Table of contents:

1. What is Rheumatology? What is a Rheumatologist?
2. Osteoarthritis
3. Osteoarthritis of the Knee

OSTEOARTHRITIS of the KNEE

THE NORMAL KNEE…
In a normal healthy knee, the leg bones called the femur and the tibia meet to form the knee joint. The bones are covered by a protective and shock-absorbing layer of tissue called cartilage.

Between the cartilage–covered bones there is a small amount of viscous fluid called “synovial fluid.” This fluid acts as both a cushion and a lubricant. Synovial fluid aids and protects the knee joint against high impact.

OSTEOARTHRITIS and the KNEE…
An osteoarthritic knee goes through stages of gradual breakdown. Cartilage develops microfractures, may soften, loses its resiliency, eventually erodes and finally wastes away so that bone touches bone. The joint shape may change, often enlarging; bone growths or spurs form and bits of cartilage may float in the joint space. Pain and limited joint motion result.

At the same time, synovial fluid changes and may lose its elasticity/viscosity. It also becomes thinner and collects in the diseased knee. Thus, the ability of synovial fluid to lubricate, cushion and protect the knee joint deteriorates.

DID YOU KNOW THAT…
? Osteoarthritis (OA) is a chronic, degenerative disease of the joints. It affects primarily the weight-bearing joints (knees, hips, spine) as well as the hands.
? About 10 million Americans, most of them over the age of 45, suffer from OA of the knee. This represents about half of the 20 million who experience some form of OA.
? 80% of people with OA report some form of limitation of movement or activities.

RISK FACTORS…
• Excessive or unusual wear or strain on the joints.
• Age, although osteoarthritis does not occur in all people as they age.
• Obesity or excessive weight
• Genetics
• Joint injuries from sports or work-related activities, or accidents.

SYMPTOMS…
• Pain in and around the affected joint that worsens with weight-bearing and movement, and improves with rest.
• Stiffness after rest, tenderness to the touch, and limitation of range of motion.
• “Crepitus” – a grating sensation in the joint during movement.
• Swelling, as a result of excess fluid collection in the joint.
• Joint deformity late in the disease process.

TREATMENT OF THE OA KNEE
Since there is no known cure for OA, the goals of therapy include reduction of pain and improvement of joint mobility. Therapies include:
Exercise for joint flexibility and surrounding muscle strength.
Heat/cold therapy for temporary relief of pain and swelling.
Weight loss to reduce stress on knee joints.
Various classes of medication for pain, such as analgesics (e.g. acetaminophen), and nonsteroidal anti-inflammatory drugs (NSAIDS, such as ibuprofen).
Viscosupplementation therapy (Injection into the knee joint)
Treatment with another class of pain medication, COX-2 Inhibitors, related to NSAIDs
Injection of cortisone preparations when other pain medications are not effective.
Surgery to replace the knee joint with a prosthetic device or to repair torn ligaments or
fibrocartilage (menisci)
Topical agents (rub-on medicine and/or patches)
Splinting
TENS unit
Canes, walkers
Proper shoeware