Osteoarthritis (OA) is one of the major diseases affecting individuals around the world. A chronic, progressive musculoskeletal disorder characterised by gradual loss of cartilage in joints, it results in bones rubbing together which creating stiffness, pain and impaired movement.
The disease most commonly affects the joints in the knees, hips, hands, feet, and spine. OA is the second most common rheumatologic problem and the most frequent joint disease with a prevalence of 22 percent to 39 percent in India. It is more common amongst women than in men. Nearly, 45 percent of women over the age of 65 years have symptoms while 70 percent of those over 65 years show radiological evidence of OA. The daily struggle with one’s own body pushes a patient into a state of paranoia.
Stressing on the plight of old-age patients suffering from OA, Dr. Himanshu Kataria of Safdarjung Hospital, said, “For senior citizens, maintaining a social circle involves going out for walks, meeting friends for yoga sessions in parks or clubs. But the persistent knee pain becomes an obstacle, leaving them confined to their homes. And in the long run this isolation affects their physical as well as psychological health.”
OA is a four-stage progressive disease, which, if not treated on time, can get worse and impact quality of life gradually.
-Stages of OA: Acute, Subacute, Chronic and Degenerative
If a patient is in the early stages-acute or subacute-mild painkillers and lifestyle changes might be the recommendation. However, if the disease has progressed to the chronic or degenerative stages, the treatment options are much more clinical. In a country where the success rate of total knee replacement (TKR) therapy is 95 percent, patients, especially the elderly, have no reason to worry.
Dr. Kataria added, “In chronic arthritis cases – where the knee pain significantly impacts one’s quality of life or leads to bowing of the legs – painkillers and exercise fail to provide pain relief. A knee replacement therapy is advised only when the conservative measures are not expected to give positive results. While the therapy provides significant pain relief, it also restores mobility thereby improving the patient’s quality of life.”
During the procedure, the damaged part of the knee is resurfaced and replaced with an artificial implant to reduce pain and smoothen the range of motion of the joint.
What an informed patient needs to do is to follow a pragmatic approach. That should include-regular following up with the doctor, abiding by the medical advice, staying strong and positive and keeping family members close. Clinically, physiotherapy and a well-balanced diet including calcium and other supplements as per the requirement of a patient can help speed up the recovery time.
On an individual level, managing the associated co morbidities with OA e.g.- obesity, diabetes, etc. are mandatory. Staying optimistic during and after the surgery is the key to combat anxiety. And, a positive attitude significantly influences the course of recuperation.