Lead a very active lifestyle? Then, mind your knees!
More younger patients are developing signs of early knee arthritis. This could be due to their active lifestyles as they take up hobbies, such as jogging, cycling and skateboarding, according to Dr Hamid Rahmatullah Bin Abd Razak, Consultant, Department of Orthopaedic Surgery, SKH. However, in certain cases it could be due to genetics.
He cites a local study conducted in 2018 that revealed that the prevalence of knee arthritis is at about 11% with a very sharp rise after the age of 40. He estimates, "If we look at the Singapore population, that will come up to about 600,000 individuals. On the global scale, it is even more staggering as the prevalence could be as high as 20 to 25% among individuals aged 40 and above, which means that there are about 600 million worldwide with knee arthritis."
Dr Hamid points out that when it comes to knee arthritis, doctors do not just look at chronological age, although the age of 65 is accepted as a general cut-off for what is known as a young knee and an older knee.
Doctors also consider the physiological age – also known as biological age – since there could be the possibility of a 22-year-old with 67-year-old knees and a 67-year-old with 22-year-old knees.
Dr Hamid has seen young patients with multiple medical problems who might not be very suitable for knee preservation because their functional demands are not at a high level. On the other hand, there are older people who still play golf, may do trekking and mountain climbing and need their knees to be functioning at a very high level and will benefit from knee preservation.
Knee arthritis is due to wear and tear of the knee joint
The usual parts that are affected include:
Prioritise safety and do not be reckless when performing strenuous exercises.
Always warm up and stretch before performing any high-impact activity to prevent injuries to your meniscus and ligaments.
Have a balanced diet, keep your weight well-controlled, and lead a healthy lifestyle with moderate exercises.
When injuries do occur, there are two main approaches – knee preservation or knee replacement.
Knee preservation is a procedure to restore the motion and function of the knee without replacing the joint. Dr Hamid adds, "We know that the end-all solution for knee arthritis is knee replacement, and we are looking at alternative methods of preserving the knee. These could include injections, surgery to repair or replace the damaged ligaments, the meniscus, cartilage and realignment of the knee."
As younger people usually have higher functional demands for their knees, knee preservation procedures, which aim to restore the motion and function of a patient's knees, are the preferred treatment options for them; instead of a knee replacement surgery, which involves replacing the joint.
Knee replacement is generally reserved for older patients with end-stage arthritis. For younger people in their 30s and 40s, a knee replacement may not allow them to continue to enjoy a very active lifestyle. In addition, a replaced knee would only last for up to 15 years, or a maximum of 20 years for a sedentary person or an older individual.
Following a knee preservation procedure, patients may need to change their lifestyles a little, such as reducing high-impact activities, to get the best outcomes.
These could range from a simple injection to complex surgery to correct deformities such as bow legs or knock knees. As the weight of the upper body is not centrally distributed if you have bow legs, this worsens symptoms and speeds up the process of wear and tear. In certain cases of bow leg deformity, doctors can restore the cartilage as well as correct the realignment of the bones through surgery to make the leg straight, so the weight is better distributed, therefore slowing down the degenerative process.
Although the guideline is at 65 years old, there is no set age for knee preservation as it also depends on a host of factors ranging from the extent of wear and tear, the weight of the patient, the activity level of the patient and their general health profile. However, there is no doubt that knee preservation offers better outcomes for young people with knee arthritis.
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