10 Key Points To Reduce Knee Osteoarthritis Pain
Knee Osteoarthritis and Pain Reduction here in Canberra
Knee Osteoarthritis is a condition that can cause pain around the knee joint. It can get worse over time and you may notice that you have less strength and movement than normal. This is a common condition, and there are various management options, including exercise.
Risk factors include age, weight and previous trauma to the knee. Over time the supportive tissue around the knee starts to degenerate resulting in pain and inflammation.
What role does exercise have in reducing
Osteoarthritis Pain in your Knee ?
The Key Information about Knee Osteoarthritis:
OARSI (Osteoarthritis Research Society International) and ACR (American College of Rheumatology) both recommend exercise intervention to be the most effective mode of management of symptoms.
With a large focus around strengthening the supportive muscle groups including the quadriceps, hamstrings, hip abductors, and calves. Exercise is highly effective in decreasing pain and optimising function of the affected joint.
If you would like guidance as to what management strategy is best for you, please book in a consultation with me or one of our Exercise Physiologists in Canberra today.
Do I need a Knee Replacement?:
Since this is a progressive condition there may become a point where you are considering a Joint Replacement. This should be discussed with your GP and nominated Surgeon. If you are experiencing any of the following circumstances it may be worthwhile discussing your options with your GP.
Severe pain that is affecting your ability to complete regular daily tasks
Severe pain while resting or sleeping at night
Lasting swelling around the joint that does not dissipate with rest and medication
No pain relief from anti inflammatory Medication
Knee joint replacements are hugely successful in managing pain associated with osteoarthritis, but they do come with a large recovery and healing process. It is important to have support around you to ensure a smooth return to normal activities of daily living.
Resistance training is a very useful tool when it comes to supporting the muscles around your new joint to ensure you regain full strength and function.
There is evidence recommending that following a resistance training program PRIOR to your knee replacement will in fact lead to a faster and more effective recovery post surgery.
Can Massage and Exercise be a Good Combination for Knee Osteoarthritis?:
Massage and Exercise are great combination to reduce you knee osteoarthritis pain symptoms. Symptom relief and safety of weekly massage make it an attractive short-term treatment option for knee osteoarthritis.
Longer-term biweekly dose of massage maintains improvement and reduces pain, however in the long term, regular exercise and leg strengthening is important.
Please look at the video below by Daniel O'Sullivan, who explains how massage fits into the management program of someone with Knee Osteoarthritis.
Let's Do This Now:
No matter what stage you are at with your Knee OA condition, we always recommend some form of physical activity or movement that is appropriate to you.
Please contact us in Canberra today if you have any questions regarding your own journey.
Aim to keep moving and especially incorporate some leg strengthening
Seek advice for an Exercise Physiologist today. Book your free chat below
The Best Knee Osteoarthritis Resources in Canberra for Exercise
As mentioned above Accelr8 Rehab is the best place for you if you need to start exercising and management for Knee Osteoarthritis. Exercise Physiology prescription is a great way to get you moving.
GLA:D Program for Hip and Knee OA - Southside Physio
There has been a strong push in the media recently for an increased awareness of the best practice and treatment of osteoarthritis (OA) in Australia. The link below to the SBS takes snippets from an insight episode that reinforces that it is important and often very beneficial to exercise when you have hip or knee OA. We have known about the benefits of exercise in OA since 2002 - and at Southside Physio have always strived for our clients to achieve their goals without surgical intervention.
Southside Physio is proud to offer the GLA:D (Good life with Arthritis: Denmark) program for those who suffer from osteoarthritis of the hip or knee. This exercise program has been developed by researchers in Denmark, and has been proven to reduce pain and improve quality of life by combining an active approach of education and group exercise.
Osteoarthritis (OA) is the most prevalent lifestyle condition in people 65 years and older, but can also affect people as young as 30 years of age. The most recent international clinical recommendations for the first-line treatment of OA are education, exercise and weight loss. Unfortunately a surgical approach is very common in Australia. The GLA:D® Australia program offers a safe and non-invasive alternative.
GLA:D® Australia training program outline:
· Initial appointment with a Physiotherapist explaining the program and collecting individual, functional data
· Two OA education sessions, including information on how GLA:D® Australia improves joint stability and symptoms of OA.
