Surgery last option in Osteoarthritis treatment

Dr Saleh Mohd Kagzi, Orthopaedic Specialist at Zulekha hospital in Dubai, says that in most cases, no obvious cause can be found. The most commonly affected joint is knee joint. “Osteoarthritis is nothing but a wear and tear of the joint over the long period of time,” he adds.

“Over a period of time, the elastic articular cartilage becomes thin and worn out. In X-rays, it shows as a reduction in joint space. Loss of articular cartilage leads to exposure of the bone ends. Exposed bone ends get damaged and become painful.”

According to Dr Kagzi, once damaged, the cartilage which covers the joint surface and acts as a cushion and provides smooth surface, is replaced by a healing tissue, which is non-elastic unlike the original.

“So over the time, new less elastic tissue replaces the original cartilaginous tissue which in the end results in a joint surface which is covered by cartilage that has less cushioning effect and less shock absorbing capacity. This in turn leads to pain during the joint movements,” he explains.

According to Dr Kagzi, knee pain is a leading symptom of osteoarthritis. Patient may experience long period of discomfort followed by exacerbations of pain and stiffness after unaccustomed activities like prolonged sitting, squatting or climbing of stairs.

The treatment of the knee is multifaceted. “If symptoms are not severe, treatment is conservative. Surgery is usually restricted to the severe cases with deformity,” he says.

Dr Kagzi says education, self-help, and exercise programmes can help patients cope with the disease. “Surgical options should be reserved for patients who have failed medical management. Alternative treatments are under investigation while studies on vitamins A, C, D, and E have been promising, but further studies are needed,” he says.

He also says osteoarthritis can run in families. “If genetic, the disease can appear in 40s and can involve many joints.” Osteoarthritis is also the end result of many other joints diseases, like rheumatoid arthritis, traumatic joint fractures, psoriasis.

—news@khaleejtimes.com