Knee osteoarthritis is a slowly progressive, degenerative condition characterized by articular cartilage erosion, chronic inflammation and bony hypertrophy (osteophytes). The condition is symptomatic in more than 1/3 of adults over age 65. (1,79) Osteoarthritic changes in the knee most commonly affect the medial tibiofemoral compartment, followed successively in frequency by the patellofemoral and lateral compartments. (1,9)
Most researchers and physicians believe that knee osteoarthritis results from excessive loading of cartilage surfaces, compounded over time. The condition is uncommon in younger populations, while the majority of seniors demonstrate at least radiographic evidence of the disease. (2) Excess weight generates disproportionate mechanical stress on load-bearing joints and is strongly linked to osteoarthritis in the lower extremity, particularly the knee. Obesity may also present a chemical risk factor, as it is thought to promote a chronic low-grade inflammation within the joints. (3) A genetic component exists, as does a gender bias. Women are two to three times more likely to develop knee osteoarthritis as compared to men. (2,4) The condition may progress at an accelerated rate in joints with a history of knee trauma or prior surgery. (5,68,79) The majority of patients who undergo knee surgery will show degenerative changes within 5-15 years. (6)
Knee osteoarthritis has been linked to occupations and activities that expose the knee to cumulative microtrauma from repetitive squatting, kneeling, pivoting or stair climbing i.e. carpenters, tradesmen and those who are required to work on unyielding surfaces as well as athletes who participate in sports like tennis, racquetball, soccer, weight lifting, dance, cycling, gymnastics and football. (2) Contrary to popular opinion, low and moderate mileage runners have no increased incidence of knee osteoarthritis as compared to non-runners. (7,8,63)
Knee mechanics are largely influenced by the function of the hip and foot. Biomechanical deficits that cause varus or valgus misalignment may lead to premature degenerative change, i.e. gluteus medius weakness and fallen arches of the foot. (1) Patients with flat feet are almost twice as likely to develop knee osteoarthritis involving the medial compartment. (10)
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What we do in our office to help this condition:
1. Perform a detailed exam, assessing the alignment of the spine, pelvis, hips, knees, ankles, and small bones of the foot. Improper alignment in any of these areas may be detrimentally affecting the function of the knee, and compromising its ability to function normally.
2. As indicated, adjust areas of spinal and extremity subluxations (misalignments), restoring proper nerve system function which facilitates healing.
3. Perform laser therapy which penetrates to the cellular level of the soft tissues surrounding the knee. This promotes better oxygen and nutrients to the tissue, which can relieve pain and facilitate the healing process.
4. Conduct an electronic foot scan to see if the integrity of the foot’s arches have been compromised. If so, custom arch supports (orthotics) would be of benefit and can be prescribed.
5. Prescribe stretches and exercises in conjunction with chiropractic care to strengthen the soft tissue around the knee.