Osteoarthritis
Osteoarthritis is the gradual wearing away of joint cartilage. Cartilage acts like a cushion on the end of your bones. Every time you take a step, it absorbs some of the pressure and transfers the force of the step through to the bone. Once this cartilage is gone there is no layer to act as the shock absorber. The two bones rub against each other and this causes pain. Osteoarthritis is common in the large weight bearing joints such as the knee and the hip.
Definition
How can it effect you?
The major symptom is groin pain and is usually felt after you have been using the joint for some time for e.g. after a long walk. Other symptoms can include stiffness in the hip joint which makes it difficult to bend down, and muscle weakness around the hip. Symptoms might be worse when there is an increase in activity or a change in weather especially when it becomes cold.
During your consultation, the doctor will ask about your symptoms and then examine your hip including its range of movement. They might find that you cannot lie all the way flat on the bed or it hurts your hip when your knee is bent towards your chest. You might find it difficult to stand on one leg. To confirm diagnosis, X-rays of your pelvis and hip will be taken to help assess how much your hip has worn out. X-rays can show joint space narrowing which occurs when the osteoarthritis is so severe from the cartilage loss that the bones on either side of the joint rub together X-rays can also show where the body is trying to compensate by growing new bone (known as osteophytes).
Unfortunately, the cartilage you are born with is the only cartilage you have for your entire life, so once it is damaged or worn out it cannot grow back. Therefore, there is no cure for osteoarthritis. The treatment for osteoarthritis is aimed at relieving symptoms to improve your quality of life and keep you active. The first line of treatment includes physical therapy (exercise, physiotherapy) and pain- relieving medications. Surgery is reserved for patients who have severe osteoarthritis or still experience pain after trialling physical therapy and medications. The amount of pain that a patient feels from their osteoarthritis is proportional to the amount of force which is passed through the joint. “Offloading the joint” means reducing the amount of force that is going through that joint. Minimising aggravating activities, such as long walks or long periods of standing, is a very effective way of decreasing your pain. Use of a walking stick can be beneficial in offloading the hip joint as well.
If non-surgical treatments have not helped with your pain and improve your quality of life, your doctor may recommend surgery. As with all surgeries, it comes with some risks and should be left as a last resort. The most common surgery for hip osteoarthritis is hip replacement surgery. This is where the ‘ball’ of the femur is removed and replaced with an artificial implant. To match this, the remaining cartilage is removed from the socket and a metal socket is inserted. This is a very effective way of eliminating hip pain. After surgery people often return to an active lifestyle including sports, pain free. On average approximately 90% of hip replacements are still in place and working well, 18 years after they were inserted.
The major symptom is groin pain and is usually felt after you have been using the joint for some time for e.g. after a long walk. Other symptoms can include stiffness in the hip joint which makes it difficult to bend down, and muscle weakness around the hip. Symptoms might be worse when there is an increase in activity or a change in weather especially when it becomes cold.
During your consultation, the doctor will ask about your symptoms and then examine your hip including its range of movement. They might find that you cannot lie all the way flat on the bed or it hurts your hip when your knee is bent towards your chest. You might find it difficult to stand on one leg. To confirm diagnosis, X-rays of your pelvis and hip will be taken to help assess how much your hip has worn out. X-rays can show joint space narrowing which occurs when the osteoarthritis is so severe from the cartilage loss that the bones on either side of the joint rub together X-rays can also show where the body is trying to compensate by growing new bone (known as osteophytes).
Unfortunately, the cartilage you are born with is the only cartilage you have for your entire life, so once it is damaged or worn out it cannot grow back. Therefore, there is no cure for osteoarthritis. The treatment for osteoarthritis is aimed at relieving symptoms to improve your quality of life and keep you active. The first line of treatment includes physical therapy (exercise, physiotherapy) and pain- relieving medications. Surgery is reserved for patients who have severe osteoarthritis or still experience pain after trialling physical therapy and medications. The amount of pain that a patient feels from their osteoarthritis is proportional to the amount of force which is passed through the joint. “Offloading the joint” means reducing the amount of force that is going through that joint. Minimising aggravating activities, such as long walks or long periods of standing, is a very effective way of decreasing your pain. Use of a walking stick can be beneficial in offloading the hip joint as well.
If non-surgical treatments have not helped with your pain and improve your quality of life, your doctor may recommend surgery. As with all surgeries, it comes with some risks and should be left as a last resort. The most common surgery for hip osteoarthritis is hip replacement surgery. This is where the ‘ball’ of the femur is removed and replaced with an artificial implant. To match this, the remaining cartilage is removed from the socket and a metal socket is inserted. This is a very effective way of eliminating hip pain. After surgery people often return to an active lifestyle including sports, pain free. On average approximately 90% of hip replacements are still in place and working well, 18 years after they were inserted.
More than 50% of people over the age of 65 will have evidence of arthritis on an X-ray and about 1 in 7 of these patients will have symptoms.2,3 Knee pain is usually felt after you have been using the joint for some time for e.g. after walking a lot you may need to sit down to rest. Depending on where your osteoarthritis is in the knee, your symptoms will vary. If you have osteoarthritis on the end of your bones you will find it hard to walk long distances. If you have arthritis under your knee cap you will likely find it painful to climb stairs or rise from a chair.
During your consultation, the doctor will ask about your symptoms and then examine your knee including its range of movement. They may find that it does not extend all the way or you have limited ability to bend your knee. To confirm the diagnosis, you will likely be sent for X-rays, including an X-ray while standing up. This allows the doctor to assess how much your knee has worn out.
Unfortunately, the cartilage you are born with is the only cartilage you have for your entire life. Once it is damaged/worn out it cannot grow back. Treatment is aimed at relieving symptoms to improve your quality of life. Treatments include:
physical therapy and exercise
simple medications such as paracetamol
minimising aggravating activities
replacing high impact exercises (e.g. running) with low impact ones (e.g. swimming, cycling)
Surgery is reserved for patients who have severe arthritis or still experience severe pain after trialling physical therapy and medications. As with all surgeries, it comes with some risks and should be left as a last resort. The most common surgery for knee osteoarthritis is a knee replacement surgery. This is where all or part of the joint is replaced. During this surgery the worn out ends of the bones are removed and replaced with metal with a high-density plastic layer, mimicking your old joint and cartilage. This is very effective in improving patients’ pain.
