Knee Arthritis- Myths, reality and management

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Dr. Shreedhar

Posted By : Dr. Shreedhar - MBBS, MS (Ortho.)

Posted On : Oct 18, 2007 (Views : 9593)

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Knee osteoarthritis is one of the commonest problems faced by everyone. It is common because it is nothing else but age related ?wear and tear? of the joint. There is however a strong genetic involvement, too, and hence patients from the same age group may have a varying degree of arthritis.

The figure below shows the anatomy of the normal knee joint. The blue lining at end of the bones is known as the cartilage. In real life the cartilage looks like the inner side of a tender coconut i.e.; white, smooth and soft. The two ?C? shaped blue structures are the menisci which act like shock absorbers. During the aging process the menisci wear out and slowly the cartilage shows tiny cracks and finally the whole cartilage wears off. Finally one gets deformities like ?bow legs? where bones start rubbing against each other.

Osteoarthritis is a slow process and takes ages to develop. A mild pain on the inner side of the joint which is typically noted while getting up from a squatting position or while climbing stairs are the first signs of developing arthritis. Many of us experience this at around 40-45 years of life and most of us ignore it!

We all age but the degree of arthritis varies from patient to patient in the same age group. Apart from genetics there are many other factors which speed up the process of degeneration. We all know that we can not change our genes but we can alter certain other factors. Load is one of the important factors and our weight is borne by our knees! Therefore keeping one?s weight under check obviously helps. Another important point to note that the load borne by the knees while working against the gravity is six times the body weight. We orthopedic surgeons hence advise all patients with advanced arthritis to avoid climbing too many stairs and to avoid sitting on the floor because this involves 6 times extra load! This also means that if you are 10 kilos overweight then the knees carry 60 kg extra load while you climb stairs!

Many patients are told by their wise relatives to ignore this advice stating ?you will forget to sit down forever? or ?your body habits will change forever?. Please understand the scientific reason behind this advice. Similarly we advise elderly arthritic patients to use a walking stick. Use of a walking stick reduces the load on the knee by 50%! In reality my patients refuse to use a stick since they feel ashamed to use one!

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