Women can conquer knee disorders

For women be it a jet-setting professional, a busy mother or a caring grandmother, a problem in the joints can mean not being able to spend precious recreational time with family and children and a stop to social activities that she enjoys most. Apart from the physical impact of arthritis, including unbearable pain and disability, the social and psychological impact of a bone condition is huge, especially for women and cannot be measured.

Impact of Arthritis on Women
Doctors point out that the disease starts with aches and pains in the joint and progresses to complete immobility in the most severe cases. For a woman diagnosed with osteoarthritis, it can come as a big hindrance to a normal family and social life as they are not able to stand for more than a few minutes, cannot bend their knees while sitting and cannot squat on the floor.

Culturally in India, a lot of activities at home or in public spaces such as temples involve bending, kneeling down or squatting on the floor and for a person suffering from osteoarthritis, performing such tasks can become near impossible. Women, especially from rural backgrounds are used to carrying out daily chores in the kitchen and religious rituals mostly by squatting on the floor and this becomes a way of life for them. A severe joint condition can rob them of this important aspect of their life.

For elderly women, the trauma of not being able to lead an active life and play an important role in the care of their grandchildren, owing to the pain and disability caused by osteoarthritis can also have a huge adverse impact. The disability can also result in social isolation as an osteoarthritis patient may shy away from gatherings and public functions because their mobility is affected. In these days of hectic work schedules and a stressful lifestyle, members of the family might not have the time and energy to nurse a patient who might be confined because of arthritis.

Treatment
Injury, wear and tear, excessive weight on the joints because of obesity and other conditions can damage the cartilage that cushions the joints of the knee and this causes them to rub against each other resulting in pain and discomfort.

There is currently no cure for arthritis. Treatment focuses on relieving symptoms such as pain and stiffness and improving function, and this can be done through educating the patient, physical therapy, controlling weight in obese patients and use of medications. In severe forms, surgery may be offered to replace the knee joint. Management of osteoarthritis may vary from patient to patient.

Exercise is one of the first steps that a doctor may suggest in the management of pain and inflammation so that the muscles around the knee can be strengthened to provide support. Physiotherapy can to some extent help in alleviating pain. Also doctors may advise overweight persons with osteoarthritis to make an effort to lose weight to lessen the burden on the knee joints.

Medication – For those with chronic pain, discomfort and inflammation of the knee joints, certain painkillers and anti-inflammatory drugs may be suggested. Surgery – When both medications and physiotherapy fail to provide relief after a period of time, surgery is the only solution. Total knee replacement or total knee arthroplasty is a surgical procedure to replace the damaged weight-bearing surfaces of the knee joint to relieve the pain and disability.

The diseased part of the knee is replaced with an implant which has two components – a cobalt-chromium part and another made of polyethylene. In patients suffering from unbearable pain and immobility, surgery could be a solution to help them walk again and lead a normal life free from pain.

If there is crippling pain and stiffness in both knees equally, orthopaedic surgeons may recommend replacement of both knees during one operation, under one anesthesia. The operations are followed by a single rehabilitation period within one hospital stay. Such two simultaneous surgeries are called Simultaneous Bilateral Total Knee Replacement or single sitting bilateral total knee replacement. (The writer is a Director, Orthopedics Fortis Hospitals)

By Dr J V Srinivas