Of the 300 patients who visit the Orthopaedics Department at the State-run Bowring and Lady Curzon Hospital in Bangalore daily, nearly 30 per cent report knee pain.
Of late, orthopaedists in the city are seeing an increased number of patients, especially women over 40, for osteoarthritis. This is a condition in which inflammation results in pain in the joints. Also a fallout of “wear and tear”, osteoarthritis is caused when the cartilage that covers and acts as a cushion inside joints wears out. The most commonly affected are knee and hip joints, say doctors.
With more women than men vulnerable to the condition, doctors say female sex and older age are the common risk factors. Other factors include excess body mass, specific occupations, repetitive knee bending or lifting heavy weights and a strong family history.
Indian lifestyle
Sharan S. Patil, chairperson and chief orthopaedist of Sparsh Hospital, says overweight people bring more pressure on their joints. “Our Indian lifestyle of squatting on the floor, using Indian toilet, bending knees to the extreme level for prayers and other activities can cause knee pain. We have been seeing more than 800 patients on a single day at our rural camps in Karnataka.”
Explaining that osteoarthritis results from an imbalance between breakdown and repair of the tissues of the synovial joint organ, he says this occurs as a result of multiple risk factors including trauma and genetic predisposition.
“The body joints are special structures where two ends of the bones meet. There is a soft cartilage that covers and acts as a cushion inside the joints. This cartilage is lubricated by synovial fluid. Following continuous use, if this cartilage wears away, the bones underneath rub against each other, producing a lot of pain. The rubbing results in little bits of debris coming out of the joints and the pain is similar to what one experiences when there is a small stone in the shoe,” he explains.
Pain and painkillers
While problems of wear and tear of the knee joint start with pain and stiffness, patients gradually develop sleep disturbance and deformity of the legs. “Most resort to painkillers, which offer temporary relief. In the long run, these painkillers can cause gastritis and kidney problems,” says Dr. Patil.
S. Rajanna, senior specialist (orthopaedics) at Bowring and Lady Curzon Hospital, says lifestyle changes such as reducing weight by dietary modification, exercise and activity modification can help in managing knee joint pain.
He says patients with symptomatic osteoarthritis of the knee should take up low-impact aerobic fitness exercises and quadriceps. “They should avoid exertion, jumping and jerky movements, using Indian toilet and walking on uneven surfaces.”
Knee replacement
Both doctors say total knee replacement is the final option for patients with knee osteoarthritis. However, this surgery is done for those patients whose daily activity is affected by the pain.
“The dreaded complication of joint replacement surgery is infection. Infection rates are low and results excellent if it is done in a good orthopaedic surgery unit. At least three knee replacements are done [at Bowring Hospital] every month,” Dr. Rajanna adds.
