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Be OK with Knee OA

What is OA?

Osteoarthritis (OA) is a chronic joint disease characterised by pain, deformity, instability,

and reduction of motion and function.

If we break down the word, "osteo" means bone and "arthritis" means joint inflammation. Therefore, OA is defined as a condition which produces inflammation in a joint. The most common joints affected are the knee, hip and finger joints, but OA can be experienced in any joint that has cartilage covering the ends of bones.

OA affects the whole joint but most of all the articular cartilage and is often described as "wear and tear", however, this is not entirely true.

Let me explain:

In a healthy joint, cartilage continually remodels by having a balance between regeneration and degeneration of the cartilage. Cartilage remodelling occurs by providing nutrients to the tissue, one way this can be done is by loading the joint through exercise.

In an Osteoarthritic joint, an imbalance of tissue remodelling occurs creating more degeneration than regeneration. This causes cartilage to thin and breakdown. However, the remaining cartilage will need some load to regenerate. Exercise can, therefore, be used to keep the remaining cartilage healthy and NOT tear or wear it away.


Why does someone get OA and others don’t?

There are certain factors which will put you at risk of developing Knee OA, such as:

  • Being overweight: added weight into your knee joint can increase your risk, however, being overweight also changes the chemical balance in your body so the cartilage does not remodel as it should, which increases the risk of OA.

  • A history of knee injury: a severe knee injury (meniscal tear or ligament injury) will put you at higher risk at developing OA in later life.

  • A family history: delicate cartilage is hereditary, therefore, if your parents have it you are at higher risk.

  • Age: cartilage is a living tissue and as we age, your cartilage will age and weaken over the years. This usually happens form 40 years and over.


How do I know if I have OA?

A GP and/or physiotherapist can provide an examination of your joint and diagnose OA without needing an x-ray. The most common signs of an arthritic joint are:

  •  Age – 40 years and over, but most common in 60+ years old

  •  Morning joint stiffness lasting less than 30 minutes or no morning stiffness

  •  Reduce range of motion in the joint


Oh no, I have Knee OA! What can I do about it?


Education

Having osteoarthritis can be a scary and a worrying time. As there is no cure for OA it is natural to feel frustrated, upset and even angry. Being aware of your feelings and having help to manage your feelings by understanding OA and seeing a professional can empower a patient to improve confidence in managing their condition.


Exercise

This is the first line of treatment, along with education and weight control. Our joints like to be moved.

Exercise will reduce pain and improve the daily tasks you may struggle with – like putting on your socks in the morning. The Royal Australian College of General Practitioners (RACGP) state:


We strongly recommend offering land-based exercise for all people with knee and hip OA to improve pain and function regardless of their age, structural disease severity, functional status or pain levels” (RACGP 2018 clinical practice guidelines).


Exercise also has lots of other benefits such as weight loss, reduces stress and anxiety, improves sleep, higher self-esteem and overall health.


Weight Management

Obesity is linked to many diseases including OA. If someone is of higher body weight, they can improve their pain and function by lowering their weight. This will also decrease the load on the knee joint, improve chemical balances in your body and slow the breakdown of cartilage.


Aids and supports

A knee brace can reduce load on a knee joint and provide support. Some people will need insoles or a walking aid, such as a walking stick, to improve their gait (walking) pattern if they are limping. Consult your physiotherapist or health care provider if you are unsure if an aid will help you.


Pharmaceutical

Medication helps reduce pain, swelling and inflamed joints. Some individuals may need pain management to help. Always consult your pharmacist or GP before starting a medication protocol.


Knee Replacements

Most people can manage their OA in one form or another. Unfortunately, 10-15% of people will need surgery. This should only be looked at if all previous stages have been exhausted.


One of the most evidenced based programs to help someone with knee OA is the GLA:D Program.

Good Life with Osteo Arthritis: Denmark (GLA:D®) is an evidence-based program aimed at improving pain, function and quality of life for people living with knee and hip osteoarthritis.

GLA:D® Australia is a group-based education and individualised exercise therapy program with compelling evidence. One year after completing GLA:D® Australian participants reported:

  • 93% of the hip/knee patients were satisfied or very satisfied with the GLA:D® program after 3 months.

  • 35-42% average pain reduction.

  • 17-29% participants reduced pain medication use.

  • 38-39% improvement in joint-related quality of life.

Grafton Physio and Sport are excited to be apart of such a great program!

If you would like more information on the GLA:D program, please contact the clinic:


More information about OA can be found at:

Arthritis NSW https://www.arthritisnsw.org.au/about-arthritis/types-of-

arthritis/?gclid=EAIaIQobChMIv6rVjb7N8AIVEYJLBR3_lgKOEAAYASAAEgJcSfD_BwE

GLA:D https://gladaustralia.com.au/

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