Osteoarthritis of hip and knee joint

When the cartilage in a joint deteriorates in quality, there can be wear or osteoarthritis (in medical language for the hip: coxosteoarthritis, and for the knee: gonosteoarthritis). The height of the cartilage then decreases and the head and cup come closer to each other. On an X-ray picture this can be seen as a narrowing of the joint gap. Also on an X-ray additional bone growth and irregularities in the bone structure can be seen. What are the consequences and what can you do yourself?

Effects of osteoarthritis

The effects of osteoarthritis are stiffness and pain at the joint or in the vicinity of it, for example due to a protective muscle reaction. The first complaints are often when starting a movement (such as in the morning when standing up), later complaints can also occur during exercise and at rest. Overloading will also be able to give extra complaints for a number of weeks. Another consequence may be that other joints have to do more to compensate for what the arthritic joint can no longer do. So the neighbors are at risk for new complaints. The adjustments and overload elsewhere can sometimes go so far that the arthritic joint itself no longer gives complaints, but no goes to the other side (!). In the physical examination, therefore, attention must also be paid to these matters.

Do it yourself to prevent osteoarthritis

What you can do yourself to prevent osteoarthritis is in the first place: use the joints. Be physically active. Most forms of osteoarthritis do not occur at the places where the cartilage is loaded most, but precisely where the least load is present. Cartilage is living tissue and is stimulated by alternating pressure and relaxation, as is the case with walking phases.

Do it yourself in osteoarthritis

The things you can do to prevent or reduce complaints caused by hip or knee osteoarthritis:

• Exercise often and do not heavily load the joint, eg cycling with light resistance
• Restrict the use of tools such as sticks
• Lose weight to normal weight by moving and eating better
• Wise use of painkillers: only if necessary
• There is discussion about the effect of chondroitin and glucosamine in osteoarthritis.

Treatment of osteoarthritis

The treatment depends on a number of factors. Operation will only take place when the symptoms become unbearable, for example if there are complaints at night and if walking is no longer going well. In an earlier stage of osteoarthritis, it is also possible to use a combination of treatments and exercises to try to stop the process and sometimes to reverse it. Exactly how that looks is different per person. Usually within 2 treatments it is clear whether the joint is heading in the right direction.

An article about wear and tear of the back can be found here.

References
Nederlandse Orthopaedische Vereniging. Richtlijn diagnostiek en behandeling van heup- en knieartrose. 2007.

NHG-Standaard niet-traumatische knieklachten 2016.

Silverwood V et al. Current evidence on risk factors for knee osteoarthritis in older adults: a systematic review and meta-analysis. Osteoarthritis Cartilage. 2015 Apr;23(4):507-15.

Brosseau L et al. Ottawa Panel evidence-based clinical practice guidelines for therapeutic exercise in the management of

hip osteoarthritis. Clin Rehabil. 2016 Oct;30(10):935-946.