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Archive for the ‘About Knee Osteoarthritis’ Category

Knee pain from high impact activities like running is a common symptom of osteoarthritis.

There are many symptoms which can help your doctor diagnose osteoarthritis.  Osteoarthritis of the knee is typically observed after patients complain of knee pain, joint stiffness, joint swelling, and pain with exercise or high activities.  Early detection is very important because osteoarthritis includes degeneration of cartilage, a joint tissue that heals very slowly.  If osteoarthritis can be diagnosed earlier, it may be possible to improve treatment outcomes and to delay or avoid surgical intervention.

Recent research published in the Biophysical Journal suggests that there may be a new way to diagnose osteoarthritis even earlier.  Since cartilage includes a high fluid content, scientists may be able to detect damage to cartilage by diagnosing the flow of fluids in the joint space.  Researchers were also able to determine that cartilage deficits caused by osteoarthritis were most visible during rapid compression of the joint.  In other words, damage to your knee from osteoarthritis should be most visible in high speed high impact activities.

So if you experience knee pain that is worst when you run, talk to your doctor.  We all hope that the pain will go away on its own, but the longer you wait before consulting a physician, the more damage can occur to your knee.  Every day that you delay treatment may eventually cost you.  Why risk it?



OA and Vitamin K

March 7, 2013

The vitamin K in these vegetables can reduce the risk and progression of osteoarthritis.

Vitamin K, commonly found in leafy green vegetables, may reduce your risk of osteoarthritis.  A recent study published in the American Journal of Medicine found that vitamin K deficiency was positively associated with knee osteoarthritis.  These results validate long-held cultural beliefs that vegetables are good for your health, and quantify one specific way in which they may improve your quality of life.  This study simply identifies a correlation between vitamin K deficiency and osteoarthritis, but that does not mean that adding vitamin K to your diet cannot improve your health now.

In fact, an independent study by the Boston University School of Medicine found that patients who recieved Vitamin K exhibited decreased osteoarthritic symptoms.  Adding vitamin K reduces knee pain, and decreases the rate of joint degeneration.  It may even be possible that it will accelerate healing.

So before you take medication and before you risk surgery, why not try a simple dietary solution?  Adding these vegetables could make your pain more manageable.

 



OA and Plasma Therapy

February 26, 2013

Platelets used in plasma therapy speed up healing, and my be helpful in treating osteoarthritis.

Platelet-rich plasma (PRP) therapy has been used by high-profile athletes for high-profile treatments.  PRP therapy works by taking a blood sample, isolating the platelets in the blood, and then injecting them back into the patient.  Platelets are an important part of the natural healing process, producing growth factors and forming blood clots to help close open wounds.  PRP therapy can reduce knee pain and improve function for patients with athletic or osteoarthritic injuries.

Recent research at New York’s Hospital for Special Surgery supports the use of PRP therapy for patients with osteoarthritis.  In a study published in the Clinical Journal of Sports Medicine, Dr. Brian Halpern evaluated the effectiveness of PRP therapy by objectively measuring the quality of patient’s cartilage with PRP treatment.  They found that after a single injection, there was no further damage to cartilage for the subsequent year.  Over that same time period, patients reported that their pain dropped to half of pre-treatment levels.

PRP therapy is a relatively new treatment, and may not be appropriate for everyone, but it might be right for you.  If you suffer from knee osteoarthritis, and struggle with knee pain, ask your doctor about PRP treatment.  A single treatment might make the next year a whole lot easier.



OA and Dysfunction

January 18, 2013

Inactivity can make knee osteoarthritis and pain much worse.

The word “dysfunction” refers to abnormal or impaired function, usually of a physiological system or social group.  With regard to osteoarthritis, generic dysfunction of an individual describes a present state below that individual’s potential; living a life of suffering and hardship when a better life is within your grasp.  Anatomical dysfunction such as severe knee deformities and knee pain can be a tremendous obstacle, but it is not insurmountable.  In the moment that your osteoarthritis prevents you from engaging in an activity, you face a broader and more damaging form of dysfunction.