· Group neuromuscular training sessions twice weekly for 6 weeks to improve muscle and joint control which lead to reduction in symptoms and improved quality of life.
Benefits of GLA:D®:
· Has been proven to reduce progression of knee/hip OA symptoms by 32%
· Is a unique program that contains exercises and teaches skills that can be applied to everyday activities
· Improves strength in the legs, especially around the hip and knee
· Provides reductions in pain
· Has been proven to increase levels of physical activity 12 months post-GLA:D®:
· Has been proven to reduce the use of joint-related pain medications
· Decrease the amount of people on sick leave.
Who can participate in GLA:D®?
· Individuals who experience symptoms of hip and/or knee osteoarthritis
· Individuals who have needed to see a health care professional due to a hip or knee joint problem
You do not need a GP referral to participate in GLA:D®, but other health-related issues may prevent you from participating. If you are unsure of your medical health, a visit to your GP is recommended before you commence. Please contact the Southside Physio team for any further questions regarding our research based treatment of hip/ knee OA.
Osteoarthritis Treatment Canberra - Knee Arthritis ACT
Osteoarthritis, also called degenerative joint disease is the most common form of arthritis. It occurs most often in older people. This disease affects the tissue covering the ends of bones in a joint (cartilage). Osteoarthritis is characterized by damaged articular cartilage, cartilage lining the hip joint.
Advanced age is one of the most common reasons for osteoarthritis of hip. You may also develop osteoarthritis if you had hip injury or fracture in the past, if you have family history of osteoarthritis, suffering from hip diseases such as avascular necrosis and other congenital or developmental hip diseases.
The characteristic symptoms and diagnostic test helps in diagnosing the condition. You will experience severe pain confined to hip and thighs, morning stiffness and limited range of motion.
Based on the symptoms your orthopaedic surgeon will perform physical examination, X-rays and other scans, and also some blood tests to rule out the other conditions that may cause similar symptoms.
Management of Osteoarthritis
The objective of the treatment is to reduce pain, improve joint movement, and prevent further damage to joint.
Non-surgical Treatment for Osteoarthritis
The non-surgical treatment of osteoarthritis involves:
- Medications: Pain-relieving medications such as NSAIDs, COX-2 inhibitors and opioids may be prescribed. Topical medications such as ointments can be applied over the skin where there is pain.
- Steroid Shots: These injections of steroids are given directly into the affected joint for severe pain when use of NSAIDs does not bring much relief. Steroids are very strong anti-inflammatory drugs and if used orally cause various side effects on other body systems. Local analgesics that prevent the sensation of pain are sometimes given along with steroids in the same shot to bring relief quickly.
- Lifestyle Modifications: Some of the lifestyle modifications include:
- A moderate exercise program
- Use of Heat or cold treatments
- Eating a healthy and well balanced diet
- Get adequate rest
- Lose weight
- Protect your joints with the use of assistive devices such as splints or braces to support the weakened joints
- Physical Therapy: Your physical therapist will teach you exercises to keep joints flexible and improve muscle strength.
Surgical Treatment for Osteoarthritis
Surgery is usually considered if nonsurgical treatment fails to provide relief. There are different surgical procedures that can be used and may include:
- Arthroscopy: Arthroscopy, also referred to as keyhole surgery or minimally invasive surgery, is performed through very small incisions to evaluate and treat a variety of hip conditions. Arthroscopy is a surgical procedure in which an arthroscope is inserted into a joint.
- Arthroscope is a pencil-sized instrument that has a small lens and lighting system at its one end. Arthroscope magnifies and illuminates the structures inside the body with the light that is transmitted through fibre optics. It is attached to a television camera and the internal structures are seen on the television monitor.
- Debridement: Arthroscopic debridement or a clean-up is a surgical procedure performed using an arthroscope. In this procedure, the cartilage or the bone that is damaged is removed using surgical instruments and the edges of the articular cartilage that are rough will be smoothened.
- A wash out or joint lavage is done using a special tool to spray jets of fluid to wash and suck out to remove the remaining debris around the joint. After lavage, any remaining loose bodies or fragments are removed. Debridement helps to reduce pain and slows down the progression of arthritis.
