The knee joint is a “heavy” part of the body, in addition to weight bearing, running and jumping can not be separated from it. The knee joint is like an old cow that has been working silently for decades, and is often the most vulnerable to injury. When many people reach retirement, their knees become more and more uncomfortable, and in addition to pain, they often have deformities, especially limited mobility. So, is there a way to make the ailing knees of the elderly move flexibly again? Please read this article “Mr. Wang’s medical history”, I believe you will understand after reading it.
–Title
There is an old man, Mr. Wang, 70 years old, engaged in mechanical research all his life, contributed to the country in his youth. Should have enjoyed his old age, but in recent years, knee pain is unbearable, adding endless troubles to life. My children wanted to do their filial duty and take their father on a trip, but they were afraid to go far away. The old man came to see me and became an acquaintance over time.
I remember the first time he came to my clinic, he looked tough, but he was on crutches, limping slightly, and had a little bit of a leg. He was very happy to see me, but also could not hide a trace of sadness. Seeing this, my heart already knew five or six points.
”Old man, how are you not well?” I opened my mouth to ask.
”Doctor Weng, finally I see you!” The old man looked a little excited, “My knee has been hurting for seven or eight years, and at first I could bear it, but in the last year or two the pain has been getting worse and I can’t go anywhere.”
”Can you straighten your leg and bend it back?” I asked and checked and found that his knee mobility was around 5° to 90°, much less than the normal 0° to 150°. In addition to this, there was an inversion deformity and positive joint space pressure pain.
The old gentleman cooperated with my examination and said, “It hurts very much when going up and down stairs and I don’t dare to walk long distances.”
”No, the joint has been deformed.” I asked him to take an X-ray of the knee to further clarify the diagnosis.
Half an hour later, the film came out.
I put the film on the light box, examined it carefully, and said to him, “This disease is called osteoarthritis.”
”Osteoarthritis ……,” the old man mused to.
Seeing his confusion, I explained to him, “A normal knee joint has a thin layer of cartilage, which is equivalent to a protective spacer. What is cartilage? It’s the white, brittle bone that we usually get when we eat chicken and duck.”
”Cartilage does not show up on X-rays, so you can see the joint space. But as you can see, your medial joint space is almost gone, which means the cartilage has worn down quite badly.” Hearing this, he nodded his head. I continued, “Without the protection of the cartilage, the bones grind against the bones when you walk, and the periosteum is rich in nerves and blood vessels, which makes it very painful. In the long run, the knee joint grows bone spurs and even deformation.”
”What is the cause of this disease?” The old man was born in engineering and wanted to find out.
”It is a degenerative disease, in other words, a manifestation of the aging of the human body. Researchers have conducted a lot of studies in recent years, but unfortunately have not yet found the exact cause. What is certain is that obesity, heavy physical work, and excessive exercise increase the burden on the knee joint and increase the risk of disease.”
”So that’s it.” He pondered, “Dr. Weng, how should this disease be treated?”
”In early osteoarthritis, there is a certain degree of cartilage wear and tear, and conservative treatment, mainly medication, injections, plasters, physical therapy, etc., is aimed at relieving pain, protecting cartilage, and slowing the progression of the disease.” I replied, “Bones can be regenerated, even if they are fractured at the age of 90, they can grow on again. But once the cartilage is worn out, it cannot be regenerated. Your osteoarthritis is already in the middle and advanced stages, and conservative treatment is hardly effective. The only way to cure it completely is to have surgery.”
When he heard that he needed surgery, the old man seemed to be unprepared and had a difficult look on his face. He thought about it and then asked, “What kind of surgery is it?”
”We thinly cut out the broken cartilage and replace it with artificial ‘alloy cartilage’ and add a wear-resistant spacer in the middle of the joint so that the knee joint can be as flexible as a normal person. Two or three days after the operation, you can go down to the ground, and after about two or three months of rehabilitation, you will basically be like a normal person.” I then showed him the beautiful pictures we had drawn of the operation and introduced the principle of the operation, and Mr. Wang, who has been involved in mechanical design all his life, listened with great interest.
”How many years will the newly replaced cartilage last?” He then asked.
”As long as it doesn’t break or get infected, it will last about 20 years without a problem. According to the literature, some have lasted up to 30 or 40 years.”
”At what age is it most appropriate to do this procedure?”
”Currently, young people do not choose this surgery as a last resort due to the limitations of the life span of the artificial component. But for older people with moderate to advanced osteoarthritis, it happens to be better the earlier it is done.”
”Why is it better to do it earlier for this group of elderly people?” The old man was a little confused.
”First of all, the quality of life of elderly people with severe osteoarthritis is quite low, they suffer from pain for years and years, and medication and injections do not work. He listened and nodded his head, and I continued, “On the other hand, if we keep delaying, once the elderly have poor heart and lung function, the risk of surgery will increase greatly, and by then, even if we want to do it, I’m afraid we can’t do it.”
”Dr. Weng, thank you very much.” He said, “I’ll go home and discuss it with my son and daughter.”
”Okay, you’re welcome.”
The old gentleman left and was greeted by the next patient. The busy outpatient clinic continued ……
A week later, one of Mr. Wang’s sons and daughters accompanied him to his follow-up appointment.
”How have you been?” I inquired.
Before the old man could say anything, his son said, “Dr. Weng, my father’s knee is really painful! We decided to have this surgery. We also want to ask, is the surgery risky?”
”The success rate of the surgery is very high as long as the surgery technique is good and there is no infection after the surgery.” I replied, “Old man, what do you think yourself?”
”I came back here because I want to do the surgery.” He nodded and said to me, “Dr. Weng, I have one more question.”
”Go ahead.”
”Can you operate on me personally?” The old gentleman gave me an expectant look.
”Of course you can!”
Soon after, Mr. Wang was hospitalized for a week, and I was touched by the meticulous care and filial piety of my children. The surgery went smoothly and was followed by regular post-operative check-ups.
Time flies like an arrow, and the years fly by. One year later, one day at the clinic, a figure came to me with a “miso”. When I looked at him, it was none other than Mr. Wang, an engineer.
”Dr. Weng, my daughter just brought me back from a trip abroad, I came to see you!” He smiled brightly, gone a year ago the trace of sadness, people more youthful.
”How are you feeling these days?” I asked him with a smile.
”Look at that!” Before the words left his mouth, he had already walked twice around the consultation room.