Osteoarthritis, commonly affecting the knee joint, is essentially the result of joint wear and tear. This could be attributed to age or a prior injury that accelerates the degeneration of the knee joint.

Individuals may have been experiencing knee pain in one or both knees for an extended period, accompanied by limited mobility while squatting or climbing stairs. Furthermore, a distinct “crunching” sound or sensation may be felt when bending the knee.

To confirm the diagnosis, Doctor may conduct a knee examination and request an X-ray to inspect the joint space or gap between the femur and tibia bones. Typically, the joint space comprises articular cartilage and meniscus, which appear as a shiny white gristle-like substance. However, articular cartilage does not manifest on X-rays, creating a gap.

If this articular cartilage wears out due to a prior injury or degeneration, the joint space narrows, often to the point where bones rub against each other, resulting in significant discomfort and knee crunching.

The treatment options for arthritis are contingent upon various factors, including:

• Age
• Severity of arthritis
• Weight
• General health
• Degree of pain experienced while at rest and walking
• Lifestyle

WHAT ARE THE TREATMENT OPTIONS FOR ARTHRITIS?

Conservative Method:

When treating arthritis, conservative methods are typically recommended for younger individuals (ages 30-60) who experience mild to moderate symptoms with minimal pain. This may include anti-inflammatory medications, physiotherapy, and lifestyle modifications such as avoiding twisting sports or changing jobs. While some individuals can be treated conservatively for many years, others may rapidly deteriorate and require surgery to alleviate severe pain.

Surgical Method:

For older patients with significant pain and arthritic changes on X-rays, surgery may be recommended. A high tibial osteotomy may be necessary for those still in their 40s-60s to relieve joint pain and grinding. This operation has an 80% success rate, and a thorough discussion with a doctor is necessary before proceeding to surgery. A successful high tibial osteotomy can enable an active lifestyle with few restrictions.

For senior patients (60+ years), a total knee replacement may be necessary when pain is constant and hinders daily activities like walking or playing golf. If pain prevents sleep or occurs at rest, it may be time for a total knee replacement. However, it is important to note that a total knee replacement is performed solely to alleviate pain and will not enable activities like kneeling, netball, touch football, ballet, or twisting sports. It can improve quality of life, enabling individuals to walk to the shops or play golf.

In some cases, a knee replacement may be performed on a younger person (40+ years) whose arthritic knee pain is severe and significantly impacts their quality of life. This operation has a 95% success rate, but the recovery period can last up to twelve months, and a thorough discussion of potential complications with the Doctor is necessary. Only individuals who accept the risks of surgery should consider having it performed.