A recent study at Northwestern university examined over one thousand patients with knee osteoarthritis.  Patients with severe knee dysfunction were roughly half as active as those without anatomical deficits.  While this may not seem extreme for individuals with severe deformities, what is frightening is that overweight individuals had the same levels of inactivity.  Obese patients showed even greater inactivity, at about a quarter of the activity level of lighter individuals still suffering from knee osteoarthritis.  Unfortunately, inactivity makes weight issues worse, and can propagate a cycle of inactivity and obesity that gets worse and worse.

But there is a silver lining:

Adjusting your activity level dramatically improves function.  An inactive (“dysfunctional”) individual can regain function and health by increasing their activity level.  If you are categorized as overweight or obese, you need not remain there.  Your ability to overcome obesity is limited only by your control over diet and exercise, because your knee pain and anatomical dysfunction will decrease with your weight.

So add some fiber to your diet.  Add a walk to your daily schedule.  And remember that slow, incremental change will keep you on the path to your goals.



OA and pain

January 4, 2013

Knee pain is a common symptom of osteoarthritis, and can be debilitating.

Recent research by Dr. Malfait at Rush University has identified a key component of the mechanism of ostoearthritis pain.  Knee pain is felt in the lower extremity and then relayed through the spine up into the brain.  In the brain, pain from osteoarthritis is primarily interpreted by proteins and receptors called MCP-1/CCR2.

Several mice that were genetically altered to have deficiencies of MCP-1 and CCR2 experienced less pain when given osteoarthritis.  This observation is important because it looks into an unexplored area of potential treatment.  Instead of simply addressing the mechanical causes of pain (including inflammation and deterioration), this research offers the potential to directly reduce pain in osteoarthritis.

Any discussion of pain should include the healthy role of pain in the body.   Pain serves to relay information about injury, and so elimination of pain receptors could allow progression of ostoearthritis in joints, further worsening the joints.  The identification of MCP-1 and CCR2 offers the potential for the isolated treatment of osteoarthritis pain without compromising the healthy pain systems of the body.



Artificial cartilage is often grown on lattices that weave collagen into a supportive tissue.

The 2012 Nobel Prize in Physiology or Medicine was awarded to researchers who developed induced pluripotent stem-cells (IPS-cells).  IPS-cells do not carry the ethical stigma of embryonic stem cells, since they can be created by coaxing mature skin cells (from consenting adults) into their developmentally flexible states.  Most importantly, they offer the opportunity to externally grow healthy living tissue as needed.  So far, IPS-cells can be grown into relatively simplistic cells (like cartilage and bone), and not into more complex tissues like livers or kidneys.

Researchers at Duke University have recently developed a new technique to grow IPS-cells into cartilage.  This technique could permit a limitless production of cartilage for researching drug treatment.  Short term (within the next 3-5 years), cartilage from IPS-cells might be sophisticated enough for implantation.  This could delay a knee replacement by several years, and dramatically improve quality of life.

Understanding the relevance of things like IPS-cells matters because it reminds us of the importance of scientific development.  One of the recipients of this Nobel Prize earned it by turning a frog back into a tadpole.  While this may seem far from the daily knee pain felt by those suffering from knee osteoarthritis, it is his research that will lead us to the artificial cartilage that may cure them.



OA and Fear

November 3, 2012

This post has been delayed by a hurricane, inspired by a spooky holiday, and grounded in science:

While osteoarthritis does not carry a terrifying death-sentence like severe cancers, it can still produce fear.  Osteoarthritis of the knee can lead to extreme pain during physical activity.  This pain can lead to apprehension about exercise.  Ultimately, that apprehension can become so severe that activity is avoided.  This can be catastrophic.

