Wear and tear of knees:

Dr Narayan Hulse

Knee wear and tear is a frequent problem that can interfere with your everyday activities and prohibit you from performing the things you enjoy. The cartilage in our knees will sustain little tears as we go about our daily lives, which would normally heal without creating any symptoms. Many variables influence the formation of these micro rips, as well as whether or not they produce pain or stiffness in the joint.

It’s a popular fallacy that age is the most important element in the development of osteoarthritis, while in truth, genetics, biomechanics, smoking, and other factors all play a role in how each person experiences the condition.

You may be putting off a doctor’s visit to address knee or hip osteoarthritis due to the fear of going through a joint replacement surgery, but that’s not always the case. Here are a few ways to prevent it.

Maintaining a healthy weight
Excess body weight exerts unnecessary strain on joints, causing cartilage to deteriorate faster. Stressing the importance of maintaining a healthy weight can help people avoid surgery. Excessive joint pressure can be alleviated by urging people to lose just 5% of their body weight. While losing weight won’t replace cartilage, it will help to relieve joint stress.

Physical therapy & regular exercising
The most important aspect of avoiding joint surgery is to strengthen the muscles that support your joints. Knee strength is determined by the quadriceps in the front of the thigh and the hamstrings in the back. The quadriceps absorb the impact when one walks, runs, or anything else that requires weight-bearing. The less load that is passed into the joint, the stronger your quads are.

Restricting physical activity can exacerbate joint problems as it causes cartilage loss between bones, which can result in painful bone-on-bone contact. Exercise promotes the flow of synovial fluid, which lubricates and loosens the joint by feeding the cartilage with nutrients. At least three times per week, patients can achieve optimal joint health by engaging in cardiovascular and low-impact activities such as the elliptical, recumbent cycle, walking, and swimming.

Joint injections
Cortisone or hyaluronic acid injections are nonoperative treatments that can help relieve knee pain. Knee pain can also be addressed with regenerative medicine treatments like platelet-rich plasma therapy. Hip pain can also be effectively treated with cortisone injections. Fluoroscopy is recommended for these injections.

An unloader brace for the knees
Unloading the painful side of the knee and shifting the stressors to the side with the least amount of arthritis is the goal of an unloader brace. Patients with osteoarthritis of the knee looking for a nonsurgical treatment option can benefit greatly from the usage of these braces as it aids in the reduction of pain and hence the enhancement of mobility.

Supplements and medications
Supplements like glucosamine and chondroitin have been shown to help with osteoarthritis. If alternative therapies fail to relieve severe pain, opioid analgesics may be prescribed. These non-surgical treatments are contingent on the patient’s willingness to make behavioural changes such as weight loss and exercise.

Proper nutrition
The consumption of nutritious alternatives aids in reaching an ideal weight, providing the required energy as well as reduces inflammation.

(The author is Director, Department of Orthopedics, Bone & Joint Surgery, Fortis Hospitals.)