Arthritis Treatment Knee Osteoarthritis And The Epidemic Of Knee Replacements

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

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

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

Osteoarthritis of knee is a put on and tear disease of articular cartilage. It arises as a consequence of the lack of ability of cartilage to keep up with excessive breakdown.

The first stage that comes about in the process of OA is an alteration in the matrix. This causes loss of cartilage resiliency. Moreover, proteins that promote inflammation (called inflammatory cytokines) are produced by the joint lining. All these cytokines activate destructive enzymes, called proteases which degrade the matrix and lead to the chondrocytes to malfunction.

Until now, 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 utilized to supply palliative relief. Ultimately, though, patients will go on to have knee replacement surgery.

As this operation has generally been reserved for elderly patients, joint replacement surgery is raising at an alarming rate amongst Middle-agers who wish to maintain a certain 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 individuals!"

The federal Agency for Healthcare analysis  and  top quality  has issued a recent report showing that knee replacements tripled in individuals ages 45 to 64 between 1997 and 2009. While 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 far more  challenging and high priced endeavor. Revision surgery takes longer, demands more expertise, is more complex, and has a greater likelihood of complications.

Clearly, there is a public health challenge if individuals with knee OA are happening to get an operation that will add incredible costs to an already overburdened healthcare system. More in a future article.