ARTHRITIS is the inflammatory process of a joint caused by the wear and tear of the articular surfaces (gliding surfaces) and the resultant increased infliction. The articular surface of a joint are made of a specialized substance called the articular cartilage which acts as a cushion as well as a very low friction material to allow the two bones forming a joint to glide against one another. With age or with injuries, this articular surface starts breaking down and becomes rough. This in turn produces an inflammatory process within the joint. The body attempts to compensate for that by producing an increased amount of fluid in the joint. However, this increase in fluid produces distention (swelling of the joint) which contributes to the pain in the joint. All joints have the potential of developing arthritis. However, the weight-bearing joints such as the hips and knees are most notorious for it.
At the early stages, arthritic conditions produce some aching and swelling with activities. Stiffness is often noted particularly after resting the joint in one position for a period of time and at this stage, arthritis is often treated with anti-inflammatory medication as well as with therapy to maintain the strength and the flexibility of the muscles around that joint. As the wear and tear of the joint continues and as the gliding surface becomes rougher and more deteriorated, some catching and locking of those joints, particularly seen in the knees, can occur. This also produces a significant increase in pain and swelling with each occurrence.
TREATMENT:
The treatment for significant swelling at times can also include Cortisone injection within the joint which helps decrease the inflammatory process and helps the function of this joint to return more toward a normal state. However, over time as the deterioration continues, the stiffness and the lack of mobility of those joints becomes more permanent. It becomes increasingly difficult for the patient to perform simple activities of daily living and it also becomes much more difficult to control the pain occurring with this progression. At times, it is necessary to perform an arthroscopic surgery to "clean out" the joint and smooth out the surfaces as much as possible. This arthroscopy allows us with a camera to also evaluate the extent of the wear and tear of the joint. Typically, x-rays are not helpful in early arthritis due to the fact that x-rays only show changes in the bone for the most part and those occur when the wear and tear of the joint is fairly advanced. During the early and middle stages of arthritis, new injectable substances have come onto the scene. These substances are very viscous in nature and are made from glycoprotein that is contained in the normal articular cartilage.
When the symptoms continue to increase and all of the conservative treatments have been tried without any success or limited success, the end-stage of arthritis will often require a joint replacement.
