Osteoarthritis

Some people experience popping, locking, or giving out of their knee. When it happens, it's sudden and can really catch you off guard. If it has happened to you, you know what I mean. Not only is it momentarily shocking, it can land you on the ground, especially a knee that gives out.

A knee that gives out is caused by knee instability. Often, the instability is related to ligament injury. Osteoarthritis of the knee is also associated with instability. Learn more about how osteoarthritis can cause your knee to give out in Knee Gives Out - Is It Osteoarthritis?

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Hip and knee replacement surgery is not uncommon for arthritis patients, especially those with osteoarthritis or rheumatoid arthritis. Two studies presented at the 2012 annual meeting of the American Academy of Orthopaedic Surgeons (AAOS) revealed that smoking is harmful for knee and hip replacement patients. According to Time.com, the first study evaluated over 600 knee replacements performed between 2005 and 2009 in arthritis patients who were in their 60s. About 115 of the study participants were smokers. Researchers found that the rate of revision surgeries was 10 times greater for smokers compared to non-smokers. Surgical complications were almost twice as common for smokers compared to non-smokers. There was no apparent difference between current smokers and past heavy smokers, suggesting smoke does irreparable damage.

The second study assessed 535 hip replacements in 500 patients between 1999 and 2009. Researchers found a 6.2% failure rate at about 18 months. After smoking habits were factored in, researchers found smokers had an 11% failure rate compared to 5.3% in previous smokers, and 3.8% in non-smokers. Researchers concluded that quitting smoking helps to decrease the risk of joint replacement failure.

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Participation in high-impact sports or activities significantly increases wear and decreases the survivorship of hip replacements, according to researchers. Football, skiing, tennis, jogging, soccer, and martial arts are examples of high-impact activities. It is not uncommon for orthopedic surgeons to warn patients about high-impact activity but there have not been many studies that actually evaluated the effect on artificial joints.

According to the study results published in the journal Clinical Orthopaedics and Related Research, a team of French researchers compared the function, wear rates, and survivorship of hip implants in 70 patients who participated in high-impact sports and 140 patients who participated in low-impact activities. They assessed the need for revision related to mechanical failure and loosening of the hip prostheses. The assessments were made at least 11 years after the hips were surgically implanted. Patients also completed questionnaires about their sports participation and quality of life. Those participating in high-impact sports reportedly had better function and quality of life than patients participating in low-impact activities. However, at 15-years followup, survivorship of hip implants was 80% for high-impact participants compared to about 94% for the low-impact participants. Patients and doctors need to be aware of the risk of high-impact activity on implant survivorship.

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According to study results presented at the World Congress on Osteoarthritis, overweight women who followed a 2.5 year diet and exercise program had a significant reduction in the incidence of knee osteoarthritis. The PROOF (Prevention of Knee Osteoarthritis in Overweight Females) study, which was conducted in the Netherlands, set out to assess whether a weight loss program plus oral glucosamine sulfate could prevent knee osteoarthritis. The trial involved 200 women who participated in the weight loss program and 200 women who served as controls and did not participate in the weight loss program. In both groups, half received glucosamine (1,500 mg/day) as well. The women who were selected for the study were 50 to 60 years old, had a body mass index of at least 27, but had no x-ray evidence or clinical signs of osteoarthritis at the study onset.

According to MD Consult, the weight loss program included a weekly group session involving various low-impact sports. The women also had sessions with a dietician. The program was designed to be a regimen that women would stick with. After 2.5 years, researchers determined that among those who complied with the program, there was 25% incidence of knee osteoarthritis among the control group and 10% in the weight loss program group. Researchers did admit that compliance was an issue. Only 25% of women remained compliant with the program. Diet and exercise are lifestyle modifications that require strict commitment. Difficult to do, even with the goal of osteoarthritis prevention.

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Knee osteoarthritis patients who will eventually need knee replacement have greater cartilage loss early in the course of their disease compared to patients who don't go on to require knee replacement. Those findings were presented at the World Congress on Osteoarthritis, based on data from the Osteoarthritis Initiative. The study involved 109 knees from study participants who had knee replacement between the first and fourth year of the Osteoarthritis Initiative, according to Rheumatology News.