- Tailor made prosthesis: A Tailor-made prosthesis or custom made prosthesis is the latest technology designed specifically for the size and shape of an individual’s anatomy. It uses CT-scanning for extremely accurate 3-dimensional mapping and measurement of the hip joint.
- Computer software transforms the data from the scan into a 3-D model of your arthritic hip and then virtually rectifies any deformity so as to restore the hip to its pre-arthritic condition. This allows the surgeon to preserve more of the bone and ligaments to accept the hip replacement implant.
Your surgeon will discuss the options and help you decide which type of surgery is the most appropriate for you.
Osteoarthritis & Rheumatoid Arthritis Canberra, ACT
Click on the links below to take go to the particular part of the section.
- What is arthritis?
- What are the different types of arthritis?
- What causes osteoarthritis?
- Predisposing factors to Osteoarthritis
- What are the symptoms of arthritis?
- How can a doctor diagnose arthritis?
- What you can do?
- What your doctor can do for you?
- Treatment Options
- Does exercise really help those who have arthritis?
- Can special diets treat arthritis?
What is arthritis?
The term arthritis literally means inflammation of a joint, but is generally used to describe any condition in which there is damage to the cartilage. Inflammation is the body’s natural response to injury. The warning signs that inflammation is present are redness, swelling, heat and pain.
The cartilage coats the joint surfaces to absorb stress, and allow smooth joint movement. The proportion of cartilage damage and synovial inflammation (the lining and fluid in the joint capsule) varies with the type and stage of arthritis. Usually the early pain is due to inflammation. Later in the disease, pain is from the irritation of the worn joint structures and inability of the joint to move properly.
What are the different types of arthritis?
There are over150different types of rheumatic diseases.e.g., Osteoarthritis, Rheumatoid Arthritis
Osteoarthritisis the most common form of arthritis. It is often referred to as wear and tear arthritis as it involves the thinning and breakdown of the cartilage lining, which cushions and protects the joints, where two bones meet. The bone may lose shape and thicken at the ends or produce bony spurs.
It causes pain in the joints and surrounding soft tissues and limits the range of movement of a joint. Osteoarthritis affects many joints including the large, weight bearing joints of the hips and knees and also the spine, hands, feet and shoulders.
There are several reasons for the development of osteoarthritis including age, being overweight, heredity factors, and joint damage from a previous injury or during early development of a joint. The severe pain of osteoarthritis can be very fatiguing and disabling.
Rheumatoid arthritis.This is an auto-immune disease in which the body’s immune system (the body’s way of fighting infection) attacks healthy joints, tissues, and organs. Occurring most often in women of childbearing age (15-44), this disease inflames the lining (or synovium) of joints.
It can cause pain, stiffness, swelling, and loss of function in joints. When severe, rheumatoid arthritis can deform, or change, a joint.
Rheumatoid arthritis affects mostly joints of the hands and feet and tends to be symmetrical. This means the disease affects the same joints on both sides of the body (like both hands or both feet) at the same time and with the same symptoms. No other form of arthritis is symmetrical. About two to three times as many women as men have this disease.
Fibromyalgia.Fibromyalgia is a condition associated with generalised muscle pain and fatigue. It is often described as a form of "soft tissue rheumatism", which means it is a condition that causes pain and stiffness around the joints and in muscles and bones. It does not cause inflammation.
Goutis a form of arthritis. The joints appear painful, tight and swollen. The pain is caused by needle shaped microcrystals which can destroy the joint cartilage. When a person has gout, they have higher than normal levels of uric acid in the blood.
The body makes uric acid from the foods we eat. Too much uric acid causes deposits, called uric acid crystals, which form in the fluid and lining of the joints. If the kidneys don’t work properly then you can’t get rid of the uric acid in the urine as you should. The result is an extremely painful attack of arthritis.
People often inherit gout and although we don’t know why, Maori and Pacific island peoples are more likely to get gout. The joint most commonly affected is the big toe.
Infectious arthritis. Arthritis can be caused by an infection, either bacterial or viral. When this disease is caused by bacteria, early treatment with antibiotics can ease symptoms and cure the disease.
