Osteoarthritis of the Knee and Hip

Osteoarthritis, the most common form of arthritis, is also called degenerative joint disease or "wear and tear" arthritis.

Almost everyone is affected by it to some extent as they grow older. It most frequently occurs in weight bearing joints, mainly knees, hips and ankles. This form of arthritis slowly and gradually breaks down the cartilage that covers the ends of each bone in a joint. Normally, cartilage acts as a shock absorber, providing a smooth service between the bones. But with osteoarthritis, the smooth surface becomes rough and pitted. In advanced stages, it may wear away completely. Without their normal gliding surfaces, the bones grind against each other, causing inflammation, pain and restricted movement. Bone spurs may form. In osteoarthritis of the knee, the shape of the bone and appearance of the leg may change over the years. Many people become bow-legged or knock-kneed. And in osteoarthritis of the hip, the affected leg may be shorter.

What are the Symptoms?

The main symptom is pain, which is caused by irritation and pressure of nerve endings, as well as by muscle tension and fatigue. The pain can progress from mild soreness and aching with movement to severe pain, even when resting. The secondary symptom is loss of easy movement, such as bending or rising normally. Morning stiffness is a problem for many people. This lack of mobility, in turn, often causes the muscles serving the knee or hip to weaken, and overall body coordination suffers.

How is it Diagnosed?

A simple weight-bearing x-ray and examination by one of our skilled orthopedic doctors will determine if you have osteoarthritis. Time-consuming and costly diagnostic procedures are not required.

What is the Treatment?

There is no cure for arthritis, but the past decade has seen dramatic new ways to manage the pain, lack of mobility and fatigue that are among its most disabling symptoms. During the early and middle stages, a treatment program of medicines, cortisone shots, ice treatments, exercise, and rehabilitation can be very effective in reducing symptoms and improving mobility.

• Medicines: Coated aspirin helps relieve pain and has few side effects. Non- steroidal anti-inflammatory drugs (NSAIDS), such as Voltaren, Feldene, Naprosyn, and Clinoril, are prescription drugs for pain and inflammation. Do not take aspirin if you are taking NSAIDS.
   

• Cortisone Shots: Cortisone shots are given for inflammation. For many people, joint arthritis is often made symptom-free for months or even years after cortisone shots. Four to six shots a year can be given without any dangerous side effects.
   

• Ice Treatments: Ice packs on the knee (three times daily, 10-20 minutes at a time) are helpful for inflammation and temporary relief of pain and soreness. Heat applications to either the knee or hip make osteoarthritis worse.
   

• Diet: There is no evidence that any specific foods will prevent or relieve arthritis symptoms. It is important to keep your weight down as much as possible because excess weight aggravates arthritis by putting added pressure on the knee.
   

• Exercise and Rest: Prolonged rest and days of inactivity will increase stiffness and make it harder to move around.

Motion is lotion for arthritis! At the same time, excessive or improper exercise can overwork your arthritic joint and cause further damage. A balanced routine of rest and exercise is best.

What About Surgery?

• Arthroscopy: Arthroscopic procedures are not generally helpful for arthritis. In some cases, a "flap" of torn knee cartilage can aggravate arthritis and cause additional pain. The cartilage flap can be removed by arthroscopy.
   

• Knee or Hip Replacement: Knee replacement or hip replacement is a very positive solution to the pain and disability of advanced osteoarthritis. The rough, worn surfaces of the joint are relined with smooth-surfaced metal and plastic components.