Knee pain is not due to ageing alone, and knee pain is not incurable either!
19 year old Swetha (name changed) a college student is not able to walk to her college due to knee pain. She is not able to start the day comfortably due to severe stiffness of her joints. Her sleep is often disturbed. She has severe knee arthritis due to condition called Juvenile Rheumatoid arthritis.
68 year old Kamatchi (name changed), has intermittent knee pain which suddenly catches unaware. She feels as though her knee might buckle and she might fall. In between episodes, she has some ache, but mostly pain free. She suffers from a Cartilage tear with early arthritis.
Pain is present in most of the adults and joint pain is the commonest cause of pain in humans. Knee in particular causes so much pain and disability in adults especially ladies in India. Most people think that this is due to ageing. However the two real life stories described above tells you that how this is not entirely true. What is more important is to determine the cause of the pain to decide the best course of action.
To know the cause of the pain, it helps us to learn a bit about this joint which is essential for our day to day life. Knee joint is a hinge joint like a door which moves in one plane of bending. This is made of three bones covered with cartilage which provides a smooth gliding surface. There are thick cartilage called menisci which shares the load transfer. Ligaments balance the bones in movment such as sitting and walking. Muscles move the joint to facilitate the movement. There are fluid filled sacs in and around the knee to lubricate just like the engine oil.
When knee hurts due to any of the above tissues, it restricts the function of the knee. People are not able to walk freely or climb stairs nor sit in the toilets or the floor cross legged. Pain disturbs the sleep and rest may not relieve the pain. Patients have accepted to crying due to the pain and are confined to their houses with inability to attend to their social activities.
Pain due to specific arthritis such as Gout and Rheumatoid arthritis can be treated well with medication when detected early. Mechanical problems affecting the soft tissues of the knee can be resolved with simple life style modifications, physiotherapy, weight reduction, diet modifications etc. Your doctor would be able to diagnose these problems with talking to you and examining alone.
Sometimes, investigations such as X ray and MRI scan can help us to pin point the cause of the problem. Severe arthritis will be usually detected on x ray itself though MRI scan may be necessary in some patients.
Severe Arthritis affecting one's life can be very successfully treated with treatment of joint replacements. Patients can return to their normal day to day life and social commitments. Not everyone will need joint replacement and some of the patients are successfully treated with key hole surgery called arthroscopic surgery.
the 19 year old Swetha is now a happy person, cycling to her college after successful knee replacement. in contrast the 68 year old lady's life has been dramatically changed by key hole surgery. A 50 year old lady who works in Governement noon meal scheme is happily cooking for the children with artificial knee. She is so happy with this artificial knee that she chose to come have her other knee replaced when it started giving her trouble. 56 year old
Sub inspector is happily doing his job and on the move thanks to the technology of artificial knee replacements.
The scenarios described above are not stories but real life history of patients with artificial knee replacements right in our country with the surgery performed to international standards with the best of care one can get.
Hope this is helpful
Warm Regards
Chocklaingam