Reactive arthritis. This is arthritis that develops after a person has an infection in the urinary tract, bowel, or other organs. People who have this disease often have eye problems, skin rashes, and mouth sores.
Systemic lupus erythematosus.Also called lupus or SLE is a form of arthritis which affects joints, muscles and other parts of the body. It is one of the autoimmune rheumatic diseases. In people with autoimmune diseases, antibodies are produced which act against certain body tissues and cause inflammation. There are two main form of Lupus: Discoid Lupus which affects only skin, and Systemic Lupus which involves the joints and sometimes the internal organs as well. Lupus (Latin for wolf) takes its name from the fact that it can cause serious rashes across the cheeks and nose (rather fancifully resembling the face of the wolf) (Arthritis NZ)
Ankylosing spondylitisis a term used to describe a form of arthritis that mainly affects the joints of the spine. However it may affect other parts of the body, e.g. hips, shoulders, knees or ankles. It causes inflammation outside the joint where the ligaments and tendons are attached to the bone, whereas in most forms of arthritis the inside of the joint is inflamed.
It usually affects the little joints between the vertebrae of the spine and tends to diminish the movement which takes place at these joints. It affects younger people, teenagers to mid thirties and more men then women.
Juvenile rheumatoid arthritis. The most common type of arthritis in children, this disease causes pain, stiffness, swelling, and loss of function in the joints. A young person can also have rashes and fevers with this disease.
Polymyalgia rheumaticawhich means rheumatic pain in many muscles, results in severe stiffness and pain in the muscles of the neck, shoulders, lower back, buttocks and thighs. Other symptoms may be fatigue, loss of weight, night sweats and fever. Visual disturbance may indicate temporal arteritis or Giant cell Arteritis.
Polymyositis.Causing inflammation and weakness in the muscles, this disease can affect the whole body and cause disability.
Psoriatic arthritis.Is an inflammatory arthritis associated with psoriasis, a chronic skin and nail disease. Psoriatic arthritis affects about 10% of people with psoriasis. It can affect single joints, usually of the fingers or toes, as well as wrists, knees, ankles and sacro iliac joints of the spine.
Bursitis.This condition involves inflammation of the bursa, small, fluid-filled sacs that help reduce friction between bones and other moving structures in the joints. The inflammation may result from arthritis in the joint or injury or infection of the bursa. Bursitis produces pain and tenderness and may limit the movement of nearby joints.
Tendinitis. Also called tendonitis, this condition refers to inflammation of tendons (tough cords of tissue that connect muscle to bone) caused by overuse, injury, or a rheumatic condition. Tendinitis produces pain and tenderness and may restrict movement of nearby joints.
What causes osteoarthritis?
Osteoarthritis is caused by the wearing out of the cartilage covering the bone ends in a joint. This may be due to excessive strain over prolonged periods of time, or due to other joint diseases, injury or deformity. Primary osteoarthritis is commonly associated with ageing and general degeneration of joints.
Secondary osteoarthritis is generally the consequence of another disease or condition, such as repeated trauma or surgery to the affected joint, or abnormal joint structures from birth.
Some people may have developmental or congenital abnormalities of the joints that may cause early degeneration and subsequently cause arthritis.
Predisposing factors to Osteoarthritis
- Injury and joint trauma- in the knee from fractures and torn ligaments and cartilage (menisci)
- Mechanical stress
- Deformity and malalignment in the hip, growth abnormalities or childhood hip problems
- Prior inflammatory disorders
- Endocrine and metabolic disorders
What are the symptoms of arthritis?There are more than 150 different forms of arthritis. Symptoms vary according to the form of arthritis. Each form affects the body differently. Arthritic symptoms generally include swelling and pain or tenderness in one or more joints for more than two weeks, redness or heat in a joint, limitation of motion of a joint, early morning stiffness, and skin changes, including rashes.
How can a doctor diagnose arthritis?
Doctors diagnose arthritis with a medical history, physical exam, x-rays and blood tests. There is no blood test for osteoarthritis.
What you can do?
- Consult a doctor to determine the type of arthritis you have. Treatment will depend on a correct diagnosis.
