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Arthritis and Total Knee Replacement

Arthritis of the Knee Joint is deterioration and inflammation of knee joint cartilage. Cartilage is the slippery layer at the end of bones that functions as a cushion and permits the knee to straighten and bend smoothly. The end of the thighbone (femur), the top of the shinbone (tibia), and the backside of the kneecap (patella) are coated by the knee cartilage. But what happens when the cartilage wears away? In this case, the space between the bones shrinks.

Before going to the types of Knee Arthritis, we must understand the parts of the knee-

  1. Cartilage- It is a type of tissue that surrounds a bone's surface at a joint. It helps in reducing the friction of movement within a joint.
  2. Femur- It is the thighbone
  3. Tibia- It is the shinbone or the larger bone of the lower leg.
  4. Patella- It is the kneecap
  5. Synovial Membrane- It is a tissue that lines the joint and packs it into a joint capsule.
  6. Synovial Fluid- This fluid is secreted by the synovial membrane around the joint to lubricate it.
  7. Meniscus- It is the curved part of the cartilage in the knees that absorbs the shock, deepens the knee joint, and also increases the contact area.
  8. Ligament- It is a type of connective tissue that covers the joint to provide support and also limits the joint's movement.
  9. Tendon- It is a type of connective tissue at connects the muscles to the bones and also aids in controlling the movement of the joint.

Types of Knee Arthritis

  • Rheumatoid Arthritis- It is an autoimmune disease in which the immune system of our body gets confused and starts attacking the healthy tissues in various joints of the body, including the knee. It also results in inflammation of the synovial membrane. In Rheumatoid arthritis, the inflammatory cells gradually destroy the knee cartilage. This type of arthritis can affect people of any age group.
  • Osteoarthritis- It is also known as degenerative joint disease and is the most common form of knee arthritis. Osteoarthritis is usually related to the wearing out of knee cartilage due to aging and it gradually advances over time. When the natural cushioning of the joints is worn out, the bones of the joints start to rub more closely against one another, and due to the absence of cartilage, there is nothing left to absorb the shock. This further results in swelling, pain, stiffness, limited ability to move, and in some cases, the formation of bone spurs.
  • Post-Traumatic Knee Arthritis- Arthritis is also developed due to a history of trauma or injury to the knee. Injuries to the ligaments of the knee make the joint less stable over time, which may lead to cartilage breakdown. This is often a temporary problem, and most people recover within a few months. But, sometimes it lasts longer and becomes a long-term (chronic) condition. Post-traumatic arthritis can be managed with exercise and lifestyle changes.

4 Stages of Osteoarthritis

  • Stage I- In this stage, there is only minor wear and tear in the joints and it is unlikely the patient will feel pain or discomfort.
  • Stage II- In this stage, the X-rays of the knee joints show more growth in bone spur, and even though the space between the bones may seem normal, people will start to experience symptoms of joint pain, and the area around the knee joints will feel stiff.
  • Stage III- In this stage, there is prominent erosion to the surface of the cartilage between bones and fibrillation diminishes the gap between the bones. With the advancement of this disease, there is inflammation in the joints which results in regular pain when running, walking, kneeling, or squatting. There may also be snapping or popping sounds while walking.
  • Stage IV- This stage is considered to be 'severe' as the joint space between the bones reduces vastly, leading the cartilage to wear off. This wearing off of cartilage results in a chronic inflammatory response and the synovial fluid also reduces. In this stage, the patient experiences severe pain when walking or moving the joint.

TOTAL KNEE REPLACEMENT

Total knee replacement, also known as Total knee arthroplasty is an orthopaedic surgery that aims to resurface a knee that is damaged by arthritis with highly crosses-linked polyethylene plastic and smooth metal. This surgery aims at the betterment of the quality of life of patients with Stage-IV osteoarthritis. The prime aim of total knee replacement surgery is to resurface the damaged parts of the knee joint and to ease the pain which can't be controlled by any other treatment.

But when is total knee replacement surgery recommended?

So, the surgery may be recommended by the doctor due to several reasons. A few of these are as follows-

  • Daily activities like walking, getting in and off chairs, and climbing stairs are restricted due to severe knee pain.
  • When there is moderate or severe pain in the while resting
  • When the swelling and knee inflammation do not improve with medications or rest.
  • When there is knee deformity due to arthritis.
  • When the condition does not improve with other treatments such as medications, injections, physiotherapy, etc.

Tags:   #Arthritis,  #total knee replacement,  #stages of arthritis

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