Knee osteoarthritis is taken as a common disability and people tend to avoid treatment. Patients benefit from shorter hospital stays after surgery due to decreased risk of hospital-acquired infections and improved comfort in their own homes. Patients are likely to be more active and have improved functional recovery when they return home. Hospitals benefit from shorter LOS including increased bed availability and decreased costs. Background - Multidisciplinary approach
To understand how osteoarthritis develops you need to know how a normal joint works. A joint is where two bones meet. Most of our joints are designed to allow the bones to move in certain directions. The knee is the largest joint in the body, and also one of the most complicated because it has many important jobs to do. (Deborah et. al. 1999 Pp. 46) It must be strong enough to take our weight and must lock into position so we can stand upright. But it has to act as a hinge, too, so we can walk. It must also withstand extreme stresses, twists and turns, such as when we run or play sports.
The knee joint is where the thigh bone (femur) and shin bone (tibia) meet. The end of each bone is covered with cartilage which has a very smooth, slippery surface. The cartilage allows the ends of the bones to move against each other almost without friction. The knee joint has two extra pieces of cartilage (called meniscal cartilages or menisci) which help to distribute the load evenly within the knee. A normal knee joint is shown in Figure 1.
The joint is surrounded by a membrane (the synovium) which produces a small amount of thick fluid (synovial fluid). This fluid helps to nourish the cartilage and keep it slippery. The synovium has a tough outer layer called the capsule which helps hold the joint in place.
The knee cap (patella) is another important part of the knee joint. The underneath of the patella is also covered with cartilage. The patella is attached to the thigh muscles by a very large tendon. The patella is fixed to the bone just below the knee joint at the front of the tibia.
The tendons are strong connecting tissues which attach the muscles to the bones on either side of the joint. They also help to keep the joint in place. When a muscle contracts it shortens, and this pulls on the tendon attached to the bone and makes the joint move. Figure 2 shows how the muscles are attached to the bones above and below the joint.
The knee joint is held in place by four large ligaments. These are thick, strong bands which run within or just outside the joint capsule. Together with the capsule, the ligaments prevent the bones moving in the wrong directions or dislocating. The thigh muscles (quadriceps) also help to hold the knee joint in place.
When a joint develops osteoarthritis, the cartilage gradually roughens ...