- Take medication as recommended by your doctor
- Rest/ and or exercise. A balance as advised by your doctor or health professional.
- Protect your joint/s from further damage.
- Pain relief such as heat or cold therapy
- Weight control to prevent extra stress on weight bearing joints
- Maintain your general health and well being.
What your doctor can do for you?
There is no cure for arthritis, so beware of ‘miracle cures’. Your doctor may prescribe anti-inflammatory medicine. They may recommend occupational therapy or physiotherapy, which includes exercises and heat treatment.
In severe cases, surgery may be suggested, such as a hip or knee replacement. The type of surgery will depend on your age and severity of the disease. In the elderly with severe arthritis, joint replacement can give good results.
Initial treatment for osteoarthritis is conservative with a balance of rest and exercise, avoiding vigorous weight bearing activities, education in arthritis management, support, and joint protection such as walking aids or braces, and non invasive pain relief techniques.
Pharmacy measures include analgesic and anti- inflammatory medication, complementary medication, possibly injections into the joint of cortisone/ corticosteroids. OA should be managed with combined non pharmacological and pharmacological approaches.
Treatment of osteoarthritis focuses on decreasing pain and improving joint movement, and may include:
- Education and understanding,
- Exercises to keep joints flexible and improve muscle strength
- support, from health professionals and family
- Joint protection, to prevent stress or strain on painful joints e.g. suitable foot wear
- Weight control to prevent extra stress on weight bearing joints
- Physiotherapy and/ or heat or cold treatments.
- Medication approaches i.e. anti inflammatory gels/rub ons, the use of non steroidal anti inflammatory medication, non narcotic analgesics such as paracetamol and complementary and alternative medications such as glucosamine with or without chondroitin and injections of glucocorticoids into the joint if needed
- Surgery to relieve chronic pain in damaged joints.
Does exercise really help those who have arthritis?
Exercise is very important because it increases lubrication of the joints and strengthens the surrounding muscles, putting less stress on joints. Exercise in heated swimming pools-hydrotherapy-can bring enormous relief from pain and stiffness.
Also studies have shown that exercise helps people with arthritis by reducing joint pain and stiffness and increasing flexibility, muscle strength and energy. It also helps with weight reduction and offers an improved sense of well-being.
Can special diets treat arthritis?
But what if you have arthritis – are diet and nutrition still such a simple matter? Can what you eat cure your arthritis? Can food prevent it from occurring? Are there foods that can cause your arthritis to ‘flare’ or go into remission?
What role do vitamins and nutritional supplements play in the treatment of arthritis? Will losing (or gaining) weight help ease your symptoms? Will taking powerful anti-arthritic medications affect your appetite or your ability to eat certain foods?
These are the sorts of questions that people with arthritis often ask, and they’re valid questions. Some questions "Can what you eat cure your arthritis?" have simple answers "No". Some questions "Are there foods that can cause your arthritis to ‘flare’ or go into remission?" aren’t so straightforward. "Perhaps…"
Most of what you need to know about diet and nutrition is common sense; healthy eating is pretty much the same for anyone, whether you have arthritis or not. But there are exceptions.
From learning about the importance of exercising regularly to fully understanding your arthritis medications, the information contained in this section is meant to provide you with insights, information and tips that can be used by you to help make living with arthritis a little bit more manageable.
For people with arthritis, learning to make it part of your life can be difficult. But learning as much as you can about your particular type of arthritis and actively working with your arthritis treatment team are two very effective ways of regaining control over your life.
There is plenty of information, some specific to arthritis and some not, that can be very helpful to someone facing the challenges associated with having a chronic or lifelong disease.
Our suggestion is – don’t let arthritis beat you. Take control. How? Arm yourself with as much information as possible. Learn from the experiences of others in similar circumstances. What we’re presenting here is a virtual toolbox of tips for living well with arthritis. Some may work for you one day and not the other.
Some may work for you but not others. That’s why we’ve tried to cover several topics. There are plenty of tools or tips here. Use them or refer to them when you need them. Call upon them when you require help
Arthritis in Knee - Canberra Orthopaedics
Arthritis of the knee: Causes, symptoms, and treatment
What is arthritis?
