27.JUN.2019 MIN READ | MIN READ

A midlife crisis can hit us in our middle-years, typically when we are in our 40s and 50s. It is that phase in life when work security gets established, family life is stable and there’s a yearning for something different. It is also during this period in our lives that the body begins to feel the strains of our yesteryears, and our joints begin to ache.

Look out for arthritis

Arthritis
One of the most common causes of joint pain is arthritis.

There are 2 major forms of arthritis, inflammatory arthritis and osteoarthritis.

Osteoarthritis, the load-related wear-and-tear of the body’s joints, is more common and usually begins after age 40. The disease affects 35% of adults aged 65 and older and is the leading cause of mobility disabilities such as difficulty walking or climbing the stairs.

The first sign of arthritis in the knee is usually pain. This is most commonly felt at the front of the knee with when climbing stairs or kneeling. As the condition progresses, even walking on flat ground can get affected. Associated symptoms include knee swelling, progressive stiffness or crookedness of the knees. Eventually, the ability to walk or stand for prolonged periods of time gets compromised.

Preventing osteoarthritis

The right approach to preventing or slowing down the progression of knee arthritis is in achieving the Right Weight, engaging in the Right Activities and seeking the Right Treatment.

Achieving the Right Weight means avoiding being overweight. The less weight your knees have to bear, the less wear-and-tear they will have.

Engaging in the Right Activities mean avoiding activities that may stress your knees. As much as possible, avoid squatting, kneeling and stair climbing. At the same time, one should maintain a healthy level of exercise and fitness.

Seeking the Right Treatment means seeing a doctor early when you start to encounter knee pain. Small problems treated early, and properly, have a better chance of being cured than if managed later.

Treatment for arthritis

When you see a doctor for knee arthritis, he or she will have 3 main avenues for treating you – medication, therapy or surgery.

Medication

Medication for arthritis
Medicines for arthritis can be ingested, applied topically or injected into the knee.

Ingestible medicines include painkillers that reduce pain but do not slow down wear and tear. Supplements like glucosamine have been shown to slow down the progression of knee arthritis.

Injectable medicines could be in the form of steroids for reducing pain and swelling, or joint lubricants that can reduce pain for up to 9 months.

Therapy

Therapy is sometimes needed to help patients regain knee mobility and strength. These two treatments, together with wearing knee guards for additional support, can reduce knee pain from arthritis.

Surgery

Surgery for arthritis
The most daunting prospect for a patient with knee arthritis is surgery. However, the right type of surgery, done at the right time by an orthopaedic specialist, has proven to be effective with very high rates of success.

Types of surgery can range from minimally invasive arthroscopy and cartilage transplantation to knee replacement.

Arthroscopy is a day surgery procedure and suitable for patients with mild arthritis. Recovery is quick, with most patients able to walk comfortably the next day.

Some younger patients with more advanced arthritis can benefit from cartilage restoration procedures.

There are various methods for restoring cartilage in the knee, ranging from arthroscopic procedures where the exposed bone is punctured to encourage new cartilage growth (microfracture), cartilage transplantation from new cartilage grown from the patient’s own cartilage (autologous cartilage transplantation), to grafting cartilage and bone from one part of the knee to another (osteochondral grafting). The choice of procedure and the success rate depends on an individual patient’s unique knee condition.

Knee replacement surgery is reserved for patients with advanced arthritis. The procedure has come a long way since its introduction 50 years ago. Today, knee replacement patients are usually able to be up walking 3 days after surgery. With the advancements in surgery techniques, the incisions are small and recovery is rapid. These developments also mean that knee replacement surgery now includes partial instead of total replacement, as well as more accurate surgery with custom designed instruments and computer guided surgery.

FAQs: Knee Arthritis

Does my diet have anything to do with arthritis in my knee?

Some patients with gout need to avoid certain foods, but the majority of patients actually do not have gout and do not need to follow a specific diet.

What supplements help prevent knee arthritis?

Studies have shown that oral glucosamine can delay the progression of knee arthritis but it has not been shown to prevent knee arthritis in people who do not have the condition.

Article reviewed by Dr Lim Lian Arn, orthopaedic surgeon at Gleneagles Hospital.

Reference

(2018, Dec 18) 11 Knee Pain Dos and Don’ts. Retrieved on 11 April 2019 from https://www.webmd.com/pain-management/knee-pain/knee-pain-dos-and-donts#2

Donohue, Maureen (2019, Jan 2) Runner’s Knee. Retrieved on 11 April 2019 from https://www.healthline.com/health/runners-knee#diagnosis

(2019, March 7) Knee Pain. Retrieved on 11 April 2019 from https://www.mayoclinic.org/diseases-conditions/knee-pain/symptoms-causes/syc-20350849

Kimberly, H. (2017, April 14) Chronic Knee Pain. Retrieved on 11 April 2019 from  https://www.healthline.com/health/chronic-knee-pain

Jon, J. (2018, October 22) Causes and tips for coping with chronic knee pain. Retrieved on 11 April 2019 from https://www.medicalnewstoday.com/articles/311308.php

27.JUN.2019
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Lim Lian Arn
Orthopaedic Surgeon
Gleneagles Hospital

Dr Lim Lian Arn is currently an orthopaedic surgeon at Gleneagles Hospital Singapore, with a special interest in knee and hip replacement and knee ligament reconstruction surgery.