They are dynamic, active, in their best age! But every now and then when exercising, your knee pinches. But not because of osteoarthritis? In fact, you do not yet see yourself as wearing a prosthesis. Or not yet. And anyway: Where does the liquid cartilage stay? Isn't osteoarthritis just a lie anyway?
In the era of general social media screaming, let's try to keep calm and focus on facts as far as they are known.
Your knee joint: flexible. Stable Low friction.
Our joints are marvels of efficiency. A mirror-smooth layer of cartilage covers the joint ends of the bones and, with its unique mechanical properties, ensures inimitably little friction. Muscles stabilize and move the joint, ligaments guide it in the correct plane.
The knee is also guided and buffered by two wedge-shaped menisci. These crescent-shaped, fibro-cartilaginous wedges fill the gap between the joint-side curvature of the femur bone and the surface of the lower leg bone, thereby increasing the contact surface in the knee and distributing pressure.
What is “osteoarthritis” anyway?
Osteoarthritis is the wear and tear of a joint, which normally begins with slight degenerative changes and can lead to complete joint destruction.
Joint wear is characterized by increasing thinning of the cartilage.
Of course, all structures described above are affected in osteoarthritis.
The joint mucosa can become inflamed and thicken and continue to rub off the cartilage. Bone pulpits form, which can rub against cartilage and ligaments. The knee-stabilizing ligaments and menisci loosen, which can lead to instability.
The cause of osteoarthritis is — like everything in life — multifactorial. However, mechanical loads play an important role; an accident can accelerate the wear process.
Does an arthrotic joint always hurt?
No, an arthrotic joint doesn't always hurt. Why a joint hurts is not entirely clear, but inflammatory changes, stress, and instability turn an arthrotic joint into a painful arthrotic joint.
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Treatment options
Every therapy is preceded by a diagnosis. Knowledge of the changes described above allows therapy that is tailored to the individual wear pattern of your joint. Unfortunately, cartilage-building therapy does not yet exist.
Inflammation can be inhibited with medication, tablets or injections into the joint.
The load can be reduced, for example, by adapting the sport. A change in the mechanical load axis can be achieved with inserts and rails. Sometimes, however, surgical, bony correction of the mechanically unfavorable “O” or “X” leg is recommended.
Joint stability can be improved through physiotherapeutically assisted strength and coordination training. Torn meniscus parts can be surgically stitched, and loosened attachment points of the menisci can be refixed (see illustration).
Blocking cartilage or meniscus parts, scraping bone pulpits and scarred mucous membrane must be surgically removed.
Only when we, as doctors, no longer expect a significant improvement in their symptoms through joint-preserving measures, do we recommend artificial joint replacement. We use computer-aided planning and verification of the operation using the MAKO technique, in which the bone incisions are made with a robot-arm-assisted saw. With this technology, we expect your knee to function better — so that you too can keep calm and stay active!
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