Knee Osteoarthritis Treatment in Newcastle
The GLA:D program is specifically designed to help reduce the pain associated with knee osteoarthritis and improve function, stability and confidence in the knee.
Osteoarthritis (OA) is a very common condition and is one of the most common causes of mobility difficulties as people age. It is estimated that 1 in 11 Australians have osteoarthritis. Osteoarthritis can also affect younger and middle aged people with 5% of people aged 35-54 having osteoarthritis.
What is osteoarthritis?
Your knee joint is formed by three bones: femur (thighbone), tibia (shinbone) and patella (kneecap).
The ends of your bones are covered in cartilage which gives a smooth coating to the end of the bones and allows them to glide easily when moving. Cartilage is both solid and elastic which allows it to both distribute load over the joint and absorb shock. Cartilage does not have a blood supply, nutrients are supplied by synovial fluid (a fluid inside the joint capsule).
In a healthy knee joint there is a balance of cartilage degeneration and regeneration. Osteoarthritis is when there is more degeneration than regeneration of cartilage.
Symptoms of knee osteoarthritis
Symptoms of knee osteoarthritis vary depending on the degree of osteoarthritis as well as other factors. Symptoms may include
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Pain - is often the earliest sign and often settles with rest. Pain sites vary and you may feel pain in the whole joint or just a smaller area (often the front and/or inner side of the joint)
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Loss of movement
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Difficulty weight bearing
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Stiffness - particularly in the morning, after prolonged rest and during colder periods
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Weakness – of surrounding muscles, this can often feel like you don’t trust your knee
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Hot, swollen joint – can be experienced by some people
Symptoms and disability from knee osteoarthritis are also influenced by other factors
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Muscle weakness
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Lifestyle factors including sleep and diet
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Comorbidities including being overweight
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Psychological factors including stress
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Beliefs eg: fear, positive or negative thoughts
Treatment of knee osteoarthritis
Physiotherapy
Current best practice guidelines, both nationally and internationally, recommend exercise, patient education and weight loss as first line treatments for the management of osteoarthritis.
At Fitness Physio we run the GLAD Newcastle (Good Living with Arthritis: Denmark) exercise and education program which has been proven to:
reduce pain
reduce the use of painkillers
reduce sick leave
improve function and walking speed
improve quality of life
increase activity levels
help participants to avoid joint replacement surgery
Surgery
Knee joint replacement
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This involves replacing the knee joint with a prosthesis. People have this procedure for end stage degeneration when they are unable to cope with the symptoms of knee osteoarthritis.
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If you are booked in for a TKR it is a great idea to consider ‘prehab’. Increasing your strength and physical fitness before your operation can set you up for better outcomes after your operation. Talk to our physios about developing a safe, achievable exercise program
Knee arthroscopy
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Knee arthroscopy which involves inserting a camera into the knee joint and essentially doing what is called a clean up - trimming and tidying up any loose or torn structures.¿ However, recent literature indicates that this procedure doesn't seem to have any long term benefits over exercise and should only be considered for extreme locking in the knee only.
Myths about osteoarthritis
X Degree of osteoarthritis predicts pain and disability
√ Scans do not predict disability. Scans are poorly related to symptoms, pain and disability ie: you can have a scan indicating severe OA and no symptoms, likewise you can have OA pain that does not show up on an xray
X OA is wear and tear
√ It is not helpful to think of osteoarthritis as wear and tear. Osteoarthritis has a number of risk factors and in most cases it is more of a risk to be/have been inactive than active. Factors influencing OA include: genetics, gender, age, obesity, physical inactivity, muscle weakness and history of sport, work or leisure related injury eg: ACL.
X Rest is helpful
√ Excessive rest and avoiding activity can make pain worse. Movement is needed for joint health and cartilage regeneration.
X Exercise is dangerous
√ Exercise is safe and beneficial for osteoarthritis. Exercise (along with education and weight management) is recommended by national and international guidelines as best practice, first line therapy for osteoarthritis.
X Pain = damage
√ Pain ≠ damage. When beginning a new activity a small amount of pain or soreness is safe and normal, this pain will settle as your body gets used to the exercise.
