Osteoarthritis of knee

Updated: Jul 29

definition

Knee arthritis is a concept belonging to the category of osteoarthritis (degenerative arthritis), and is a disease accompanied by gradual loss of articular cartilage in the knee joint and related secondary changes and symptoms. It is a degenerative disease that progresses slowly due to the gradual wear and tear of articular cartilage, and most commonly appears in middle-aged and elderly people.

cause

Symptomatic knee arthritis is known to occur in 9.6% of men over 60 years of age and 18% of women. In the United States, it was reported that radiographically observed arthritis was observed in 19.2% to 27.8% of patients over the age of 45 in the knee joint, and in 37% of those over 60 years of age. The prevalence increases with age. Risk factors for the development of arthritis can be classified into systemic risk factors and local risk factors. Systemic risk factors include race, age, sex, obesity, hormonal changes, genetic influences, bone mineral density, and nutritional status. Local risk factors include joint biomechanical changes, joint damage, occupation, sports, physical activity, and development. Gender abnormalities, etc. The pathogenesis of osteoarthritis is difficult to explain with one risk factor, and various risk factors work in combination. Aging is one of the most important risk factors in the development of arthritis in all types of arthritis, and its prevalence tends to increase as the elderly population increases. Under 55 years of age, the male to female ratio is similar, but as the age increases, it is more common in females.


Classification

It has been classified as primary or idiopathic and secondary or successive. The primary type belongs to the case where there is no specific organic cause, and the secondary type belongs to the case where the cause is clearly proven, such as trauma, congenital anomaly, or biochemical abnormality. However, even if it is diagnosed as secondary, there may be cases where the cause cannot be identified, and even if exposed to the same cause, not all of them progress to arthritis. As the cause of idiopathicity has recently been gradually elucidated, the distinction between idiopathic and secondary is becoming increasingly unclear. There is no significant difference in clinical progression between the two classifications, and the difference in symptoms and radiological and pathological correlations is not clear.


Symptom

The pain caused by arthritis occurs gradually, and the area around the knee joint may swell. Many difficulties arise in flexing the knee joint, and stiffness occurs. In the case of degenerative arthritis, pain increases after activity, so it is common to have pain in the evening or before sleep.


Diagnosis/Test

After confirming the pain and range of motion of the knee, an X-ray examination is performed to observe the decrease in joint spacing. In addition, precise imaging tests such as MRI may be helpful.


therapy

1. Conservative treatment


1) Correction of lifestyle

- It is recommended to maintain an appropriate weight and avoid activities that may affect the knee joint, such as running.


2) Medication

- Simple analgesics such as aspirin and Tylenol are the first-line treatment for common arthritis. Non-steroidal anti-inflammatory drugs (NSAIDs) may be more effective, but may cause gastrointestinal upset, and steroids, the most powerful anti-inflammatory drugs that can be injected into the joint, are sometimes used. A lubricant containing hyaluronic acid is injected in case of degenerative arthritis to improve the quality of joint fluid.


3) exercise


4) Use of orthosis


5) Other conservative treatment


2. Surgical treatment

- For arthritis that does not respond to conservative treatment, surgical treatment is inevitable. Surgical methods include arthroscopic surgery, proximal tibial osteotomy, and artificial joint replacement.


Diet/Life Guide

There are no special foods to watch out for.

[Naver Knowledge Encyclopedia] Osteoarthritis of knee (Seoul National University Hospital Medical Information, Seoul National University Hospital)

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