As people get older, one of their biggest complaints is aching joints, particularly their knees. Painful knees making walking difficult and can severely limit a person’s mobility. One cause of joint pain is arthritis. There are some ways to prevent arthritis, but first it is important to understand how it develops.
What is the anatomy of the knee?
It is important to understand the anatomy of the knee in order to understand its function and its dysfunction. The knee is one of the major joints of the body. It is called a joint because it is where two major bones join: the femur (thigh bone) and the tibia (shin bone). The ends of the bones are covered in cartilage. This cartilage acts as a buffer and makes the two bones slip against each other. Without the cartilage, the bones would grind. Beyond the cartilage, there are other important measures to decrease friction. There are two menisci: the lateral meniscus and medial meniscus. They sit on the tibia, underneath the two bony prominences of the femur. They act as a layer of protection and help the bony surfaces glide.
There are also ligaments that help maintain the stability of the joint. There are two ligaments on the side, the lateral collateral ligament – on the outside of the knee – and the medial collateral ligament, on the inner side of the inner. There are also two more ligaments inside the knee. The Anterior Cruciate Ligament (ACL) is responsible for stabilizing forward movement of the knee. Likewise, there is a Posterior Cruciate Ligament. This too aids stability. It prevents the tibia from moving backwards.
What are common knee injuries?
Injuries to the meniscus
Menisci can be injured mainly through twisting or hyper-flexion of the knee. They can be partially torn of fully torn. Symptoms include swelling, pain, and a clicking and/or popping sensation. Orthopedic surgeons or sports physicians may be able to diagnose these injuries just through physical exam. However, the only definitive way to diagnose meniscus tears is through an imaging modality called Magnetic Resonance Imaging (MRI). As this modality is very expensive and the immediate treatment is rest and ice, doctors prefer to avoid MRIs if possible.
Many people injure their ACL in sports activities. This typically happens by planting one’s foot and twisting. The ligament can either fully tear or partially tear. When that happens, their knees become unstable and the tibia can move further forward than it is supposed to. Likewise, tearing the PCL can also cause instability. In this case, the tibia bone can move backwards more than it is supposed to. These movements may be so small that the patient does not notice them. Only someone well trained, like an orthopedic specialist, can tell the difference. Typically,
these injuries are associated with pain, swelling, and a pop. These have to be diagnosed with an MRI. Surgeons are able to repair these tears in surgery, so the MRI helps them plan their surgical approach.
Fractures of the Bone
Breaking either the femur or – more commonly – the head, or top, of the tibia can lead to long-lasting damage. Any time a fracture occurs, the body recognizes the inflammation in the area. This break often also causes a break in the cartilage. Over time, this tiny break may turn into chronic changes.
What is osteoarthritis?
Osteoarthritis is the most common form of arthritis. It is essentially due to overuse, and can be triggered or accelerated by a previous injury. The cartilage that wraps around the ends of the bones wears down naturally over time. With continued use, inflammation will develop in the area. Sometimes, the bones begin to produce spurs or deposits in the joint space. This causes the joint space to narrow, increased friction, and increased inflammation. This is what causes the pain and swelling of arthritis.
How do knee injuries lead to osteoarthritis?
As stated above, injuries in the knee can cause osteoarthritis over time. A break in cartilage can introduce even more opportunities for the cartilage to break down. This accelerates the process of arthritis. This is true in other joints in addition to the knee.
Are there any ways to prevent this?
Once the damage is done, it is almost impossible to completely undo it. However, there are ways to try to slow the process. One important way is to maintain a healthy body weight. The knees experience significant pressure. Decreasing one’s weight will decrease the stress on the knees. Being active in general helps reduce knee pain. In particular, strengthening the quadriceps muscle helps prevent more injuries.
What else can I do about osteoarthritis and knee pain?
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