- Today we're going to discuss
osteoarthritis of the knee.
We're going to answer your questions
about knee osteoarthritis,
such as what parts of your knee are involved.
What happens to your knee as osteoarthritis develops?
What does your knee pain feel like?
When do you have pain,
and how does it limit you throughout the day?
How do we diagnose your osteoarthritis?
What tests are important
in evaluating your knee pain?
What are the non-surgical treatment options
for controlling your knee pain?
What are the surgical treatment options
for alleviating your osteoarthritic symptoms?
Why is physical therapy so important after surgery?
And finally, how to prevent and protect
against continued knee pain?
Let's talk about the normal anatomy
or the normal parts list.
This is the front view of the knee.
We have first the thigh bone,
called the femur.
And this sits on top of the leg bone,
called the tibia.
On top of this leg bone
there are two shock absorbers
that are called the meniscus.
I'm just drawing them in three dimension.
The ends of the thigh bone,
let's look at this end,
have on them a nice, smooth surface
that's almost Teflon-like,
nice and smooth and hard.
This is the gristle on the end of the thigh bone.
And then the meniscus or gasket
is horseshoe shaped.
It's thick in the back,
and it's thick in the front.
This is the shock absorber
called the meniscus.
This is the normal parts list.
Let's talk a little bit
about the abnormal parts list
when we have osteoarthritis.
Once again, here's the end of the thigh bone.
And here's the top of the leg bone
with the two meniscus,
both horseshoe shaped.
And what we find is that with osteoarthritis,
first of all, the ends of the thigh bone,
let's look at this end,
start wearing down.
And we can have some roughened, beat-up surfaces,
some of them with bigger bone chips flying off.
Some of them with smaller bone chips flying off.
This is surface
wear and tear
osteoarthritis.
Then the meniscus,
if we draw it here now,
has a tendency, especially in the back,
to start getting weaker
and actually flattens out like a pancake.
The front, by the way, often will stay nice and thick.
Well, this flattening causes a weakness,
which in turn can cause this tissue to tear.
And the tear almost always starts in the back.
And when that tear has progressed far enough,
you can actually develop a little flap
when you kneel, squat,
sometimes with stairs,
sometimes just with sitting.
So you can see that little flap separates.
The front often stays intact.
Again, this is a torn meniscus.
Let's talk about the factors
that contribute to ostearthritis of the knee.
First of all, family history.
Well, there's no specific gene
that we found for osteoarthritis.
But certainly, we know that osteoarthritis
has a tendency to run in families.
By that I mean that if a parent or a grandparent
has osteoarthritis,
then you may have a higher likelihood
of developing osteoarthritis.
Obesity, well, the higher your weight,
the more pressure across your knee joints,
the higher the frequency of osteoarthritis.
How about previous sports injuries?
Well, if you've had an old football injury
or an old skiing injury,
there's no question that you're at a higher risk
for osteoarthritis.