Arthritis is the inflammation of one or more joints. Its symptoms are mainly pain,
swelling, and stiffness. Any joint in the body can be affected by the disease, but it is common in
the knee. Knee arthritis can be a hindrance to many everyday activities to a patient. Knee arthritis
can limit one from walking or climbing stairs .the most common type of arthritis is osteoarthritis
and rheumatoid arthritis, mainly adult diseases. The knee is the largest and the strongest joint in
the body. It is made up of the lower end of the femur (thighbone), the upper end of the tibia(shin
bone), and the patella (knee cap). The end of the three bones is covered with cartilage, a smooth,
slippery substance that protects and cushions the bone as you bend the knee. The knee joint is
surrounded by a thin lining called the synovial membrane, which releases a fluid that acts as a
lubricant at the cartilage and reduces friction. (zeng, 2019)
Osteoarthritis is the most common form of arthritis in the knee. It is a generative 'wear
and tear" type of arthritis that wears away the cartilage. As the cartilage gradually wears off, it
becomes frayed and rough and the protective space between the born decreases resulting in bone
rubbing on bone and this produces painful bone spurs. The friction in between the bones causes
more pain hence osteoarthritis develops slowly (Zeng et.al, 2019).
Osteoarthritis (OA) is the most common joint disorder in the United States, where 10% of men
and 13% of women aged 60 and older. The number of people affected by osteoarthritis is likely
to increase due to the aging of the population and the obesity prevalence. Osteoarthritis is ranked
as the most frequent cause of physical disability among older adults. The disease affects both
men and women. Before age 45, it is more common to men than women, while after the age of
45, osteoarthritis is more common in women. According to the United Nations, by 2050, people
aged over 50 will count for more than 20% of the world's population. Of that 20%, a
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conservative estimate of 15% will have symptomatic osteoarthritis, and one-third of these will be
totally disabled. This translates to 130 million people who will be suffering from osteoarthritis
worldwide in 2050, of which the disease will disable 40 million people (Wei et al., 2020)
According to MOVES, 1039 subjects with a mean age of 62 years and 54.2% being
female were included in this study. The prevalence of self-reported osteoarthritis was
9.9%.knees, and hands were the most frequent sites of the disease. It was also discovered that
there was a higher number of women and participants without professional activity.
According to the National health interview survey (NHIS), the years 2013 – 2015 sample adult
core components to estimate average annual arthritis prevalence in the civilian, non
–institutionalized us adult population aged 18 years or older. Overall, an estimated 22% (54.4
million adults had doctor-diagnosed arthritis, with significantly higher age-adjusted prevalence
in women (23%) than in men (18%). Arthritis prevalence increased with age.
There is no cure for arthritis, but there are a number of treatments that may help relieve
pain and disability it may cause.
Medications
Medications are focused on decreasing symptoms of the disease. The Pain-relieving
medications include acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDS).
Narcotic pain medications are not recommended due to their addictive nature. Although many of
these medicines are readily available in chemists, one should consult a health care provider
before taking medications since some may have adverse side effects.
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Supportive devices
Supportive devices such as braces and orthotics help to support and stabilize painful
damaged joints. Medical devices should be used as instructed by healthcare provider therapists or
trained licensed professionals.
Exercise
Exercise improves flexibility, joint stability, and muscle strength. Regimens such as
swimming, water aerobics, and low impact strength training are always recommended. These
have been proved to reduce the amount of pain and disability that osteoarthritis suffers
experience. Excess or vigorous exercises are avoided since they may increase arthritis symptoms
and potentially hasten the disease progression. All exercises should be as directed by physical
therapists.
Hot and cold therapies
Intermittent cold and hot treatments may provide temporary relief of pain and stiffness.
Such include hot water shower or bath and being careful while applying heating and cooling
pads or packs.
Surgery
When osteoarthritis pain can't be controlled with medical management and interferes with
everyday activities, surgery might be an option. It's usually reserved for patients with significant
osteoarthritis. Several types of techniques can be employed, including minimally invasive joint
replacement techniques. Although surgery has many risks, it can be very effective at restoring
some functions and reducing pain for appropriate individuals.
