On 13 Aug, 2022 Seniors Today hosted their weekly Health Live webinar. This week we had with us Dr Dilip Shah who answered questions and queries about osteoarthritis.
Dr Dilip Shah is a leading Orthopaedic Surgeon based in Mumbai. With over four decades of experience, Dr Shah completed his MBBS from the KEM Hospital and Seth GS Medical College in 1978 and MS – Orthopaedics from KEM & GSMC in 1980.
He is a member of the World Orthopaedic Surgeon’s Association (SICOT) and the Bombay Orthopaedic Society.
Osteoarthritis is the medical term and arthritis is the common nomenclature in use.
Factors that can give rise to osteoarthritis:
- Infection
- Ageing process
- Female > Male
- Congenital factors
- Genetics and genetic making
- Obesity
- Joint overuse eg marathoners or frequent runners
- Joint trauma
- Surgical intervention
It leads to a slow and sedentary life. It also causes pain which can increase with time and also lead to joint destruction, joint instability, muscle dystrophy and disuse.
In osteoarthritis, the focal point is the disintegration of the cartilage. The cartilage around the joint becomes rough. As the disease progresses, the cartilage wears out and there are fissures over the cartilage. This also makes the cartilage very thin and dry.
How can we treat osteoarthritis:
- Non pharmacological methods:
- Education about the disease and subject
- Exercises
- Prevention of joint injuries
- Weight loss
- Orthotic devices
- Pharmacological methods:
- Topical application- NSAIDs, patches, rubefacient ointments
- Oral- NSAIDs, muscle relaxants, Opioids
- Intra articular injections of corticosteroids
- Surgical intervention
- For symptomatic treatment
- Joint restoration surgery
- Joint alignment surgery
- Joint replacement surgery
The knee has 3 compartments. When only one of the compartments, usually the medial or outer compartment is replaced, it is called a unicompartmental joint replacement surgery.
Complete/ total knee replacement surgery is when all 3 compartments are replaced along with the lower end of the femur, upper end of tibia and quite often the knee cap which is also called patella. This should only be done when the patient is in extreme pain, or has difficulty in performing day to day activities. The idea of a total knee replacement surgery should come from the side of the patient.
Arthroscopy gives you an advantage for not over 6 months.
Osteoarthritis is not just a disease that involves some wear and tear of the joints, it is defined by structural and cartilage changes. There are also changes in the muscles, bone and synovial tissue at the joint. Osteoarthritis is a collective of signs and symptoms.
Imaging is a standard tool to diagnose osteoarthritis, however a patient should only be treated if he shows any associated clinical symptoms and signs.
Similarly, if an individual comes with complaints and symptoms that are more clinically relevant to osteoarthritis than the radiological imaging shows, the patient should be treated accordingly.
Exercise, education and weight loss wherever applicable is a suitable line of treatment for osteoarthritis.
Joint mobilisation exercises are beneficial, wherever applicable.
Total joint replacement surgery is an appropriate treatment for individuals with advanced hip and knee osteoarthritis. But total joint replacement is not advised to everyone with a diagnosis of osteoarthritis.
Many people never reach a point where a total joint replacement surgery is a necessity or even required.
In conclusion, osteoarthritis is a chronic disease of the joints, with no cure or permanent treatment.
Total knee replacement surgery can cost you a lot. But the prosthesis used will last you for a minimum of 20 years which cost between ₹90,000 to ₹1 lakh. The price can vary depending on the type of implant/ prosthesis you are getting implanted.
You should not jog unless you do not have an artificial jogging track available. When you jog, you load your knee upto 3 times the weight that you do when you’re standing; it’s 2 times when you’re running and 1 time when you’re walking.
It’s better to do brisk walking or running than jogging.
Exercises are in 2 phases:
- Static quadriceps exercises
- Knee bending exercises
Walking and exercising in the water is advisable for individuals with weak muscles, it also applies less load on your joints.