Arthritis is inflammation which can affect one or more joints, causing pain and stiffness. Rather than being one single disease, there are actually over 100 different forms of arthritis, and it is a leading cause of chronic pain and disability among Australians especially as the population ages.
Read on to find out more about the causes and pain associated with arthritis in knee, as well as the treatment options available to aid in recovery.
What causes arthritis in knee?
The knee is the largest and strongest joint in the body, and is made up of three bones: the lower end of the femur (thighbone), the upper end of the tibia (shinbone), and the patella (kneecap).
Where the three bones touch, they are covered with articular cartilage, which cushions the bones as the knee bends and straightens. The meniscus are two additional wedge-shaped, rubbery pieces of cartilage which provide shock absorption between the thighbone and shinbone.
The knee joint is also surrounded by the synovial membrane which is responsible for lubricating the cartilage and reducing friction.
While there are over 100 types of arthritis, the most common ones affecting the knee are:
The most common form of arthritis, Osteoarthritis is caused by wear and tear, and most commonly affects people over the age of 50.
Osteoarthritis wears away the articular cartilage (the smooth outer covering of the bone), causing the protective space between the bones to decrease. This results in the bones of the affected joint rubbing together during movement, causing pain and bone spurs to develop.
Osteoarthritis develops slowly and worsens over time.
Rheumatoid arthritis is a chronic autoimmune disease that attacks multiple joints throughout the body by causing the synovial membrane to swell, resulting in pain and stiffness.
Rheumatoid arthritis usually affects the same joint on both sides of the body.
A form of osteoarthritis, posttraumatic arthritis occurs as a result of an injury such as a fracture or dislocation.
Instability from meniscal tears and ligament injuries can cause additional wear on the knee joint, which can result in arthritis.
What are the symptoms of arthritis of the knee?
Pain and inflammation are common symptoms of arthritis of the knee, with the pain usually developing slowly over time. The pain is often worse in the morning or after periods of inactivity, and some people notice more pain with changes in the weather (particularly cold weather).
Other symptoms include stiff and swollen knee joints, difficulty bending and straightening the knee, pain during or after vigorous exercise, weakness or buckling in the knee, and the feeling of the knee “locking” and making creaking, clicking, or grinding noises (called crepitus) during movement.
How is arthritis in knee diagnosed?
Arthritis in knee can be diagnosed through physical examination (your doctor will look for signs of weakness, previous and current injuries, problems weight-baring and walking, and pain and tenderness among other symptoms), x-rays, and sometimes an MRI or CT scan.
Blood tests can also be useful for detecting certain types of arthritis, such as rheumatoid.
What treatment options are available for arthritis in knee?
While there is no cure for arthritis, there are treatment options available which may help to relieve pain and keep active.
Initially, arthritis of the knee may be treated with non-surgical options such as rest, icing / heat, physiotherapy, anti-inflammatory medications, changes to activity, and steroid injections.
Switching high-impact activities such as running to lower-impact activities like swimming, as well as losing weight can help to reduce stress to the affected joints. Devices such as a cane, knee brace, bandaging, and shock-absorbing insoles may also help.
If these treatment options are unsuccessful, surgery may be necessary.
GLA:D (Good Life with Arthritis: Denmark) - TM Physio Canberra
WHAT DOES GLA:D INVOLVE?
This education and exercise program reflects the latest evidence in osteoarthritis (OA) research. It also includes feedback from people with OA and trainers on what works in the real world to help patients manage OA symptoms.
GLA:D AUSTRALIA TRAINING CONSISTS OF:
- A first appointment explaining the program and collecting data on your current functional ability
- Two education sessions which teach you about OA, how the GLA:D™ Australia exercises improve joint stability, and how to retain this improved joint stability outside of the program
- Group neuromuscular training sessions twice a week for six weeks to improve muscle control of the joint which leads to reduction in symptoms and improved quality of life
The GLA:D program is run in private, public, and hospital physiotherapy clinics. The cost of the program can vary depending on location and size of the group. Please discuss this with the provider listed below.
