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Archive for February, 2011

Knee OA

Knee OA & Obesity

Researchers from Boston-based Brigham and Women’s Hospital used a mathematical model to analyze data at a national level that looked at occurrences of knee osteoarthritis, obesity, and conditions like cancer, heart disease, diabetes, and lung disease.  They were trying to figure out how knee osteoarthritis and obesity affects longevity and quality of life.

Older Americans suffer from both obesity and osteoarthritis of the knee.  These are common chronic ailments that affect people over 50 years of age in our country.  It is estimated that decreasing obesity rates could decrease total knee replacement surgery by over 269,00 cases and could save somewhere around 19.5 million years of life!

Estimates range from 30 to 60 pounds of force is added to every step a person takes for every ten pounds they are overweight.

Knee OA

Knee OA

The Annals of Internal Medicine reported this month that Americans over 50 with knee osteoarthritis lose about 86 million “quality-adjusted life-years”.  A computer simulation called the “Osteoarthritis Policy Model” examined the effects of knee OA and obesity.  The simulation compared adults between the ages of 50 to 84 and divided them into four groups:  obese patients, patients with Knee OA, obese patients with knee OA, and people without knee OA who aren’t obese.

Obese patients with knee OA lose twice as many “quality-adjusted life-years” compared to the group that wasn’t obese and didn’t have knee OA.  The groups that faired the worst were black and hispanic women.  The authors of the publication wrote, “the disproportionate burden these conditions impose on black and hispanic women suggests that future studies should investigate tailoring prevention and treatment strategies to sex and racial or ethnic subpopulations.”

The more you weigh, the more your knees hurt

The more you weigh, the more your knees hurt

Almost 50% of people living in the United States will develop osteoarthritis of the knee by the age of 85.  That number jumps to 66% in the obese.  A study performed at University of North Carolina at Chapel Hill shows that a person’s risk to develop knee OA increases as their body mass index increases.

The study suggested that those at the greatest risk were people who had normal body weight at the age of eighteen but gained weight and became obese became by the time they were 45 or older.

So how do you exercise and lose weight if your knee hurts?  Knee braces work.  Knee braces are covered by Medicare, Medicaid, and most major HMOs and PPOs.

Knee Exercise

Knee Exercise

Pre-operative exercise programs help patients with osteoarthritis of the knee after they have their knees replaced.  People who undergo “pre-habilitation” experience better leg function and faster recovery times.

So even if you decide to have total knee replacement surgery you still have to exercise!

71 patients were divided into two groups at the University of Louisville.  One group underwent an exercise program before surgery.  The exercises was developed to improve knee and leg strength, through light walking and step exercises.  Standard preoperative care was provided to the other group of patients.

The group that exercised before they had their knees replaced experienced less pain during functional tests and increased extension strength.  The findings published in the Journal of Strength and Conditioning suggests exercise before surgery results in quicker recovery.

Knee Replacement

Knee Replacement

There is an increasing trend toward knee replacement (total knee arthroplasty) in treating knee osteoarthritis.  A teaching hospital in Hong Kong looked at 750 patients who had their knees replaced from January of 2000 to December of 2009.

The number of total knee replacements increased from 91 in 200 to 181 in 2009.  There were 588 females who had their knees replaced compared to 162 males with 589 left knees being replaced and 568 right knees.  The men age of the patients having their knees replaced did not change significantly but the number of patients over 80 years of age increased from 4.8% to 13.8%.

This article was published in the Hong Kong Medical Journal (Feb 2011).

Vitamin D

Vitamin D

Research presented at the American College of Rheumatology’s Annual Scientific Meeting in Atlanta shows that increasing vitamin D intake will most likely not help slow down your osteoarthritis of the knee.

The study examined looked at two groups of patients, one was given vitamin D, and the other was given a placebo.  X Rays and functional testing were performed on each patient at the beginning and end of the study.

Lead Investigator at Tufts New England Medical Center, Timothy McAlindon, said, “This study tested whether vitamin D supplementation , given over a two-year period, could influence the rate of progression of joint damage in people with knee osteoarthritis.”

Glucosamine is an amino sugar. In case it’s been a while since you took a biology class, amino sugar is a critical building block for the creation of connective tissue and healthy cartilage in the body. People who suffer from osteoarthritis have deteriorating cartilage that fails to repair itself.

Cartilage is worn away as the body moves, and the cartilage will restore itself to its normal shape when a healthy body is at rest. For osteoarthritis patients a glucosamine supplement promotes the creation of proteoglycans and glycosaminoglycans that improve the natural repair process. Even if you don’t suffer from osteoarthritis, taking a glucosamine supplement is still a good idea. Take as a preventative measure, glucosamine supplements can minimize the possibility of suffering from arthritis later.

If you’re not keen on surgeries but are seeking relief from osteoarthritis pain, particularly in your knees, supplements have proven helpful in alleviating pain. One such supplement is Cosamin ASU. Cosamin ASU is a formula that combines NMX1000 avocado and soybean unsaponifiables (ASU) with glucosamine and sodium chondoritin sulfate.

If the information in the above paragraph just sounds like medical mumbo-jumbo, let me break it down further. ASU is a potent ingredient that protects cartilage which is crucial to healthy joints. Combined with the glucosamine and sodium chondoritin sulfate, the supplement helps slow down the deterioration of cartilage in joints. To put it as simply as possible, these supplements knee joint will make walking, running, and other activities a lot more bearable.

Flat Feet

Flat Feet

Arthritis Care and Research recently published findings that elderly patients with flat feet have more knee pain on most days as compared to patients with higher arches.

The article indicates that flat feet may make knee osteoarthritis pain worse.

Douglas Gross was the lead researcher on the publication.  He said, “When your feet flatten, it can change your posture or the way you move.  One consequence may be that when a person puts weight on a flat foot the lower leg rotates inward – which over time could damage the cartilage at the inner knee.”

Custom foot orthotics may be an option, but more research has to be done.

Mental Aspects of Tai Chi Relieves Knee Pain

Mental Aspects of Tai Chi Relieves Knee Pain

Researchers at Tufts University released findings that knee pain can be reduced in the elderly by participating in Tai-Chi.  Two groups of elderly patients with osteoarthritis were studied.  20 patients participated in hour-long Tai-Chi classes twice a day for 12 weeks.  Another 20 patients participated in stretching exercises and other therapy for the same time period.

The Tai-Chi group experienced a significant decrease in knee pain as compared to the other group of patients.

Tai-Chi is a a low-impact exercise that develops the body’s “chi” or energy.

Tai-chi utilizes deep breaths, meditation, gentle postures, and gentle movements.  It improves balance, flexibility, and coordination.  This type of exercise is relaxing and easy on the knees.  It is also believed to enhance memory and concentration.  It is also reported to help relieve pain, anxiety, and stress.

Researchers believe that developing the “chi” helps reduce the anxiety and negative thoughts surrounding the pain associated with knee osteoarthritis.