Knees Popping? Here’s How to Prevent (and Treat) Osteoarthritis

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According to the CDC nearly one in every two Americans will experience some type of osteoarthritis pain in their lifetime.  We asked Dr. Neil Roth of Lenox Hill Hospital in NYC to tell us what you can do to prevent osteoarthritis, and manage it if you’ve been diagnosed with the condition already.

What exactly is osteoarthritis, and how do people get it?

Osteoarthritis essentially is an inflammation of cartilage in the joint, and it can be in any joint of the body. It affects articular cartilage, which is a certain type of cartilage that coats bones and allows the surfaces of a joint to glide freely against each other. As you age, articular cartilage can get damaged through normal wear and tear, injuries, or trauma.

If we speak specifically about the knee, some of the things that can happen to patients in their younger days that can lead to having arthritis down the road include tears of the meniscus, tears of the anterior cruciate ligament (ACL), or fractures in some of the bones of the knee. All of these can put you at higher risk for developing osteoarthritis as you get older.

How is osteoarthritis treated?

Because osteoarthritis is a progressive disease, what we try to do is halt the progression of the problem by attacking it with modification to nutrition, exercise, daily activities, medication and bracing.  When those fail there are still great options to treat this surgically.

Some of the best treatment options out there are around treating the underlying cause of this.  If you have a meniscal tear oftentimes we do an arthroscopy to clean out the tissue so it doesn’t cause any further damage to the arterial cartilage, but once we’ve done a diagnosis of articular cartilage damage and osteoarthritis there are a number of things we do to try to diminish the symptoms.

I put my patients on an exercise program to strengthen the muscles around the joint. For the knee joint specifically, we’ll oftentimes strengthen the quadriceps, hamstrings, and calf muscles, and work to keep and restore range of motion throughout the knee joint.

Oftentimes with arthritis people have pain, limitations in motion, and that in turn limits the joint mobility, so a lot of treatments are geared toward strengthening, restoring joint mobility and trying to diminish pain.  Oftentimes we’ll use over-the-counter anti-inflammatories like Advil, Aleve, and Motrin. There are higher strength medications as well.

We’ll also consider doing injections; one type is a corticosteroid injection, which is a powerful agent that works locally in the joint.  A newer type of injection is called viscosupplementation, which is like an oil job for the knee. These injections lubricate the knee and tend to diminish some inflammatory pain as well.

Another option is to give braces that will unload the joint or support the joint. There are a lot of lower profile braces out now that allow people to engage in activities that they like to do and give them the support they need so they don’t have a lot of pain.

How can people prevent osteoarthritis pain before it happens?

If you’re having pain and swelling in a joint, or a mechanical symptom like locking, a doctor should evaluate you fairly quickly. If you’re doing something that aggravates the pain and the pain goes away when you’re not doing that, there are things you can do diminish the pain while it’s going on, including icing the joint or taking over-the-counter anti-inflammatories. If after a week the symptoms are still persistent, that’s when you need to be evaluated.

Can osteoarthritis be treated through nutritional supplements?

There are a lot of supplements out there.  Chondroitin sulfates, glucosamine and MSM act as mild anti-inflammatory agents, so those are good for patients who can’t tolerate normal anti-inflammatories.  If you have a peptic ulcer, or GI distress, you can take anti-inflammatories, so these nonconventional supplements are absolutely appropriate.

When would you recommend surgery for osteoarthritis of the knee? 

I recommend surgery after all conservative care treatment options are no longer helpful and when the patient’s activities of daily living or recreational activities are compromised. Surgical options range from knee arthroscopy to total joint replacement.

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Dr. Neil Roth is a board certified Orthopedic Surgeon specializing in Sports Medicine with Lenox Hill Hospital. He has
served as an assistant team physician for the Los Angeles Lakers, Dodgers, Kings and Angels, the Anaheim Ducks as well as the University of Southern California. Dr. Roth is also an independent spokesperson for the OA Nano knee braces.

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