【Health Lecture】Love health, love sports, start from the knees

The knees age first. As we age, the water content of our knee cartilage decreases, and the fatigue resistance weakens. The more we use the knee joint, the more weight it bears, the greater the probability of articular cartilage wear, and the faster the knee joint degenerates. The recovery function of cartilage after damage is very poor, which will cause knee pain over time and lead to knee osteoarthritis. So, how to be a qualified healthy elderly? To love health and exercise, you must start with the knees.

Knee pain is the main clinical manifestation of knee osteoarthritis and a common cause of health problems for the elderly, often affecting their normal lives. The overall prevalence of knee osteoarthritis is about 8.1%, with a prevalence of about 50% in people over 65 years old and 80% in people over 75 years old, accounting for more than 80% of the total global disease burden, and has become a common "social disease."

The knee joint is the largest load-bearing joint in the human body. A normal knee joint is mainly composed of the following parts: the femur at the top, the tibia at the bottom, the patella in front, the meniscus in the middle, and the joint capsule around. Articular cartilage has elastic function and is difficult to repair after injury. The existence of the meniscus makes the femur and tibia more compatible, and their existence can buffer external forces.

If we do not pay attention to protecting the knee joints, excessive exercise, incorrect posture, cold, etc. will cause knee pain and damage the articular cartilage. Due to the special structure of articular cartilage, it has almost no regeneration ability. Once damaged, it cannot repair itself. Eventually leading to knee osteoarthritis.

How to be a healthy old man? Love health, love sports, start from the knees! Here, Dr. Cheng reminds all the old people to do "three less, three more, one protection". Climb less, squat less, get cold less, swim more, walk more, lift your legs more, and protect your knees. Only when we pay attention to these, can we protect our knee joints and truly be a healthy old man.

Of course, if you have knee pain and knee osteoarthritis, don't be afraid. According to the "Guidelines for the Diagnosis and Treatment of Osteoarthritis" (2018 edition), we divide the treatment of knee osteoarthritis into four levels: basic treatment, drug treatment, restorative treatment and reconstructive treatment.

Basic treatment: including weight control, health education, physical therapy, reasonable exercise, and changing bad habits.

Drug treatment: includes oral medications and topical medications.

Topical medication: Patients with early-stage knee osteoarthritis, especially those who are elderly or have more underlying diseases, should first choose topical medication. It should be used with caution when there are wounds, rashes and other adverse conditions on the skin, and should be stopped immediately if allergic reactions occur.

Oral medications: Oral medications are absorbed by the gastrointestinal tract, can reach higher blood concentrations, and are more effective than topical medications; at the same time, their toxic and side effects are also relatively large.

Intra-articular injection of drugs: Commonly used injection drugs include glucocorticoids, platelet-rich plasma, chitosan, sodium hyaluronate, etc., which can effectively relieve pain and improve joint function.

Restorative treatment: including osteotomy, cartilage repair, arthroscopic cleaning, etc.

Arthroscopic cleaning is mainly aimed at patients with symptoms such as mechanical locking or meniscus tear. Arthroscopic loose body cleaning and meniscus molding can alleviate the symptoms of some early and middle-stage patients.

Reconstructive surgery: including total knee replacement and unicompartmental knee replacement. Total knee replacement is the measure taken when knee osteoarthritis develops to the final stage.

Unicompartmental knee replacement: It is the best choice for pain relief and knee preservation surgery. It only performs surface replacement on the diseased compartment without damaging other structures of the knee joint. The postoperative joint function and kinematics are closer to those of a natural joint. At the same time, the surgery has little trauma, small incision, less bleeding, short operation time, quick postoperative recovery, and greater patient satisfaction.

The team led by Dr. Cheng Qian from Tongren Hospital affiliated to Shanghai Jiao Tong University School of Medicine has carried out robot-assisted computer-navigated unicompartmental replacement surgery, which perfectly integrates precision, digitization and intelligence, making knee preservation treatment more minimally invasive. Before the operation, the patient's knee joint is CT scanned, the relevant data is input into the computer, the matching prosthesis is selected, the amount of osteotomy is calculated, the position of osteotomy during the operation is simulated, and multimodal image fusion and intelligent imaging technology are used to accurately locate and apply robot-assisted surgery. Accurate preoperative design and perfect intraoperative replication make the operation more perfect and the patient more comfortable.

How to be a healthy old man? Start from the knees! Love the elderly, love health, with the advent of the intelligent era, robot computer navigation assisted knee preservation treatment, precise pain relief, let you stride forward!

About the Author

Cheng Qian, Deputy Director of Administration, Department of Orthopedics, Tongren Hospital, Shanghai Jiao Tong University School of Medicine

PhD, Associate Chief Physician, Associate Professor, Master's Supervisor

Vice Chairman of Shanghai Sports Medicine Youth Committee

Member of the Science Popularization and Health Education Working Committee of China Medical Education Association

He is a reviewer of the journal Arthroplasty of the Asian Artificial Joint Society, an editorial board member of the Chinese Journal of Osteoporosis, and a reviewer of the Journal of Practical Medicine and the Chinese Journal of Tissue Engineering Research. He went to Germany for exchange and study, and studied joint replacement and arthroscopic techniques under the tutelage of Professor Jerosch, the chairman of the German Orthopedic Society and a famous sports medicine and joint surgery expert. He is good at computer-navigated robot-assisted minimally invasive unicompartmental replacement for knee osteoarthritis, and is proficient in joint replacement and arthroscopic treatment of hip, knee, shoulder, elbow and ankle joints, especially in arthroscopic treatment of frozen shoulder, rotator cuff injury, knee meniscus and ligament injury.