06 July 2011

OSTEOARTHRITIS, KNEES

Osteoarthritis (OA), also known as degenerative arthritis, is a condition of the joint that worsens with time. It is the most common type of arthritis and there is no cure.

It is caused by wear and tear due to excessive use over the years or to old injuries in the affected joints. It commonly affects people over 60 years of age. It mostly affects the large weight-bearing joints like the knees, hips and spine, causing pain and stiffness which is worst at the end of the day. The affected person may have difficulty in walking, climbing stairs, squatting or kneeling.

RISK FACTORS

  • Family History

  • Sex ( Females are at higher risk)

  • Obesity ( 66% of obese people are at risk for Knee OA )

  • Age ( higher risk above 45 years old)

  • Joint Injuries

  • Physical Activities ( repetitive trauma to joint)

  • Ethnicity ( Asians are at higher risk )

FEATURES

Typical features include :

  1. narrowed joint space

  2. cartilage loss and damage

  3. bone spur formation

SIGNS AND SYMPTOMS

Signs and symptoms include :

  1. Joint pain and swelling

  2. Cracking sounds in joint

  3. Stiffness

  4. Difficulty in movement

70% of OA cases are that of Knee OA.

25% of sufferers are unable to perform major activities of daily living.

TREATMENT OPTIONS

  1. Lifestyle modification ( weight loss, decreased weight-bearing activity etc)

  2. Physiotherapy ( strengthening of the muscles around the joint )

  3. Oral supplements ( e.g glucosamine)

  4. Painkillers ( side effects of medications need to be managed carefully )

  5. Joint Injections ( steroids, viscosupplementation)

  6. Surgery ( for severe cases when all other treatments have failed to provide relief)

LATEST UPDATES

Viscosupplementation is indicated for the treatment of pain in patients with Knee Osteoarthritis, who have failed to respond adequately to conservative therapy and painkillers. It involves an injection into the affected knee joint. It basically replaces damaged joint fluid with a substance similar to healthy joint fluid, in order to reduce pain, improve the knee joint's natural shock-absorbing qualities and to improve mobility and function.

The response to this injection varies from patient to patient, but relief from pain is felt from 1 week to 6 weeks post-injection. Pain-relief with this injection can last from 6 months up to 1 year.

Patients can opt for either the one-time injection or the series of 3 injections on Day 1, Day 8 and Day 15. The effects of both are similar.

Prices are around $840 for the single injection,

or $280 per injection for the series of 3 injections.

References: http://www.hpb.gov.sg/diseases/article.aspx?id=568