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Joint and Spine Center
Osteoarthritis of the Knee and Hip
Osteoarthritis, the most common form of arthritis, is also called degenerative joint disease or "wear and tear" arthritis. Almost everyone is affected by it to some extent as they grow older. It most frequently occurs in weight-bearing joints, mainly knees, hips, and ankles. This form of arthritis slowly and gradually breaks down the cartilage that covers the ends of each bone in a joint. Normally, cartilage acts as a shock absorber, providing a smooth surface between the bones. But with osteoarthritis, the smooth surface becomes rough and pitted. In advanced stages, it may wear away completely. Without their normal gliding surfaces, the bones grind against one another, causing inflammation, pain and restricted movement. Bone spurs may form.
The number one symptom is pain. The pain is caused by irritation and pressure on nerve endings, as well as muscle tension and fatigue. The pain can progress from mild soreness and aching with movement to severe pain, even when resting.
The second symptom is loss of easy movement, such as bending or rising normally. Morning stiffness is a problem for many people. This lack of mobility, in turn, often causes the muscles around the joint to weaken, and overall body coordination suffers.
As with any diagnosis, a good history and physical examination are key. X-rays are the best imaging test for the diagnosis of arthritis.
There is no cure for arthritis, but the past decade has seen dramatic new ways to manage the pain, lack of mobility, and fatigue that are among its most disabling symptoms.
Viscosupplementation — This treatment is a series of injections that lubricates the knees and can reduce pain for several months. It's an advance for arthritis knee pain that works very well for some patients.
Medicines — Coated aspirin helps relieve pain and has few side effects. Non-steroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen and naproxen may be used for pain and inflammation. Do not take aspirin if you are taking NSAIDS. Check with your physician before starting or stopping any medications.
Cortisone Shots — Cortisone shots are given for inflammation. For many people, joint arthritis is often made pain free for some time after a cortisone shot. Four to five shots a year can be given without any dangerous side effects.
Diet — There is no evidence that any specific foods will prevent or relieve arthritis symptoms. It's important to keep thin, however, because excess weight aggravates arthritis by putting added pressure on the knee and hip.
Exercise and Rest — Prolonged rest and days of inactivity will increase stiffness and make it harder to move around. At the same time, excessive or improper exercise can overwork your arthritic joint and cause further damage. A balanced routine of rest and exercise is best.
Arthroscopy — Arthroscopic procedures are not generally helpful for advanced arthritis. In some cases, a "flap" of torn knee cartilage can aggravate arthritis and cause additional pain. The cartilage flap can be removed by arthroscopy.
Knee or Hip Replacement — Knee replacement or hip replacement may be a very positive solution to the pain and disability of advanced osteoarthritis. The rough, worn surfaces of the joint are resurfaced with smooth metal and plastic components.