Knee pain in the elderly? The truth about osteoarthritis revealed!

Author: Cao Jiangang, Chief Physician of Tianjin Hospital

Reviewer: Chen Desheng, Chief Physician of Tianjin Hospital

It is not uncommon for the elderly to stagger, experience unbearable knee pain when going up and down stairs, or even develop bowed legs. As the weather gradually turns cooler, many elderly people will suffer from knee pain, which is actually caused by osteoarthritis. Osteoarthritis, commonly known as "bone spurs" and "bone hyperplasia", is a group of diseases caused by various reasons that damage the integrity of articular cartilage. The articular cartilage is destroyed and loses its elasticity. At the same time, the subchondral bone undergoes hardening or cystic changes and osteophytes are formed, which can cause pain and movement disorders. In severe cases, the affected limb may become disabled. In the elderly, knee osteoarthritis is a very common joint degenerative disease, and its incidence gradually increases with age.

Figure 1 Copyright image, no permission to reprint

1. Why do you get knee osteoarthritis?

Knee osteoarthritis is a degenerative change of the joint caused by various reasons, which is mainly related to the gradual wear and degeneration of cartilage. The following five factors are particularly critical in the occurrence of knee osteoarthritis.

1. Age As you age, the articular cartilage gradually loses its elasticity, leading to increased friction and damage to the cartilage.

2. Obesity and overweight Being overweight will increase the burden on the knee joints. The knee joints of obese people often need to bear greater pressure and the cartilage will wear faster.

3. Joint injury Knee injury (such as meniscus injury) or long-term repetitive mechanical injury (such as knee injury in professional athletes or heavy manual laborers) are important causes of osteoarthritis. People who overuse their joints or fail to effectively protect their joints are more likely to develop osteoarthritis.

Figure 2 Copyright image, no permission to reprint

4. Genetic factors: People with a family history have a higher risk of developing knee osteoarthritis.

5. Joint deformity Certain congenital or acquired knee deformities (such as O-shaped legs or X-shaped legs) will change the way the joints bear weight, causing excessive wear of the cartilage in certain parts, thus leading to osteoarthritis. Therefore, once obvious joint deformities cause pain symptoms, they should be corrected as soon as possible to reduce the risk of wear.

2. Symptoms of knee osteoarthritis

Osteoarthritis of the knee develops slowly, and the early symptoms are often mild. As the disease progresses, the symptoms will gradually worsen. Common symptoms are as follows.

1. Joint pain The earliest symptoms of knee osteoarthritis are usually mild pain, especially during activities or after standing or walking for a long time. As cartilage degeneration progresses, the pain will become more severe and may even occur when resting.

Figure 3 Copyright image, no permission to reprint

2. Joint stiffness Patients often feel joint stiffness when they get up in the morning or after sitting for a long time. This stiffness usually eases after activity, but as the disease progresses, the duration of the stiffness will gradually increase.

3. Joint swelling The inflammatory response will cause swelling around the knee joint, and the patient will feel discomfort in the knee joint.

4. Limited mobility As the disease worsens, the range of motion of the knee joint will gradually be limited, and the patient will have difficulty going up and down stairs, squatting or standing. In severe cases, it will affect daily walking.

5. In the late stage of joint deformity, patients may experience joint deformities such as O-legs or X-legs. Severe wear of articular cartilage can lead to direct friction between bones, which is a typical manifestation of late-stage osteoarthritis.

Figure 4 Copyright image, no permission to reprint

3. Treatment of knee osteoarthritis

1. Non-surgical treatment

(1) Drug treatment: Nonsteroidal anti-inflammatory drugs (such as celecoxib) are commonly used drugs that can relieve pain and inflammatory reactions. In addition, intra-articular injection of sodium hyaluronate can play a lubricating role, reduce friction between bones, and improve joint function. It should be noted that the use of drugs should be in accordance with the doctor's advice and avoid long-term excessive use.

Figure 5 Copyright image, no permission to reprint

(2) Physical therapy: including joint function training, muscle strength training, heat therapy and other methods, which are very effective for patients with early and mid-stage osteoarthritis. Strengthening the muscles around the knee joint can help reduce joint pressure and improve joint mobility.

(3) Lifestyle adjustment: Maintaining a healthy lifestyle is essential for the management and prevention of knee osteoarthritis. Controlling weight and doing moderate exercise (such as swimming, cycling, etc.) can effectively reduce the burden on the knee joint and avoid overuse of the joint.

2. Surgical treatment When non-surgical treatment is ineffective or the disease progresses to the late stage, surgical treatment is a necessary option.

(1) Arthroscopic surgery: For patients in the early or middle stages, arthroscopic surgery can be used to remove bone spurs and worn tissues in the joints, which can relieve pain and improve joint function. Arthroscopic surgery is less invasive and patients recover quickly, making it an effective method for treating early lesions.

Figure 6 Copyrighted images are not authorized for reproduction

(2) Osteotomy around the knee joint: For patients with joint deformity, osteotomy can adjust the alignment of bones, reduce joint pressure, and delay disease progression. This type of surgery is mostly suitable for middle-aged patients to avoid premature joint replacement.

(3) Joint replacement: When the cartilage of patients in the advanced stage is severely degenerated and the function is severely limited, total knee replacement is usually required. This is a major surgery that can significantly improve the patient's quality of life and is the recommended choice for patients in the advanced stage.

4. Prevention and health care of knee osteoarthritis

Although knee osteoarthritis is a degenerative disease that is difficult to completely avoid, its occurrence can be delayed and its progression can be slowed down through reasonable prevention and health care measures.

1. Control your weight Maintaining a healthy weight is one of the important measures to prevent knee osteoarthritis. Losing weight can significantly reduce the burden on the knee joint and delay the wear of cartilage.

2. Moderate exercise: You can choose exercises that have less impact on the knee joints, such as swimming, cycling, walking, etc., which help maintain joint mobility without causing additional pressure on the joints.

3. Avoid excessive use of the knee joints. In daily life, you should avoid long-term weight bearing, frequent squatting or excessive use of the knee joints. If necessary, you can use auxiliary tools such as knee pads to reduce the burden on the joints.

4. Maintain good eating habits and supplement nutrients such as calcium, vitamin D, collagen, etc., especially for the elderly, which can be obtained through diet or supplements.

Figure 7 Copyright image is not authorized for reproduction

Although knee osteoarthritis is very common among the elderly, early prevention, reasonable treatment and scientific health care can effectively control the disease, improve the quality of life, and allow the elderly's knees to "move" normally!