Modern methods of treating knee osteoarthritis

Knee osteoarthritis is a condition in which the natural cushioning between the joints is worn away, causing the bones of the joints to rub against each other more strongly, causing pain, stiffness, and limited movement. Sometimes bone spurs form in the knee area. Osteoarthritis in general and knee osteoarthritis in particular are the consequence of many factors such as age, occupation, lifestyle, environment and accompanying inflammatory joint diseases.

Outstanding physician, Associate Professor, Dr. Dang Hong Hoa, Head of Musculoskeletal Department, Tam Anh General Hospital in Hanoi, said that many patients with subjective knee osteoarthritis do not receive early treatment. The disease in its severe stages causes many dangerous complications, restricting movement, affecting quality of life, and the most severe is disability. Depending on the disease case and the different levels of degeneration, doctors provide individualized treatment regimens, including medical treatment such as intra-articular injections. In some cases, it is necessary to combine surgery such as artificial joint replacement surgery to bring comprehensive results.

For example, Ms. Huong, 62 years old, living in Hai Phong, has suffered from knee osteoarthritis for 4 years, with knee effusion recurring many times on a background of diabetes, high blood pressure, and obesity. Ms. Huong took medicine but her illness improved slowly. The condition became more and more severe, causing her to have frequent knee pain, difficulty walking, especially going up and down stairs, unable to squat or cross her legs, and stiffness in the morning.

Associate Professor Hoa diagnosed Ms. Huong with stage three knee osteoarthritis, accompanied by acute synovitis and osteoporosis. The doctor prescribed to drain the fluid from the joint and inject exogenous Hyaluronic Acid (HA) solution into the joint. According to Dr. Hoa, this method helps relieve pain quickly, is anti-inflammatory, inhibits degeneration, connects proteoglycans and increases the synthesis of articular cartilage cells.

Combining physical therapy exercises, after 2 weeks, the patient’s pain symptoms decreased significantly and joint fluid improved. After about 8-12 weeks, the patient improves 90% of joint stiffness symptoms and can walk and go up and down stairs more easily.

In addition to HA injections, other intra-articular injection methods include platelet-rich plasma (PRP), stem cells and collagen, which together give positive treatment results for knee osteoarthritis. These methods follow the trend of conservative treatment, are effective for mild and moderate stages of degeneration, activate and support other cells to recover, and stimulate the body to regenerate. This helps fight inflammation, reduce pain, and restore joint function.

In case of severe joint damage, the patient needs joint replacement to restore mobility. Depending on each case with different levels of joint damage, mobility needs and ages, patients are prescribed appropriate knee replacement types such as cementless knee joints, Medial Pivot joints, UC (Ultra Congruent) joints. . These are new types of joints, with high range of motion, low abrasion, long life, reduced bone loss, and reduced risk of knee dislocation after surgery.

Like Mr. Thao, 71 years old, living in Nghe An, his knee joint is swollen and painful, he can barely walk, and medical treatment is no longer effective. MSc. Nguyen Quang Ton Quyen, Deputy Head of the Department of Orthopedics, said Mr. Thao has stage 4 osteoarthritis, the articular cartilage layer in his right knee is almost completely eroded, the bone ends are deformed, the joint space is narrowed, subchondral bone fibrosis, the amount of joint lubrication fluid is seriously reduced.

The team performed the kinematic alignment knee replacement surgery technique for Mr. Thao, making an incision below the muscle, protecting the muscle to help the patient recover the ability to stretch the knee faster. The incision is closed with biological glue which is effective in terms of aesthetics and post-operative care.

According to Dr. Quyen, with this technique, the artificial knee joint is similar to the natural knee joint in terms of function and curvature of the leg axis, allowing internal and external rotation, helping to increase joint flexibility. Thanks to that, the patient can restore leg shape and mobility quickly, and the feeling of movement is also more real.

After 24 hours of surgery, his pain was significantly reduced, he could walk easily, and was no longer dependent on a wheelchair. Combined with physical therapy, about two weeks later, the patient can walk and do normal activities.

According to the World Health Organization, in 2019, there were 528 million people living with osteoarthritis. Of these, about 73% are over 55 years old and 60% are women. With an aging population, obesity and increasing injuries, the incidence of osteoarthritis continues to increase globally.

To effectively prevent and treat osteoarthritis, Associate Professor Hoa recommends that people eat and exercise scientifically and in moderation. When there are unusual signs such as swelling, pain, joint stiffness, patients should go to the doctor early to find the exact cause, get appropriate treatment, and avoid dangerous complications.