Does Arthroscopy help Osteoarthritis?

Does having an arthroscopy help the osteoarthritic knee?

Getting a lot of press recently are articles that say no. But once again, that's not the whole story.

It has been shown that if you have moderate to severe osteoarthritis in isolation an arthroscopy is of little benefit. What complicates things is that there is often more than one cause of symptoms.

It is common to also have meniscal tears or loose bodies within the knee joint. These can be responsible for a great deal of pain and physical symptoms such as giving way.

An arthroscopy is a safe and effective way of addressing these problems. As long as the individual is aware that the key hole surgery is targeting only these components of the problem, and not making the knee "unworn", they should be happy with a significant reduction in pain.

They will still have some residual pain from the arthritis but less pain is still less pain.

Click here for a transcript of a radio interview with an orthopaedic surgeon discussing this topic

More evidence for Knee Bracing

More articles and more positive findings.

Fabian E. Pollo, PhD and Robert W. Jackson, MD had a study entitled:'Knee Bracing for Unicompartmental Osteoarthritis' published in The Journal of the American Academy of Orthopaedic Surgeons.

To quote their summary:

"Unicompartmental osteoarthritis of the knee affects millions of individuals. Most nonsurgical management of this progressive disease is primarily directed at reducing inflammation and pain with medication. Evidence supports the clinical efficacy of bracing for managing osteoarthritis of the knee. In some patients, bracing significantly reduces pain, increases function, and reduces excessive loading to the damaged compartment. A variety of health and functional status instruments, as well as radiologic techniques and biomechanical investigations, has been used to evaluate the unloading capabilities of these braces. Although changes in angulation are relatively minimal, the braces have been shown to load share and thus reduce the stresses in the degenerated medial compartment of the knee."

That is, they do as promised and are a valuable tool in the fight against arthritic knee pain.

Online retailers such as The Brace Shop have plenty more product specific information

Knee Replacement Animation

Here is a basic animation of a knee replacement I stumbled upon.
I know that some people prefer animation to actual footage.
It gives you a nice simple visual summary of the "before" and "after".

Stairs - Why does going down hurt more?

Just about everyone with osteoarthritis of the knees gets increased pain on stairs. What most people don't realize is that it is common for descending to hurt more than ascending.

This is because your knees act as the brakes when going down stairs. Your quadriceps muscles provide the braking force that acts through your knees to control body weight. Without this control you would continue to accelerate until things got unpleasant.

This pain in descending is likely to be particularly bad if you have arthritis in your patellofemoral joint.

What should you do?

Again, building quads strength is vital. Weak quads will result in poorly a controlled descent which is likely to aggravate the joint further. Try to avoid stairs only if your arthritis is having a particularly bad flare up. Avoiding stairs makes muscles weaker, not stronger.

Support your knees with strong muscles and they will respond by giving you less pain.

Exercise and Knee arthritis

Evidence continues to mount in support of exercise to treat knee osteoarthritis. This recently in the press....

http://www.smh.com.au/news/seniorshealth/strength-training-may-slow-knee-arthritis/2006/10/05/1159641444112.html

What have you got to lose?

Infection and arthroscopy

Infection is a hot topic and a major source of anxiety for anyone undergoing surgery.
If you are lining up for an arthroscopy (key-hole surgery) what do you need to know about the risks of infection?

Firstly, your skin is your best barrier against infection, so any break in the skin creates a risk.
The main benefits of key-hole surgery is the very small incision site. This causes less trauma to the knee and therefore less pain. Small incisions also mean a decreased risk of infection as more of the skin is intact.

Primarily for this reason infections following knee arthroscopy are very rare. Rates vary from hospital to hospital but are generally less than 1%.

This is good news as deep infections following surgery are a serious complication. Unlike getting a cut on your hand infected, a joint infection offers bacteria more options to thrive. The surgical incision goes all the way into the joint and offers a point of access to this warm, moist environment.

Superficial skin infections can usually be treated by oral antibiotics but joint infections often require a return to theatre for a washout as well as antibiotics.

Infections will always be a risk with any surgical intervention, but it is reassuring to know that the odds are very much on your side with arthroscopic surgery.