It's the largest joint in the human body. It helps you stay active, flexible and plays an essential role in facilitating movement. And yet, in spite of the fact that any problem or injury affecting the knee would have the power to render you immobile, it is one the most overlooked aspects of health care.
There's no denying that we often worry about our knees only after a crippling pain sets in. At this point, the damage has already been done and replacement surgery is perhaps the only option. But knee problems don't happen overnight. It's a slow process that occurs within the first four decades of your life accelerated by a combination of bad lifestyle choices and genetic issues.
Know your knees: The knee is a joint that is protected by cartilage -- a soft, flexible, connective tissue that is not as hard as bone, but harder than muscle. It forms a protective cover and links the two major bones of the leg. Any damage to this cartilage can be painful and irreversible unless surgery is involved.
Aging and Arthritis: "The health of your knee cartilage can be affected by many factors," says Dr Srinivas J.V., senior orthopaedic surgeon, Fortis Hospital, Bangalore. "In osteoarthritis, the knee cartilage is completely worn out, until bone rubs against bone. It's a result of a slow process of degeneration, either due to an overactive lifestyle or severe lack of calcium in the body. One group is particularly at risk. Women in our culture get married early and have two or three children in their twenties. These women severely lack calcium and by the time they reach their forties, they are invariably affected by osteoporosis, a bone brittling disease (in which bones have less than 30% of calcium) that can put you at risk, not only to fractures, but to degeneration of the knee cartilage as well. Inflammatory arthritis (extreme swelling or pain accompanied by degeneration of cartilage) can cause severe damage too, but as this occurs as a result of genetic factors and diseases in the body, it can hardly be avoided."
In most cases, damage to the knee cartilage is due to the natural process of aging. But there are ways you can protect yourself against the pain and avoid making the damage worse. "First of all, it's important to maintain an ideal body weight. Being overweight or obese will only put more pressure on your knees," says Dr Srinivas.
"Exercising regularly will also help your joints stay mobile and flexible. Timely diagnosis and the control of diseases like diabetes and hypothyroidism are important too, because if these disease run rampant in the body, it could affect healthy cartilage."
Invest in bone health: A good time to start investing in healthy bones is from childhood. "Active children build strong bones," says Dr Srinivas. "The more active you are, the more nutrition you are feeding to your knee cartilage. It's a pity these days that an increasing number of children lead sedentary lives and remain glued to their computer screens and television sets. As bone health peaks between 20-40 years, one should continue to participate in sports and stay active as much as possible during these years. That's the best gift you can give to your knees because after the age of forty, both men and women lose at least 3% of their bone calcium every year. It is impossible at this stage to build calcium reserves and popping pills just won't work." Most Americans and Europeans, he adds, manage to engage in sports during these crucial years, so for this population, knee problems only become an issue during the fag end of their lives--in their eighties. However, Indians seldom indulge in sports, especially as middle age sets in (Of course, just watching the IPL doesn't count!). For us, knee problems crop up as early as the forties, severely threatening our mobility and adding greater discomfort to old age.
Take precautions: If you're already experiencing pain, Dr Srinivas emphasizes the need to take precautions. "Don't make knee pain worse by climbing the stairs or sitting cross-legged on the floor. Always sit on chairs or a raised surface until the pain recedes," he says. "Avoid walking on hard gravelly surfaces and performing strenuous exercises when there is pain. Rest is the best remedy." In the long-term, switching to low impact activities such as swimming and walking (with less pressure on the joints) is a good idea.
Surgical Options: For people with advanced osteoarthritis, there is now relief. Knee replacement surgery is fast becoming a common procedure in India.
This surgery can cost an average of Rs.80,000 to1.5 lakhs, depending on your hospital and post-surgical care. The procedure involves partially or completely replacing the knee. Recovery can take upto 3 weeks, after which one can return to normal life -- the pain completely recedes and the knee is as good as new. After surgery, doctors advise an active lifestyle that will help further weight loss and prevent fresh damage to the knee joints. Remember, caring for your knees is a lifelong process. After all, it's thanks to this joint that we have the ease and freedom of mobility.
