Arthritis is characterised by joint pain and inflammation. Inflammatory conditions, like rheumatoid arthritis, can result in joint erosion and destruction, affecting multiple joints throughout the body. While modern drugs have proven effective in managing these conditions, joint replacement may become necessary in certain instances.
Osteoarthritis, on the other hand, involves the gradual deterioration of shock-absorbing cartilage in joints, typically impacting the hip and knee. Weight-bearing joints, such as knees and hips, are particularly susceptible to osteoarthritis, affecting 18% of knee joints and 11% of hips. The prevalence of osteoarthritis rises with age, with 42% of men and nearly half of women over 75 experiencing it. In the UK, around 9 million people have sought treatment for osteoarthritis.
Interestingly, with the increasing adoption of active lifestyles, there has been a surge in osteoarthritis cases among younger age groups, causing pain and disability during a phase of life when full activity is desired. Currently, 33% of individuals over 45 seek treatment for osteoarthritis to preserve their ability to engage in various activities.
What is osteoarthritis?
Osteoarthritis occurs when the articular cartilage covering the ends of our joint bones degenerates over time. This cartilage, responsible for smooth joint movement, gradually dries out and loses its effectiveness, eventually leading to wear and tear. As the cartilage thins, bone exposure and the formation of bone spurs (osteophytes) around the joint result in pain, stiffness, and swelling. Weight-bearing joints are particularly susceptible, causing significant pain and disability.
What causes osteoarthritis?
The unique structure of articular cartilage, with its low friction rate, is ideal for joint function. However, due to its lack of a blood supply, it relies on nutrient diffusion through its matrix and cannot regenerate once damaged.
Osteoarthritis can have genetic factors and often runs in families. In younger patients, joint damage, deformation, or misalignment may be the cause, stemming from childhood issues, infections, or injuries. For most individuals, wear and tear over time contribute to the development of osteoarthritis.
What are the treatment options for knee arthritis?
In the early stages, maintaining mobility through exercise is crucial, offering benefits such as joint nourishment, weight management, and muscle strengthening. Physiotherapy is often recommended when discomfort and stiffness arise. Low-impact exercises like cycling, swimming, and Pilates help manage pain before considering joint replacement. Pain-relieving medications, anti-inflammatories, and injections can control pain, allowing for continued activity.
As osteoarthritis progresses, daily activities become increasingly challenging, with pain potentially affecting sleep. Surgical intervention may become necessary at this point. Mr Sulaiman Alazzawi will order scans and tests to assess the degree of deterioration, guiding you through the decision-making process regarding joint replacement surgery. He will discuss available options, addressing potential benefits, risks, and complications to help inform your decision.
Mr Sulaiman Alazzawi is a Consultant Orthopaedic and Trauma Surgeon based at St Georges University Hospital and the South West Elective Orthopaedic Centre in Epsom. He specialises in hip and knee replacements and treating painful or failing joint replacements. His private practice is based at Fortius Clinic and Parkside Hospital in Wimbledon and Spire St Anthony’s Hospital in Sutton.
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