Osteoarthritis (OA) is a degenerative disease characterised by damage to the articular cartilage. The articular cartilage is the smooth white tissue that covers the ends of bones that come together at a joint. The cartilage slowly wears away, and in the process bone spurs form at the joint. The knee joint is particularly susceptible to osteoarthritis, and people who have OA in their knees experience pain and swelling daily. There are a variety of treatment options available for such people.
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Non-surgical and surgical treatments are the two avenues open to people suffering from osteoarthritis of the knee.
Non-surgical treatments include lifestyle modification, exercise, supportive devices and medication.
Lifestyle modification often means losing weight because many people afflicted with osteoarthritis of the knee are overweight. It can also involve stopping activities that worsen the condition. An exercise regimen can alleviate pain because it improves leg muscle strength and tone. Supportive devices such as canes, shoe inserts, and knee braces can help to lessen the pain of standing and walking. Medication encompasses the use of over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like paracetamol, ibuprofen and naproxen as well as prescription NSAIDs like celecoxib to relieve pain, inflammation and swelling. Glucosamine and chondroitin sulfate are over-the-counter oral supplements that may help relieve pain.
When non-surgical treatments fail, the patient has four surgical options: arthroscopic surgery, osteotomy, total or partial knee replacement, and cartilage grafting. In osteotomy the surgeon cuts the shin or thigh bone to try to realign the knee. Cartilage grafting or transplantation involves removing damaged cartilage and replacing it with healthy cartilage taken from another part of the knee.
People who take NSAIDs (over-the-counter or prescription) as part of their treatment of osteoarthritis of the knee should know that there are problems associated with long-term use of these drugs. The first problem is that over time the body will build up a tolerance to the drug so that it becomes less effective. A second problem that might affect people taking more than one medication is the problem of drug-drug interaction. This means, for example, that the pain medication for the knee might interfere with the action of a blood thinner. Third, long-term use of NSAIDs can lead to changes in kidney and liver function and can compromise blood clotting.
Acupuncture and magnetic pulse therapy are two other treatment options for OA of the knee. Acupuncture involves the placement of fine needles in specific areas of the body in order to relieve pain. Magnetic pulse therapy employs a pulsed signal sent to the knee from a surrounding electromagnetic field.
Glucosamine and chondroitin sulfate can cause side effects and can interfere with other medications even though they are natural substances found in articular cartilage.
Research efforts are concentrating on the discovery of new drugs for treating OA of the knee and on the improvement of techniques of cartilage transplantation.
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