Osteoarthritis is a chemical process. It is not just mechanical wear and tear, but a process that involves cellular and chemical changes. These changes affect all joint tissues (cartilage, bone, joint capsule, ligaments and muscle).

In the event of any trauma and age related changes, the body will attempt to repair damaged tissue. With synovial joints, such as the knee, the repairs to cartilage and bone are not made with exactly the same tissue. Consequently tissue re-modelling can result in changes to the joint surface.

The pictures below show how these changes can progress over time and result in significant loss of function. Not to mention discomfort!

Knee One
mild osteoarthritis knee joint

On the right of the joint you can see a small bone spur. Also notice how the joint space on the right side (medial compartment) is less than the left side ( lateral compartment). This is a sign that the cartilage is breaking down faster than it can be re-built.

Knee Two
moderate OA knee

Further narrowing of the medial joint space and more irregularities along the surface of the joint line.

Knee Threesevere osteoarthritis knee Wide spread joint changes with the complete loss of medial compartment joint space. This knee is appropriate for joint replacement.

But what about knees one and two?

Is it possible to minimise the inappropriate / excessive chemical response and minimse any additional trauma?

Chris Creaghan at  Injection Clinic believes that by focusing treatment on the metabolic process (chemistry) and the mechanical forces (strength, alignment, range of movement)  then positive changes can be made.

To minimise mechanical trauma aspects such as footwear, movement patterns, joint strength and range of movement all need to be addressed.

But whilst many people follow this exercise advice, the correction of the joints chemistry is often overlooked. Osteoarthritis is an active metabolic process and therefore exercising a knee joint when the process is active can often cause more pain and further inflammation.

To detect these changes Ultrasound scans can highlight excessive blood flow through joint tissues and also detect excessive fluid / swelling. Once detected these areas can be directly injected with medication or excessive fluid can be aspirated. Guided injections of cortisone are an efficient and proven way to suppress inflammation and once the metabolic process has been calmed down, then exercises can commence.

For maintaining the health of the knee joint, along with exercises, medication such as Ostenil can be used. This helps restore normal levels of joint lubrication.

Platelet Rich Plasma (PRP) can also be used to ensure there is optimal nutrition to the joint. (For more information please have a look at the latest post on PRP Injections). Click here.

Remember that best chemistry and best mechanics will always pave the way for the best treatment of any arthritic joint. There isn’t a cure, but there is best management.

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