Arthritis Treatment Knee Osteoarthritis As Well As The Epidemic Of Knee Replacements

The most frequent style of  arthritis, osteoarthritis (OA), affects more than 20 million Americans. Among the primary targets for this disease is the knee.

OA affects articular cartilage, the gristle that caps the ends of long bones. Articular cartilage is a "pudding" which is made up of a matrix of proteoglycans (arrangements of proteins and glycogen molecules.) Furthermore, there is a framework of tough collagen fibers. Within this proteoglycan/collagen structure are cells called chondrocytes.

The maintenance of normal cartilage integrity is extremely dependent upon the metabolic function of all of these chondrocytes.

Osteoarthritis of knee is a dress in and tear disease of articular cartilage. It arises because of the lack of ability of cartilage to keep up with excessive breakdown.

The 1st stage that takes place in the entire process of OA is an alteration in the matrix. This causes loss of cartilage resiliency. In addition, proteins that promote inflammation (called inflammatory cytokines) are produced by the joint lining. These cytokines activate destructive enzymes, called proteases which degrade the matrix and result in the chondrocytes to malfunction.

Thus far, the treatment of meniscus tear symptoms is mostly symptomatic. Several medicines, called non-steroidal anti-inflammatory drugs (NSAIDS), analgesics (pain-killers), exercises, physical therapy, and injections are utilized to offer palliative relief. Ultimately, though, patients will go on to have knee replacement surgery.

As this operation has mostly been reserved for elderly patients, joint replacement surgery is increasing at an alarming rate between Middle-agers who want to maintain a specific level of activity.

According to a recent report (Associated Press, Lindsay Tanner), "nearly one in twenty Americans older than 50 has an artificial knee- that's 4 million people!"

The federal Agency for Healthcare Research and good quality  has issued a recent report showing that knee replacements tripled in individuals ages 45 to 64 between 1997 and 2009. As it is admirable and speaks to the increased activity level in a group of patients that formerly could be sitting in rocking chairs, in another sense, it raises other issues.

This is specially  disturbing since revision surgery (replacement of the replacement) will be needed in the future and this is a  way more difficult and costly endeavor. Revision surgery takes longer, requires more expertise, is more complicated, and has a greater likelihood of complications.

Clearly, there's a public health issue if individuals with knee OA are taking place to get an operation which will add enormous costs to an already overburdened healthcare system. More in a future article.