You do not need a referral from you Doctor, however you may be eligible for a rebate from Medicare for some of the cost of the program, if deemed appropriate by your GP
CAN I PARTICIPATE IN GLA:D AUSTRALIA
GLA:D™ Australia is a program for all individuals who experience any hip and/or knee osteoarthritis symptoms, regardless of severity.
You may participate in the GLA:D™ Australia program if you have a hip or knee joint problem that resulted in visiting a health care provider.
You may not be able to participate in the GLA:D™ Australia program if:
- You have other reasons for your hip and/or knee pain, including; tumor, inflammatory joint disease, result of hip fracture, soft tissue or connective tissue problems
- You have other symptoms that are more pronounced than the osteoarthritis problems (for example chronic generalized pain or fibromyalgia)
- You are unable to understand and communicate in English
Osteoarthritis, What is osteoarthritis? - Australian Institute of ...
What is osteoarthritis?
Osteoarthritis is a chronic condition characterised by the breakdown of the cartilage that overlies the ends of bones in joints. This results in the bones rubbing together, causing pain, swelling and loss of motion (Figure 1). Osteoarthritis mostly affects the hands, spine and joints such as hips, knees and ankles, and usually gets worse over time.
Figure 1: Comparison of healthy joint and joint with osteoarthritis
Source: AIHW 2015.
As osteoarthritis progresses it can become difficult to perform everyday tasks. At first pain is felt during and after activity, but as the condition worsens pain may be felt during minor movements or even at rest. Affected joints may also become swollen and tender which can affect fine motor skills.
Osteoarthritis has no specific cause, however several factors contribute to the onset and progression (Chapman & Valdes 2012), including:
- being female
- genetic factors
- excess weight
- joint misalignment
- joint injury or trauma (such as dislocation or fracture)
- repetitive joint-loading tasks (for example, kneeling, squatting and heavy lifting).
How common is osteoarthritis?
Osteoarthritis is the most common form of arthritis in Australia. An estimated 2.2 million (9.3%) Australians have this condition, according to the Australian Bureau of Statistics (ABS) 2017–18 National Health Survey (NHS). Osteoarthritis represented over half (62%) of all arthritic conditions in 2017–18 (ABS 2019).
Although osteoarthritis affects people of all ages, the prevalence increases sharply from the age of 45 years. 1 in 5 Australians (22%) over the age of 45 have osteoarthritis. It is most common in adults aged 75 and over, with just over one-third (36%) of people in this age group experiencing the condition (Figure 2).
Osteoarthritis is also more common among females than males, affecting 10% of females compared with 6.1% of males (after adjusting for age).
Figure 2: Prevalence of self-reported osteoarthritis, by age and sex, 2017–18
Note: refers to people who self-reported that they were diagnosed by a doctor or nurse as having osteoarthritis (current and long term) and also people who self-reported having osteoarthritis.
Source: AIHW analysis of ABS 2019 (Data table).
For people aged 45 and over the prevalence of osteoarthritis was slightly lower in Major cities (19%), compared with Inner regional and Outer regional/Remote areas (25% and 23%, respectively).
The prevalence of osteoarthritis was higher for people living in the lowest socioeconomic areas (25%) compared with people in the highest socioeconomic areas (16%). Women had higher rates of osteoarthritis compared with men for all regions and socioeconomic areas (Figure 3).
Figure 3: Osteoarthritis prevalence, by remoteness and socioeconomic area, people aged 45 and over, 2017–18
Note: Age-standardised to the 2001 Australian population.
Source: AIHW analysis of ABS 2019 (Data table).
GLA:D® Program | Canberra Health Network
Joint Pain Jacqui
Jacqui Couldrick is one of the most commonly referred to Physiotherapists by Orthopaedic Specialists and GP’s in Canberra for assessment and treatment of Hip and Knee Osteoarthritis.
Jacqui was Canberra’s first GLAD Hip and Knee Osteoarthritis Program provider. Jacqui’s real passion would be to ensure those who have been diagnosed with osteoarthritis are given access to evidence based treatment options such as exercise, education and dietary advice.
Primary Total Knee Replacement - Canberra Knee Clinic
Primary total knee replacement, also called total knee arthroplasty, is a surgical procedure in which the worn out or damaged surfaces of the knee joint is removed and replaced with artificial parts.
