility is difficult, the doctor may recommend surgery. (1) Arthroscopic surgery Arthroscopic surgery is now widely used in the treatment of knee injury lesions. The surgery is less invasive, less painful, and has a faster recovery. Arthroscopic joint cleaning in mild to moderate knee osteoarthritis can effectively relieve pain and improve joint function. However, arthroscopic surgery has very limited efficacy in patients with severe knee osteoarthritis, and symptoms tend to recur quickly. (2) Artificial joint replacement surgery (including unicondylar replacement, patellofemoral joint replacement, and total knee surface replacement) Knee prosthesis replacement, with over 600,000 surgeries performed worldwide each year, has become one of the most successful orthopaedic surgeries of the 20th century. The number of these procedures is increasing as the standard of living improves, attitudes change, and society ages in pursuit of a higher quality of life. joint replacement is required for those over 60 years of age with severe knee disorders for which non-surgical treatments have failed. This surgery is usually performed under general or semi-body anesthesia and the operation usually takes less than 90 minutes. It involves the use of special surgical instruments to precisely remove the damaged joint surface and then install an artificial joint prosthesis. You can walk with assistance and perform functional rehabilitation exercises 1 day after surgery.