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Weight control
Since obesity is a known risk factor for osteoarthritis, working to better manage weight
may help prevent and improve osteoarthritis. Weight loss for patients with osteoarthritis has been
proven to be efficient in reducing pain in weight-bearing joints and as moderate inflammatory
processes that contribute to osteoarthritis.
Research synthesis is important since it addresses the gap in the diagnostic and
biomarkers for osteoarthritis. Weight control will help improve disease monitoring and help
facilitate medicine development that can reverse the progression of the high- burden condition.
There is currently a need for research in the following areas; cost-effectiveness, safety, and
efficacy of the long-term management of osteoarthritis with the current pharmaceutical therapies.
New emerging technologies, diagnostics and biomarkers to more effectively measure the status
and progression of osteoarthritis. Evaluation of both the impact of risk factors and the
effectiveness of potential therapies using these new diagnostics and biomarkers.
Progress in osteoarthritis research has resulted in the identification of signaling pathways with
potential mechanistic targets. This has led to the emergence of a variety of symptomatic and
disease-modifying therapies in recent years. It is evident that osteoarthritis is not solely caused
by wear and tear of the joint but rather a sophisticated interplay between catabolic and anabolic
effects of chondrocytes, which involves the entire joint. As with other disorders, the future of
osteoarthritis may lie in combination therapy.
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References
Vina, E. R., & Kwoh, C. K. (2018). Epidemiology of osteoarthritis: literature update. Current
opinion in rheumatology, 30(2), 160.
United Nations. World Population to 2300. Available at:
http://www.un.org/esa/population/publications/…/WorldPop2300final.pdf
Guglielmo, D., Murphy, L. B., Boring, M. A., Theis, K. A., Helmick, C. G., Hootman, J. M., …
& Croft, J. B. (2019). State-specific severe joint pain and physical inactivity among
adults with arthritis—United States, 2017. Morbidity and Mortality Weekly
Report, 68(17), 381.
Evans, J. T., Evans, J. P., Walker, R. W., Blom, A. W., Whitehouse, M. R., & Sayers, A. (2019).
How long does a hip replacement last? A systematic review and meta-analysis of case
series and national registry reports with more than 15 years of follow-up. The
Lancet, 393(10172), 647-654.
Palmer, A. J., Glyn-Jones, S., & Amiras, D. (2017). Imaging Assessment of the Knee. In Joint
Preservation in the Adult Knee (pp. 13-21). Springer, Cham.
Wei, J., Wood, M. J., Dubreuil, M., Tomasson, G., LaRochelle, M. R., Zeng, C., … & Zhang, Y.
(2020). Association of tramadol with risk of myocardial infarction among patients with
osteoarthritis. Osteoarthritis and Cartilage, 28(2), 137-145.
Lue, S., Koppikar, S., Shaikh, K., Mahendira, D., & Towheed, T. E. (2017). Systematic review
of non-surgical therapies for osteoarthritis of the hand: an update. Osteoarthritis and
Cartilage, 25(9), 1379-1389.
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C. Zeng, M. Dubreuil, M.R. LaRochelle, N. Lu, J. Wei, H.K. Choi, et al. Association of tramadol
with all-cause mortality among patients with osteoarthritis J Am Med Assoc, 321 (10)
(2019), pp. 969-982
Saxby, D. J., & Lloyd, D. G. (2017). Osteoarthritis year in review 2016:
mechanics. Osteoarthritis and cartilage, 25(2), 190-198.
Zhou, Y., Wang, T., Hamilton, J. L., & Chen, D. (2017). Wnt/β-catenin signaling in
osteoarthritis and in other forms of arthritis. Current rheumatology reports, 19(9), 53.
Glyn-Jones, S., Palmer, A. J. R., Agricola, R., Price, A. J., Vincent, T. L., Weinans, H., & Carr,