Thursday , August 18 2022

My old knee, if it’s cold and throbbing … Osteoarthritis of the knee :: Jiangnam newspaper


“Oh, my knees, it’s raining.” This is something that old people often say. As we get older, our joints age and become sore, swollen and stiff. Come learn about osteoarthritis of the knee that is left as a trace of time.

Osteoarthritis of the knee occurs when the cartilage in the knee that supports and distributes the weight is eroded.

According to the National Health and Nutrition Survey, 3.5 out of 10 adults over the age of 50 suffer from knee arthritis. The risk factors for the development of arthritis can be classified into systemic risk factors and local risk factors. Systemic risk factors include race, age, sex, obesity, hormonal changes, genetic effects, bone density, and nutritional status. Local risk factors include joint biomechanical changes, joint injury, occupation, sports, exercise and development. Exceptions, etc. It is difficult to explain the pathogenesis of osteoarthritis with a single risk factor, and different risk factors work in combination. Aging is the most important risk factor for the onset of arthritis in all types of infections, and its incidence tends to increase as the elderly population grows.

The symptoms that appear in patients with arthritis in the knee include aching, throbbing pain and limitation in joint movement. In the morning, the symptoms of joint stiffness along with pain first appear and usually last for about an hour. If the pain lasts for more than an hour, consider inflammatory arthritis. Patients with arthritis in the knee usually report that the pain worsens with weight-bearing activity and less with rest.

Osteoarthritis of the knee usually begins in the inner part of the femur, and as the degenerative changes become severe over time, the leg curves outward, looks like an O-shaped leg and even walking becomes difficult. Other symptoms include pain when squeezing along the surface of the joint, or a squeezing sound when moving the knee, accompanied by pain or swelling in the knee joint. Also, when touching the knee bone, abnormal bones grow around the joint, and bone extensions such as bumps can be felt.

Diagnosis of osteoarthritis of the knee is possible through a simple physical examination and X-ray examination after approval of the site of pain and symptoms. Other testing methods include bone scan, arthritis, arthroscopic diagnosis and magnetic resonance imaging (MRI). Medication reduces pain and edema and slows the progression of the disease. Class drugs include non-narcotic analgesics, non-steroidal anti-inflammatory drugs, selective Cox-2 inhibitors, and opioid analgesics.

Injection therapy also includes intra-articular steroid injection and hyaluronic acid injection. Steroid injection is known to the general public as ‘bone injection’. It has a strong anti-inflammatory function, so it is used when the joints are swollen or full of water, and the effect is excellent. However, if there is a risk of infection and frequent treatment, there may be side effects of steroids, so it is recommended to limit it to 3 to 4 times a year. Hyaluronic acid is a component secreted for lubrication and nutrition in normal joints. It has anti-inflammatory, risky and analgesic effects, and has few side effects, but the exact principle of action is still unknown.

Surgical treatments include arthroscopic surgery (arthroscopic surgery), corrective osteotomy and artificial joint surgery. Arthroscopic surgery has the advantages of short and short operation time, rapid recovery and the ability to use the original joint as it is. However, this cannot be done if the joint damage is severe. Remedial osteotomy is performed when there is more than half of the knee joint and the rest is relatively intact. It is a surgery that moves the axis that carries weight of the lower limbs to a healthy side, thus reducing walking pain and making daily life easier. This surgery is suitable for relatively young patients (before the age of 50) or physically active.

Artificial joint surgery is performed when arthritis in the knee is so severe that it is difficult to treat with other treatments. An artificial joint is inserted after removal of the old joint. Artificial joint surgery is performed taking into account the degree of disease, age and level of activity. In case of severe inflammation of the knee joint, severe heart disease, advanced cirrhosis of the liver, etc. If you are under the age of 50, you should postpone or avoid surgery if you need to continue exercising or strenuous exercise.

Exercise is the most important thing in all areas, including preventing arthritis in the knee, reducing pain and managing it after surgery.

To use the artificial joint for a long time after surgery, it is helpful to strengthen the surrounding muscles, especially the thigh muscles. Among the various training methods, in general, it is recommended to perform physical activity in which the weight is not heavy on the knee, such as walking on flat ground, indoor cycling or swimming. Exercises such as stair climbing and mountaineering can be difficult on the knee, so it is recommended to continue walking on flat ground about 3 months before the challenge.

The amount of exercise may vary depending on the degree of inflammation of the joints and the strength of the individual muscles, but in general, it is recommended to do this 3 to 5 times a week, with light sweating, and about 30 minutes a day. do not exaggerate. It is best to decide in consultation with the doctor in charge as the degree of the disease and the ability of the individual to exercise should be considered.

In old age strength training is more important than the above aerobic exercise. In particular, the thigh muscles should be strengthened with proper exercise methods as they play a role such as protecting the knees and facilitating blood circulation in the lower extremities. It is recommended to perform strength training within an hour and at least twice a week.

It is advisable to stretch enough before and after each exercise. After training, if you have joint pain or a feeling of heat, it is best to apply an ice pack. If the pain is severe, it is good to give the joint a rest.

Many patients neglect the knee pain and say, “I’m old, so I can not resist” or “I’ll be fine soon.” Because the knee joint is an essential joint for walking, it is directly related to quality of life. Director Ko Gio-hoon said, “I hope the exercise and proper treatment of knee arthritis will help preserve the quality of life.”

By Jung Min-jo, team reporter [email protected]

< Help = Rehabilitation Medicine Specialist of Heeyeon Nursing Hospital, Kyohoon Koo, Director >

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