A recent article in Arthritis Care & Research studied predictors for treatment success.  The authors examined numerous factors including age, BMI, surgical history, and physical therapy treatments.  After their exhaustive review, they found only 2 factors were directly linked to the outcome of the treatment:  Knee instability, and fear of physical activity.

This means that the negative effects of being scared of exercise may be equivalent to damaged ligaments, muscles, and menisci.  In other words, the psychological effects of fear are as dangerous to your health as the physical effects of injury.

So if the thought of exercise makes you nervous, even if you know that it will bring you pain, do not let your fear make you unhealthy.  Work through it now, and overcome your fear.  It will help you later.



Osteoarthritis of the knee often leads to knee pain.  Long-term inactivity can make the osteoarthritis and your quality of life much worse.  This means that short rests can increase knee pain.  In fact, sitting for a brief time can lead to joint stiffness.  That makes it harder to move your knee, and makes motion painful.

In most cases, joint stiffness is due to inflammation of the synovium (the fluid which helps to lubricate your knee).  More severe joint stiffness can be caused by shortening of tendons and ligaments in the knee, but this is often over longer periods of inactivity.  If the synovium is inflamed, the pain is intense at first, but decreases as the joint is used.  This means that avoiding activities because of joint stiffness you can limit your overall function.  However, while increasing activity should reduce stiffness, too much exercise can make the osteoarthritis worse.

Overall, persistent activity is the best way to reduce joint stiffness.  Avoiding painful activities can lead to shortening of tendons and ligaments.  This would make future activities much more difficult.

The best take away is:  Use it or lose it.

 



OA and Inactivity

September 29, 2012

Osteoarthritis of the knee can be painful.  It can cause pain in many different activities of daily living.  This does not mean that it should be debilitating.

A recent article in the Cape Gazette addresses the “ceiling” effect.  The “ceiling” effect is where individuals suffering from osteoarthritis limit themselves to the activities that are comfortable.  While this may make things easier in the short term, it can be bad in the long term for several reasons:

1:  Avoiding painful activities can mean missing out on life.  As osteoarthritis progresses, the number of painful activities increases and the you will be increasingly limited.

2:  When you prevent yourself from exercising, you lead an inactive lifestyle.  Inactivity can lead to obesity, which makes the osteoarthritis worse.

3:  Inactivity can stiffen joints, reducing range of motion.  This further increases the pain and discomfort with motion, leading to more restricted activities.

So instead of avoiding knee pain, consider your options for pain management.  There are many types of physical therapy, bracing, medications, and even surgeries that can help you return to your desired activities.  Don’t let osteoarthritis keep you on the couch.



OA Signs And Symptoms

September 11, 2012

Knee Pain

Osteoarthritis refers to inflammation of a joint and its surrounding bone.  It often results from the accumulation of mechanical stress on the joint.  In most cases, there is degradation of the articular cartilage in the joint.  Articular cartilage is important because it is slick, and lets joints move with very little friction (less than ice rubbing against ice).  Articular cartilage lets a healthy joint move smoothly, and also has a limited role as a shock absorber.  In people with osteoarthritis, swelling in the joint increases pressure on the cartilage and can lead to break down.  Once the surface of the cartilage is broken, friction rapidly increases and the cartilage may wear away.  This is why OA can often be classified as degenerative.

Knee pain can often result from osteoarthritis.  As the osteoarthritis gets worse, the cartilage becomes less effective at reducing friction when the knee bends.  This is particularly problematic when the knee is supporting body weight.  Eventually, all of the cartilage in the knee may rub off, resulting in direct bone on bone contact.  This can significantly increase knee pain.

Knee pain from osteoarthritis is often treated with non-steroidal-anti-inflammatory drugs like Advil or Tylenol.  Knee braces are also an effective treatment option because they can help “unload” the knee joint.  This reduces the stress and pressure on the joint surfaces, and can prevent the bones in the knee joint from rubbing against one another.  Osteoarthritis can also be treated with cortisone injections.  Mild forms of osteoarthritis may be effectively treated with rest, ice, elevation and compression.