The knee is made up of the femur (thigh bone), the tibia (shin bone), and patella (kneecap). The meniscus, the soft cartilage between the femur and tibia, serves as a cushion and helps absorb shock during motion. Arthritis (inflammation of the joints), injury, or other diseases of the joint can damage this protective layer of cartilage, causing extreme pain and difficulty in performing daily activities.
Orthopaedic surgeon Dr Klar may recommend surgery if non-surgical treatment options have failed to relieve your symptoms.
Indications for surgery
Total knee replacement surgery is commonly indicated for severe osteoarthritis of the knee. Osteoarthritis is the most common form of knee arthritis in which the joint cartilage gradually wears away. It often affects older people. Other forms of arthritis exist such as rheumatoid arthritis.
In a normal joint, articular cartilage allows for smooth movement within the joint, whereas in an arthritic knee the cartilage itself becomes thinner or completely absent. In addition, the bones become thicker around the edges of the joint and may form bony “spurs”. All of these factors can cause pain and restricted range of motion in the joint. Dr Klar may advise total knee replacement if you have:
- Severe knee pain which limits your daily activities (such as walking, getting up from a chair or climbing stairs).
- Moderate to severe pain that occurs during rest or awakens you at night.
- Chronic knee inflammation and swelling that is not relieved with rest or medications.
- Failure to obtain pain relief from medications, physical therapy, or other conservative treatments.
- A bow-legged or knocked-knee deformity of the leg.
- Poor quality of life and significant functional limitation.
Knee Replacement Surgery
The goal of total knee replacement surgery is to relieve joint pain and restore the alignment and function of your knee. The surgery is performed under spinal and/or general anaesthesia.
Dr Klar will make an incision in the skin over the affected knee to expose the knee joint. Dr Klar uses the Zimmer Nex Gen and Persona TKR components and the I-Assist computer navigation system for all primary knee replacements. This represents the best-surviving implants currently available on the market as proven on the National Joint Replacement Registry NJRR.
Computer navigation ensures the components are optimally fitted and aligned in your knee. The damaged portions of the femur bone are cut at appropriate angles using specialized jigs.
Dr Klar then cuts or shaves the damaged area of the tibia (shinbone) and the cartilage. This removes the deformed part of the bone and any bony growths, as well as creating a smooth surface on which the implants can be attached. Dr Klar will place a plastic piece called an articular surface between the implants to provide a smooth gliding surface for movement.
This plastic insert will support the body’s weight and allow the femur to move over the tibia, similar to the original meniscus cartilage. The femur and the tibia with the new components are then put together to form the new knee joint and all components are cemented into position with antibiotic bone cement.
To make sure the patella (knee cap) glides smoothly over the new artificial knee, its rear surface is also prepared to receive a plastic component or button. With all the new components in place, the knee joint is tested through its range of motion. The entire joint is then irrigated and cleaned with a sterile solution.
The incision is carefully closed, an injection of local anaesthetic (to stop bleeding inside the knee) is infiltrated into the joint and a sterile dressing is placed over the incision.
Rehabilitation begins immediately following the knee replacement surgery. A physical therapist will teach you specific exercises to strengthen your leg and restore knee movement, and your physiotherapist will come to walk you briefly at about 4 hours after the operation to minimise your risk of blood clots.
You will be able to walk with crutches or a walker. Your physical therapist will also provide you with a home exercise program to strengthen thigh and calf muscles. Blood transfusion is occasionally needed after total knee replacement surgery but is less likely these days.
Most patients stay in hospital 3-5 days after a primary knee replacement.
Risks and complications
As with any major surgery, possible risks and complications exist and those associated with total knee replacement surgery include:
- Knee stiffness or arthrofibrosis
- Infection in the artificial knee joint
- Blood clots (deep vein thrombosis) or lung clots
- Nerve and blood vessel damage
- Ligament injuries
- Patella (kneecap) dislocation or fracture
- Plastic liner wearing out
- Ongoing pain of uncertain origin in up to 10% of patients
- Loosening of the implants
- Unsightly or thickened scar
- Complex regional pain syndrome