OSTEOARTHRITIS OF THE KNEE
You should not have to accept to live in pain. A successful conservative treatment can provide control on the course of the disease. And when this is not enough, surgery is effective to regain painless mobility and quality of life.
WHAT IS KNEE OSTEOARTHRITIS?
Contrary to popular belief, osteoarthritis is not an unavoidable age-related inconvenience. It is a disease, that manifests by the combination of two processes on one or more joints: destruction and distorted reconstruction.
Osteoarthritis affects the entire joint, with progressive loss of articular cartilage, bone deformities that can impair movement (cysts and abnormal growths called osteophytes), and weakening and loosening of muscles and ligaments that normally provide support and stability for the joint.
Osteoarthritis can affect any joint. The knee joint is highly impacted by body weight, and one of the most frequently affected.
WHAT CAUSES ARTHRITIS?
A distinction is made between "primary" osteoarthritis, the origin of which is unknown and most probably multi-factorial, most often affecting multiple joints in elderly people, and "secondary" osteoarthritis, which most often affects only one joint and which develops after a lesion of the articular surface (for example after a trauma, repeated stress, or a necrosis linked to the consumption of alcohol or certain drugs).
WHAT ARE THE SIGNS AND SYMPTOMS OF OSTEOARTHRITIS OF THE KNEE?
The first sign of osteoarthritis is usually pain in the knee area.
The pain typically manifests after prolonged rest, by morning stiffness, and is triggered by physical activities such as running, walking, jumping, or climbing and descending stairs.
One can also experience fatigue-related pain, when standing for a long time for example
Gradually, pain appears after shorter walking distances, and becomes increasingly limiting. As the lesions get worse, the range of motion of the joint is limited and limping appears.
The pain can typically present as osteoarthritis attacks or periods of painful peaks which occur especially at the end of the day or even at night, sometimes with swelling of the joint due to the presence of an effusion. You may have acute pain related to mechanical blockages or pseudo-blockages of the joint.
WHY DOES IT HURT?
The joint surfaces and the cartilage per se do not have nerve endings. The pain can come from the bone in the immediate vicinity of the joint, the joint capsules and their internal membrane and other soft parts which have many pain receptors (ligament and tendon insertions, muscles).
It is essentially the inflammation that is painful.
When the inflammation becomes chronic, it self-maintains and affects all tissues in contact. The bone just under the cartilage reacts by deforming. Another phenomenon is very problematic: the muscles and tendons, which normally have the role of supporting and protecting the joint, weaken. The joint becomes more vulnerable to injury.
The pain of osteoarthritis is typically maximum when movement is initiated after a period of immobility of the joint. The pain usually subsides after a few minutes of activity. The two pitfalls to avoid are prolonged inactivity and sedentary lifestyle and lesions due to intense sportive activity. It is recommended to avoid the practice of sports involving impacts such as jogging, and to encourage regular gentle activities like swimming, cycling or Pilates. The practice of yoga can be beneficial but be careful however of certain postures : it is important to make sure to choose a qualified instructor and to inform him of your condition so that he can adapt your exercises if necessary.
WHEN SHOULD YOU SEE YOUR DOCTOR?
If you have pain, you limp, or if the range of movement of your knee is limited, we recommend that you see a doctor right away to perform a complete diagnosis, relieve pain and inflammation, and initiate targeted therapy to protect your joint.
The current evidence-based recommendation is to initiate appropriate treatment without delay when the first symptoms appear (conservative at first, then surgical if the painful symptomatology persists despite a well-managed conservative treatment) because the prognosis is better if the treatment is initiated quickly.
Without treatment, pain and functional limitations create a vicious circle: social and professional activities are limited, the muscles melt, and injuries progress.
HOW TO PREVENT ARTHRITIS OR CONTROL ITS EVOLUTION?
Conservative treatment for osteoarthritis of the hip is based on four essential pillars:
1. Reduce the impact of weight load
With each step, the load on the knee is more than 4 times the body weight. It is therefore important to relieve the joint of any excess weight, to slow the progression of the disease. In addition, as we will see below, by modifying your diet you can also act on the inflammation itself.
2. Fight inflammation and pain
In the acute phase, drug treatment is often necessary. In some cases, intra-articular injections may have short-term pain relief.
Our experience is that it is often very effective to make changes in one's diet, which has a great influence on inflammation, which is why we have integrated management by a registered dietitian into our treatment program.
3. Maintain the joint function
By striking the right balance between strengthening muscles to supporting the joint and working to maintain joint mobility, with professional follow-up for restoring motion without risk.
4. Protect your joints in everyday activities
With the help of an occupational therapist, we learn to avoid inappropriate gestures during physical professional activity, intense sport and even in everyday life. Occupational therapy sessions are an opportunity to adopt the right gestures for wearing, bending down ...
The occupational therapist also assesses the benefit of offering technical aids. Orthopedic insoles can compensate for a difference in leg length and cushion the impact of the foot on the ground. Canes or crutches, to be worn on the side opposite the pain, relieve the joint.
DISCOVER OUR KNEE ARTHRITIS TREATMENT PROGRAM
To effectively control the progression of the disease, we must act on several levels. We are proud to offer each patient a unique personalized program, which combines:
• Individual medical monitoring by our interdisciplinary team of therapists
• Advanced musclular strengthening technology guided by artificial intelligence
• Daily support, with our online monitoring program
• ... and more to accompany you and motivate you towards the joy of painless movement!
WHAT IS THE IMPACT OF ARTHRITIS ON YOUR LIFE?
The WOMAC questionnaire is a scientifically validated instrument for objectively assessing the impact of osteoarthritis on your quality of life. It is frequently used to measure the difference before and after a therapeutic intervention.
In case of worsening pain or severe disability, a surgical solution will be used.
The three most frequent three types of intervention are total or partial knee prosthetic replacement and displacement osteotomy. The choice of your intervention will be discussed in detail with you, depending on your symptoms, your medical results, and taking into account your personal priorities.
For relatively young and active people, whose lesions are not too advanced and are probably due to a misalignment of the joint causing an overload damaging one side of the joint (legs in X or in parenthesis).
We correct the axis of the leg to put more weight on the healthy side of the joint.