OSTEOARTHRITIS OF THE KNEE.
This article would target the areas below;
Definition of OA
Causes/Risk factors of knee OA
Signs and symptoms of knee OA
Diagnosis of knee OA
Physiotherapy management of knee OA
DEFINITION OF OSTEOARTHRITIS
Osteoarthritis in general is a condition that occurs when there's degeneration of the articular cartilage found on the surfaces of bones which form a joint. Joint is formed by articulation of two or more bones. Each of these bones forming the joint has it surface covered with this cartilage to help prevent the bones from gliding directly on each other.
The cartilage is capable of providing cushioning at the joint and also produce a smooth, friction-free movement.
Osteoarthritis is a condition that mostly affect weight-bearing joints such as hip, knee and elbow joints. But the joints of the feet, and that of the hands and spine can equally be affected as well,but this rarely happens compared to that of the major joints especially knee joint.
It becomes spondylosis when it affects the spine.
The wearing away of the articular cartilage in osteoarthritis, makes the bones forming the joint, now have direct contact (kissing each other) during movement. This makes the whole joint becomes inflamed and result in pain, swelling and stiffness in the joint.
Most often after the cartilage is damaged, the body tries to repair this worn-out tissue and this process normally results in changes in the structure of the joint(Abnormal).
This then triggers symptoms such as pain, swelling, and stiffness in the particular joint affected.
Osteoarthritis is also known as "degenerative arthritis or "wear and tear disease ".
Osteoarthritis can affect each and every individual but ageing is the major apparent factor that may increase one's risk of developing it.
OSTEOARTHRITIS OF THE KNEE
The knee is a hinge joint formed primarily by the articulation of the femur bone and the Tibia bone.
The surfaces of each of these two major bones is covered by a coating of tough, but smooth and slippery tissue, called cartilage. This cartilage as earlier explained provides cushioning, and facilitates smooth friction-free, pain free movement at the knee.
OA of the knee occurs when this cartilage degenerates or wears out, making the bones touching each other directly during movement.
After the cartilage is damaged, the body starts to repair this and the process eventually result in structural changes in the bones that makes the joint becomes inflamed and cause pain, swelling, and stiffness in the knee joint. This changes in the knee joint after the damaged cartilage may be:
1.Osteophytes formation at the edges of the knee joint.
2.Thickness of the synovium as a result of over production synovial fluid than normal, which causes swelling, one of the most apparent sign of the condition.
3.Stretched tissues that surround the joint making the joint less stable.
Although the damaged cartilage can't be reversed, staying active and maintaining healthy body weight, as well as some treatment may slow the progression of the disease and help improve pain and joint dysfunction.
Osteoarthritis of the knee is progressive. It becomes worst as one ages. It normally occurs /starts at the early forties with a range of 40-60years.
CAUSES/RISK FACTORS OF KNEE OA
The most apparent cause of knee OA is unknown (idiopathic), but degeneration of articular cartilage found between the joint, on the surface of the femur and the tibia bones. This is different from osteochondritis dissecans, which is the separation of the articular cartilage from the subchondral bone. The cartilage breaks along with the bone it lies on.
Most often this articular cartilage degeneration may be influenced by the risks factors below;
#Ageing: The chances of developing knee OA increases with age. As one ages, there is changes in the anatomy and physiology of the structure of the knee joint. Wear and tear of the cartilage may occur during ageing, as well as osteophyte growth.
#Sex: The cases of knee OA is more in women than in men. The reason as to how this exist is yet to be known.
#Obesity :Obesity is one of the most contributing factor for the developing of knee OA. Excess body weight gain may increase stress put on the knee joint which may cause the cartilage degeneration.
#Genetics : It has been established that one becomes higher risk of knee OA when one of the parents or family member has had the disease before.
#Knee joint injuries
#Repeated stress on the knee
#Certain metabolic disease such diabetes, where iron becomes more in the body can also increase one's risk.
SIGNS AND SYMPTOMS OF KNEE OA.
Patients with knee OA may have the following signs and symptoms. This becomes worst as the patient ages.
*Pain in the knee during activity
*Stiffness in the knee especially in knee flexion
*Tenderness on palpation
*Loss of Flexibility in the knee
*Popping / Cracking sound on active and passive movement
*Bones spurs or osteophytes formation may be shown on X-ray report
*Swelling due to inflamed soft tissues.
DIAGNOSIS OF KNEE OA
Based on the age of the patient and the signs and symptoms the patient may present with, doctors may prescribe X-ray and Magnetic Resonance Imaging reports to determine whether there's any # or cartilage degeneration or osteophyte growth.
Doctors may prescribe pain killer medications to manage your pain but the stiffness, strength loss and endurable loss may not be restored and a physiotherapist may come in here.
Surgical management : In most severe cases, total knee replacement would have to be done to replace the cartilage. This also has it own side effect.
PHYSIOTHERAPY MANAGEMENT OF KNEE OA.
Physiotherapist may do further assessment in collaboration with the info of the X-ray report to ascertain whether your condition is Knee OA.
The physiotherapy management of knee OA may target most of the signs and symptoms the patient may be presenting with. The physiotherapist may set goals that would target :*Maintain joint flexibility
*Increased muscle strength
*Reduced pain
*Enhances endurance
These goals are achieved via some techniques instituted via exercises and use of modalities assistive aids.
1.Active exercises such as staircase climbing, mini squats, Leg swinging may help increase ROM and develop strength. Quadriceps bench, and therabands can be used to create resistance in knee flexion and extension to gain strength in hamstring and quadriceps. Isometric exx can equally be used for the strength gain.
2.Aerobic conditioning exx. Such as cycling, treadmill, swimming is used to improve the endurance level of the patient.
3.Hydrocollator packs applied to relief pain and reduce any swelling present. Infrared, can be used instead to achieve same purpose.
4.Passive mobilization of the involved knee
5.Knee Support may be prescribed for ambulation. This would help reduced the stress put on the knee during ambulation.
How do you prevent it?
One can prevent OA of the knee by managing one's body weight, preventing Diabetes.
Knee OA is manageable, the earlier you see a physiotherapist, the better your prognosis or treatment outcome.
ST. John of God College of health
Duayaw Nkwanta.
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