KOCHI: Osteoarthritis, commonly known as OA, is a joint disease caused by the disintegration of cartilage in a joint in the body. It is primarily found in weight-bearing joints such as the ankle and knee but also arises in joints of the hand as a result of daily activity. Knee joint OA is a progressive disorder. The degeneration of the articular cartilage (white tissue that protects bones from rubbing against each other) causes knee pain, stiffness and a weakened joint structure.
While cartilage serves as a natural cushion between the bones, synovial fluid lubricates and supplies adequate oxygen to the joint, facilitating smooth joint motion in a healthy individual. Over time, the cartilage weakens and becomes thinner, resulting in roughness around the joint. As this develops, pain and swelling of the knee come into play, making everyday movements such as walking or sitting laborious.
Stage one OA is minor and is usually accompanied by minimal pain or discomfort. The joint looks normal on x-ray.
In stage two, bone deposits called Osteophytes grow in number around the joint as the cartilage weakens further. Stiffness aggravates, especially after the person stays in a sitting position for long periods of time. Moderate OA or stage three is when day-to-day activities such as walking, running, bending and kneeling cause distress owing to loss of cartilage and inflammation. As OA advances into the severe stage four, symptoms are very prominent. Cartilage breaks down, joint fluid reduces, diagnosis shows bone against bone contact and even walking becomes painful.
To boost overall joint health, an anti-inflammatory diet may be followed. This includes antioxidant-rich foods like fruits and vegetables, extra virgin olive oil and low-fat dairy products like cheese, milk and yogurt which are high in vitamin D and calcium. Excess body weight can increase pressure around the knee joint and, in turn, cause inflammation.
Immediate pain relief for OA is possible with standard medications such as Paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), opioids, superficial creams, etc. To reduce unbearable pain, direct steroid injections have also been employed in the past. PRP or Platelet Rich Plasma is a newly-found regenerative therapy that is extremely effective for knee OA. When PRP is injected into the joint, its dose is certified according to need.
The technique has been proven to greatly reduce knee pain and stiffness, gradually bringing back ease of movement to the patient. This process, combined with other medicines and physiotherapy, triggers the natural healing tendencies of the patient’s blood.Severe cases of OA are treated with surgeries such as total knee replacement (TKR) or high tibial osteotomy (HTO). The author is a consultant orthopaedic surgeon at Regencare, Kochi.