MRI is not routinely indicated for OA workup; however, it can detect OA at earlier stages than normal radiographs. Ultrasound can also identify synovial inflammation, effusion, and osteophytes which can be related to OA. Blood tests such as CBC, ESR, rheumatoid factor, ANA are usually normal in OA, although they may be ordered to rule out inflammatory arthritis. If the synovial fluid is obtained, the white blood cell count should be less than 2000/microL, predominantly mononuclear cells (non-inflammatory), which is consistent with a diagnosis of OA. Hyaluronic acid is a natural lubricant that mimics the synovial fluid in a healthy knee joint. Generally given each week for three to five weeks, HA gel — or viscosupplementation — acts like a shock absorber that cushions the space around the knee joint and allows the bones to rub against each other with less pain.
Osteoarthritis (OA) is a joint disease affecting the entire joint, including the cartilage, bone, and joint lining. Unfortunately, the effects of osteoarthritis of the knee can’t be reversed. But treatment and self-care can help relieve your symptoms and slow your condition’s progress. Though walking with knees medialized and with hiking poles reduced the first and largest peak of medial contact force by only a small amount, these gait modification methods reduced medial contact force significantly over the rest of stance phase 39. Furthermore, elimination of excessive knee flexion during mid stance may make these two methods effective at reducing the first peak as well 39.
Osteoarthritis (OA) is the most common form of arthritis, affecting millions of people worldwide. In particular, OA of the knee is a prevalent condition that can significantly impact an individual’s quality of life. Understanding the pathophysiology of OA of the knee is crucial in order to develop effective treatment strategies for managing the symptoms and progression of the disease.
Both Dr. Tjong and Dr. Paul say if your inside knee pain isn’t going away after the normal at-home remedies like RICE and taking an OTC pain reliever, the best first step is to see a doctor for a proper diagnosis. This ensures you’re doing the right exercises and stretches (and not making your knee pain worse). This is especially important if it has been longer than two to three days for swelling that isn’t reacting to OTC medication. You’ll notice a lot of inflammation and swelling with a meniscus tear, which is diagnosed with an X-ray or MRI. Depending on the severity, treatment can include knee arthroscopy, a minimally invasive procedure that cuts away the torn part of the meniscus, taking ibuprofen and/or working with a physical therapist.
The main cartilage matrix-degrading enzymes are zinc-dependent metalloproteinases (MMPs) belonging to the MMP and A Disintegrin and Metalloproteinase with Thrombospondin motifs (ADAMTS) families. MMPs include the collagenases MMP-1 and MMP-13 (highly efficient against type II collagen as a substrate), MMP-3 (a potent aggrecanase), and MMP activator [9]. Lubrication injections are done using hyaluronic acid and aim to provide more cushion to help lessen the impact on the damaged joint.
In addition, the role of neuroinflammation and central sensitization mechanisms as underlying causes of pain chronicity has been characterized. This has led to a renewed definition of OA, which is now intended as a complex multifactorial joint pathology caused by inflammatory and metabolic factors underlying joint damage. Since this evidence can directly affect the definition of the correct therapeutic approach to OA, an improved understanding of these pathophysiological mechanisms is fundamental.
Among these, we can find the Osteoarthritis Research Society International (OARSI),13 American College of Rheumatology (ACR)14 and American Academy of Orthopedic Surgeons (AAOS)15 publications. Lifestyle changes – especially enrollment in exercise and weight reduction. AARP is a nonprofit, nonpartisan organization that empowers people to choose how they live as they age. All other Authors have critically contributed to the analysis of evidence and provided major intellectual input to the paper. All authors have read and agreed to the published version of the manuscript.
Among those therapies, one of the most studied has been IA CS, but it seems that the current data might not be clear given that efforts to elucidate the exact mechanism of action, analgesic efficacy, indication, and safety profile are still ongoing. Recent papers have not been able to provide a robust and clear answer on using IR CS by patients. Part of the conflicting data is because of the high variability of the design of the studies that make them hard to be compared. Nowadays with the advancements in technology and ultrasound, we should aim to use this option whenever available to increase the rate of adequate IA placement of the injected substance. The truth is that this new presentation of an old medication will require more research to clarify some doubts regarding the indications and magnitude of the benefits of the IR option. But it seems that it might play a role if there is a concern of HPA axis suppression and hyperglycemia given its pharmacodynamic properties.
What is Osteoarthritis of Knee?
Osteoarthritis of the knee is a degenerative joint disease characterized by the breakdown of cartilage in the knee joint. Cartilage serves as a cushion between the bones in a joint, allowing for smooth movement. In OA of the knee, this cartilage deteriorates over time, leading to pain, stiffness, and reduced range of motion in the affected joint.
Pathophysiology of Osteoarthritis of Knee
- Cartilage Degradation: One of the key features of OA of the knee is the gradual breakdown of cartilage in the joint. This process is thought to be mediated by a combination of mechanical stress, biochemical factors, and genetic predisposition.
- Inflammation: Inflammation plays a significant role in the pathogenesis of OA of the knee. It is believed that pro-inflammatory cytokines and enzymes are released in response to cartilage degradation, leading to further damage and pain in the joint.
- Bone Changes: As OA progresses, changes in the underlying bone structure of the knee joint may occur. These changes can include the formation of osteophytes (bone spurs), subchondral sclerosis (hardening of bone beneath the cartilage), and subchondral cysts.
FAQs
- Is Osteoarthritis of the knee a hereditary condition?
While genetics may play a role in the development of OA of the knee, other factors such as age, obesity, joint trauma, and repetitive stress also contribute to the onset of the disease.
- Can Osteoarthritis of the knee be prevented?
Although OA of the knee cannot be completely prevented, maintaining a healthy weight, exercising regularly, and avoiding joint injuries can help reduce the risk of developing the condition.