MRI was used to measure cartilage thickness. Researchers found that patients who had received a knee replacement had three times as much cartilage loss as controls (patients who did not go on to have surgery). Cartilage loss may be a useful biomarker going forward in clinical trials. Aside from predicting knee replacement, cartilage loss may predict the effectiveness of DMOADs in clinical trials. Also, the findings support the theory that if treatments could slow cartilage loss, the need for knee replacement might be delayed. For now, a link between cartilage loss and knee replacement has been drawn.

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According to a report in Rheumatology News, a review of the medical charts of 264 patients revealed that many who had bariatric surgery experienced "near-complete resolution" of their knee osteoarthritis. The findings showed that 3 types of bariatric surgery produced statistically significant results for obesity-related comorbidities (e.g., hypertension, diabetes, osteoarthritis).

Of patients undergoing RYGB (roux-en-Y gastric bypass), 71% reported that knee osteoarthritis resolved. Knee osteoarthritis also resolved for 63% of those who had LSG (laparoscopic sleeve gastrectomy) and 51% of patients who had LAGB (laparoscopic adjustable gastric banding). If the preliminary results can be matched in clinical trials, the body mass index requirement for bariatric surgery may be lowered for those with comorbidities.

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Researchers evaluated the short-term effectiveness of therapeutic ultrasound for knee osteoarthritis. They assessed pain, physical function, walking, disability, and psychological status of knee osteoarthritis patients.

There were 42 knee osteoarthritis patients randomly assigned to receive therapeutic ultrasound or sham ultrasound. The patients also were treated with hot packs, interferential current, and isometric quadricep exercise. Both groups were treated 5 times a week for 3 weeks. According to study results published in the April 2012 issue of the International Journal of Rheumatic Diseases, patients in both the therapeutic ultrasound group and the sham group had significant improvement in pain, stiffness, physical function, walking, disability, depression and anxiety. While ultrasound was found to be safe, it did not seem to offer additional benefit to knee osteoarthritis patients already receiving conventional physical therapy.

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While there is yet to be a cure for osteoarthritis, a lot can be done to manage the disease. Patients, as well as doctors, should keep up with the latest treatment recommendations. In 2000, the American College of Rheumatology (ACR) released treatment recommendations for hip and knee osteoarthritis. Now, in 2012, the ACR has updated recommendations for treating hip and knee osteoarthritis and they have added recommendations for treating hand osteoarthritis.

The recommendations are valuable for providing guidance and highlighting sound treatment options but each patient still needs to be assessed and examined by their own doctor. Learn more in Treatment of Hand, Hip, and Knee Osteoarthritis - 2012 ACR Recommendations.

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Between the femoral and tibial components of the knee, there are two wedge-shaped pieces of cartilage. Each wedge-shaped piece of cartilage is known as a meniscus. We often hear about meniscal tears, especially among athletes or those who play contact sports. But meniscal tears can happen in older people, too, as cartilage wears thin.

Learn more about the symptoms, diagnosis, and treatment of meniscal tears. Also consider this important question - do meniscal tears predispose patients to develop osteoarthritis? Read more in Meniscal Tears and Osteoarthritis.

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According to research presented in a poster session at the annual meeting of the Canadian Rheumatology Association, the risk for cardiovascular disease is higher among people with osteoarthritis compared to those without osteoarthritis. However, researchers couldn't explain why with certainty.

In the study, 12,624 osteoarthritis patients were compared to 61,131 people without osteoarthritis. After adjusting for potential factors that might be related to an increased risk, the analysis showed a 19% increase in the risk of cardiovascular disease in people with osteoarthritis compared to those without osteoarthritis. According to Rheumatology News, researchers suggested the increased risk could be related to decreased physical activity in osteoarthritis patients. Other possible factors may be body mass index, smoking, and the use of certain prescription drugs. Researchers will follow up to try to validate their findings.

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