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Knee Arthritis

Arthritis in the Ageing Trinbagonian by Dr. Godfrey Araujo

Joint pain, bone pain, aching muscles, stiffness and an altered gait may all be regarded by many in our population as “arthritis”. The fact is that there are many different types of arthritis which by definition is an inflammation of a joint (anythingwith “itis” denotes an inflammatory reaction). What we denote as arthritis is usually osteo-arthritis which is a degeneration of the cartilage covering the ends of the bones (“the gristle”) of our joints.

Depending on the degree of wearing out of this cartilage, we will have mild moderate or severe arthritis with pain, swelling, reduced range of motion of the joints and stiffness, along with the inability to walk for long distances, climb stairs, stoop and participate in sporting activity. This is especially so with aching knees.

What should we do?
Obviously prevention is the key- so weight control, judicious exercise (we should try to avoid high impact activities on hard surfaces which may increase the wearing out of our knees and hips) and care of our joints with proper nutrition and use of the appropriate footwear for our chosen activity to keep fit. If we do develop pain and or swelling of the joints – especially the knees – then we need to seek medical advice. There are other conditions which can cause the pain and swelling apart from arthritis. There are meniscal tears, ligamentous injury (sprains), or osteochondral lesions i.e. Focal damage to the cartilage (rather than a wearing out) covering the bone. Your GP can usually guide you on this but may need an expert opinion if the case is not straightforward.

The orthopaedic surgeon is the “bone specialist” who will listen to the history of the problem, examine you, order and review investigations (X-rays, CT Scans or MRIs) to make a diagnosis. Depending on the cause of the problem, the cure may be to adjust our lifestyle: weight loss, activity modification, footwear change including orthotics (i.e. special insoles), which along with the appropriate use of medication, and physical therapy or exercise may allow us to return to normal. If this is not the case then you may need an arthroscopy (keyhole surgery) to look inside the knee and treat the pathology or you may need a knee replacement.

A knee replacement denotes a resurfacing of the damaged ends (the femur and tibia as well as the patella) so that bone does not rub on bone. The metal and plastic surfaces remove this painful rubbing and allow the patient to have a pain-free, improved motion, often alignment and function of the knees.