Osteoarthritis of the Knee — A Major Cause of Pain and Disability

Osteoarthritis of the Knee — A Major Cause of Pain and Disability

Almost half of all U.S. adults and nearly two-thirds of obese adults will develop painful osteoarthritis of the knee by age 85.

Osteoarthritis of the knee is more frequent after the age of 50, but can occur at any age. On occasion, it is precipitated by an injury, but more commonly it occurs as a result of a lifetime of wear and tear. It can lead to a great deal of disability, interfering with mobility, increasing the risk of falls, contributing to deconditioning of the muscles, and markedly impairing quality of life.

For most adults, the presenting symptom is pain, which is made worse by movement. As the disease progresses, the knee can swell and become deformed. This condition can be very painful and difficult to manage, prompting many patients to look to arthroscopic surgery as a solution. However, new research indicates that the minimally invasive procedure may not be as beneficial as once thought.

Thanks to magnetic resonance imaging, a detailed evaluation of the abnormal knee is possible. In many cases the knee exhibits loose fragments, the cartilage is irregular, and a torn meniscus is frequently found.

Although arthroscopy’s efficacy is controversial, there is a general feeling that arthroscopy greatly relieves symptoms and reduces the need for a total knee replacement for many years.

In the past few years, this conventional wisdom has come into question. Two research studies recently published in the New England Journal of Medicine indicate that the value of arthroscopic surgery is questionable.

Osteoarthritis is more common in overweight adults.  A weight loss of as little as 11 pounds reduces the risk of developing knee osteoarthritis among women by 50 percent.

While there is little need for arthroscopic surgery, partial or total knee replacement remains a mainstay of therapy for those patients in whom pain is continually present and unrelieved by pain management, movement is very difficult, and quality of life is poor. There is no question that this operation, done under the right circumstances, can be very successful. Remember, though, that appropriate medical care combined with exercise and weight loss may prevent the need for a major surgical procedure.