Arthritis Treatment Knee Osteoarthritis And Also The Epidemic Of Knee Replacements

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

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

The preservation of normal cartilage integrity is very dependent on the metabolic function of such chondrocytes.

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

The 1st step that takes place in the whole process of OA is an alteration in the matrix. This causes loss of cartilage resiliency. Furthermore, 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 lead to the chondrocytes to malfunction.

To date, the remedy for meniscus tear symptoms is mostly symptomatic. Several medicines, called non-steroidal anti-inflammatory drugs (NSAIDS), analgesics (pain-killers), exercises, physical therapy, and injections are used to give palliative relief. Ultimately, though, patients will go on to get knee replacement surgery.

While this operation has generally been reserved for elderly patients, joint replacement surgery is growing at an alarming rate among Baby boomers who wish to maintain a particular level of activity.

According to a recent report (Associated Press, Lindsay Tanner), "nearly one in twenty Americans over the age of fifty has an artificial knee- that's four million people!"

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

This is specifically  disturbing as revision surgery (replacement of the replacement) will be required in the future and this is a  rather more  challenging and pricey endeavor. Revision surgery takes longer, needs more expertise, is more complex, and has a greater likelihood of complications.

Undoubtedly, there's a public health challenge if people with knee OA are taking place to get an operation which will add marvelous costs to an already overburdened healthcare system. More in a future article.