We often have elderly people who come to the clinic with knee pain, complaining about their pain: they can’t walk fast, they can’t get up from squatting, their pain is getting heavier and heavier, and their knees are getting bent, which seriously affects their quality of life. At an age when they should be enjoying their lives, they are troubled by pain, limited mobility, depression, pain for themselves and worry for their children. In fact, this is a very common disease called “osteoarthritis”, which is also known as “long bone spurs”, “osteophytes” and so on. Patients usually do not understand the cause of osteoarthritis, but it is actually a normal aging process, just like the hair will be gray when you get older, about half of all people over the age of 60 have arthritis, especially as China is entering an aging society, osteoarthritis is plaguing more and more elderly people. Osteoarthritis starts in the articular cartilage, which gradually wears away as we age, eventually exposing the bone under the cartilage and causing pain when we move. Unfortunately, once cartilage wears away, it cannot be repaired with current medical care. So how can we prevent and treat osteoarthritis? The incidence of the disease is closely related to age, as discussed earlier. 2. More female patients, especially after menopause: In people aged 45 to 55, the frequency of men and women is comparable, while after the age of 55, there are significantly more female patients, and overall women are twice as likely as men to suffer from osteoarthritis. 3. Obesity, obesity will lead to increased joint stress, easily leading to osteoarthritis, followed by obesity-related systemic metabolic factors are also related to the onset of osteoarthritis. Occupational factors, some occupations have greater damage to the joints, such as heavy laborers, miners, dancers, weightlifters, etc., mainly due to long-term wear and tear of joint cartilage by high-intensity stress or injury. 5. Joint damage is also an important factor causing osteoarthritis: such as joint instability caused by ligament damage around the joint, meniscus damage or intra-articular fracture, etc. In fact, this is also very understandable. Damage to the ligaments around the joint leads to uneven stress on the joint and accelerates wear and tear, and the intact meniscus originally plays a cushioning role, but a broken meniscus will wear the joint cartilage and accelerate the aging and degeneration of the joint. In addition, genetic changes, nutritional disorders of articular cartilage, metabolic abnormalities, neurological abnormalities and changes in the biomechanical environment of the joint can cause osteoarthritis. Wearing high-heeled shoes with a sharp or wide heel increases the usual stress on the knee joint when walking and changes the stress point of the knee joint, which can also easily cause osteoarthritis. Currently, there are several treatments for osteoarthritis: 1. Lifestyle changes First, patients should establish the concept of self-maintenance, take the initiative to avoid various factors that are detrimental to the joints, squat less, go up and down stairs less, and try to use the elevator. Older people who like to exercise can change the way they exercise, such as avoiding mountain climbing, which is a big burden on the knee joint, and swimming instead. Obesity can lead to osteoarthritis, but it can also increase the burden on the cardiovascular and endocrine systems, so pay attention to weight control. If you feel your pain is severe, you should walk with the help of a cane or crutches, you can also use knee pads and wear comfortable sports shoes. For patients with osteoarthritis of the knee, muscle exercise is mainly aimed at the quadriceps muscle. The best way to exercise the quadriceps muscle is straight leg raise: lie on your back on the bed, straighten the lower limb and raise it at an angle of 45°, maintain it for 10s, and do it about 100 times a day. It is important to note that exercise therapy is only applicable to patients in the stable phase, if the patient is in the acute phase of the onset of pain, exercise therapy is neither scientific nor practical. 3, drug therapy Clinical often use non-steroidal anti-inflammatory drugs (NSAIDs): these drugs have anti-inflammatory, analgesic and antipyretic effects, is the most commonly used drugs for the treatment of osteoarthritis. Glucosamine: Glucosamine has both anti-inflammatory and pain-relieving effects, as well as delaying the development of osteoarthritis of the knee, and is considered to be the first drug or slow-acting drug to change the condition of osteoarthritis. In vitro experiments have also confirmed its good effect on cartilage metabolism, and it is also referred to as a chondroprotective agent. In the United States, glucosamine is a nutritional product and is available in supermarkets. In Europe and elsewhere, it is a prescription drug. In recent years, it has gradually gained the attention of clinicians and patients in China. If you can seize the opportunity to start early in osteoarthritis and adhere to a longer-term treatment, you may have taught good results. Although hormonal drugs can reduce pain, multiple intra-articular injections of hormonal drugs can degenerate the joint and lead to “corticosteroid arthropathy”. Since hormonal drugs are a double-edged sword, they can only be injected once for patients with joint oozing and severe pain. Another type of medication is hyaluronic acid, which can be interpreted as a lubricating fluid in the joint cavity and is beneficial in relieving joint pain, increasing mobility, eliminating synovial inflammation and slowing disease progression. However, drug treatment mainly plays a role in controlling symptoms and relieving pain, but it cannot cure the disease, but can only play a role in slowing down the development of the disease, just like the cosmetics commonly used by lesbians, which can only delay the aging of the skin, but cannot fight the aging process. 4.Surgical treatment There are two main types of surgery, arthroscopic cleaning and artificial joint replacement. Arthroscopic debridement mainly targets damaged ligaments, menisci, cartilage fragments and removes the inflammatory factors that cause synovitis through intraoperative high-dose joint lavage. The goal of arthroscopic debridement is to reduce symptoms by removing mechanical barriers and inflammatory factors. It is not intended to regenerate new cartilage (rather it may accelerate degeneration). Rather, it is intended only to relieve symptoms; it does not alter the pathological changes or course of osteoarthritis. It will not have any effect on cartilage dysfunction caused by already existing articular cartilage damage or abnormal cartilage metabolism. It can provide relief for patients in the acute phase with significant symptoms. The ultimate treatment for osteoarthritis is arthroplasty, which is like a metal “jacket” for the knee joint to replace the necrotic cartilage surface, hence the name “surface replacement. There is a misconception among patients that when surgery is mentioned, especially “joint replacement”, most of them immediately look sad and feel very scared. In developed countries, a large number of elderly people undergo this surgery every year and are freed from pain and resume normal activities. However, compared to patients in other developed countries, the elderly in China have many considerations, and many patients who have made up their mind easily miss the best time for surgery and have to continue to live with pain. In fact, if you can overcome the psychological barriers and undergo surgery early, you will not only save yourself from pain, but also spare your children from worry and enjoy the happiness of your family, why not?