Osteoarthritis & Senior Life

On 12 July, 2025, Senior Today hosted its weekly Health Live Webinar with a Senior Orthopaedic Surgeon, Dr Avinash Date, who spoke on and answered questions about Osteoarthritis. He is Consultant Orthopaedic Surgeon at the Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai. 

Dr Avinash Date is an MS in Orthopaedic Surgery, DNB and MRCS from Edinburgh. He’s also done his FRCS and diploma in Health Administration. He completed his post graduation in orthopaedic surgery from KEM Hospital and also worked as a lecturer at the LTMG Hospital of Science for 3 years. He then gained experience in complex trauma. Dr Date has over 30 years of experience and specialises in bone and joint orthopaedics. He has worked at various multiple speciality hospitals in Mumbai as a consultant, Head of Department and also as a teaching faculty for arthroscopic surgeries in the UK. Dr Date has done his fellowship in Knee Surgeries through the International Center for Orthopaedic Education in France. He also did a fellowship in lower limb arthroscopy from Asia Pacific, Australia. He worked in the UK for six years and gained valuable experience in trauma and arthroscopy. He mastered new techniques in joint replacement, including computer navigation during this time. He has done several total knee replacement, total hip replacement and trauma cases over a period of time. 

Osteoarthritis is wearing of the cartilage of the articular cartilage. 

A normal knee is made of:

• Articular cartilage: it is a smooth covering over the bone. It is protective in nature  
• Ligaments: lateral and medial ligaments are present around the knee and 2 inside the knee joint 
• Menisci: these are the cushion between the 2 bones. They function as shock absorbers 
• Synovial fluid: provides lubrication 

Types of osteoarthritis:

1. Primary osteoarthritis: age related degeneration
2. Secondary osteoarthritis: this can be due to-
   1. Intra or extra articular fractures, ligament injuries and meniscal tears.
   2. Rheumatoid arthritis, alkalising spondylitis 
   3. Secondary to psoriasis 
   4. Acute or chronic infections ions of the knee joints 
   5. Tumors 

Symptoms of osteoarthritis include:

• Pain while walking, especially when walking down stairs. There can also be pain in the knee while climbing upstairs, this depends on the part of the knee involved/ affected 
• Difficulty in walking 
• Night pains- this indicated very severe osteoarthritis 

Osteoarthritis also negatively affects your social life in many ways. Where one starts to avoid social functions and gatherings and long travels. 

Not only that, it also has psychological effects, where it can eventually cause depression, reduced/ no social contact and can also spoil relationships with your relatives. 

Physical effects of osteoarthritis include:

• Heart diseases 
• Hypertension 
• Obstructive sleep apnoea
• Diabetes Mellitus Type II 
• Hyperlipidemia 

Osteoarthritis has different grades, from stage 1 to stage 4

1. Stage 1: Articular cartilage starts wearing off 
2. Stage 2: more of the articular cartilage wears off. Osteophytes can also be seen 
3. Stage 3: you start to see some gaps under the articular cartilage. The gap between the 2 bones starts increasing  
4. Stage 4: gap between the 2 bones is completely gone 

Investigations done to confirm the diagnosis:

• X ray 
• MRI- this is done only if the symptoms do not match the findings on the X ray
• Scanogram- this is done to see the mechanical axis and alignment of the hip, knee and the ankle. 

Medicines used for treatment of stage 1 and stage 2 of osteoarthritis:

• Glucosamine hydrochloride or sulphate 500mg, twice a day 
• Nutritional supplements 
• Diacerin 
• Chondroitin sulphate 

Other non surgical treatments include:

• Lifestyle modifications 
• Regular exercises, stretching and strengthening 
• Nutraceutics/ medicines
• Use of a cane 
• Splints or an osteoarthritis brace 

For stage 3: in addition to the above mentioned lifestyle modifications and treatment modalities, there’s also, Viscosupplementation- a lubricant fluid is injected inside your knee joint. It provides lubrication and also prevents further wearing of the articular cartilage. This can also be given with a steroid. 

Treatment modalities for stage 4:

• Knee replacement: in this surgery, the cartilage of the bone above is removed and replaced with a cap at the top. At the bottom and in between is the plastic. Thus, the movement occurs between the joints like a normal knee joint. 

Unicompartmental Arthritis:

1. Patellofemoral arthritis- the treatment is patellofemoral replacement 
2. Medial compartmental arthritis: the treatment is unicompartmental (only one part of the knee joint is replaced)

Advances in the field of Knee Replacement Surgery:

• Computer navigation 
• Robotic knee replacement 
• PSI (Patient Specific Instrumentation)