Mill Creek Keto

Clinical examination is essential for diagnosis. "A constant pain as soon as one uses his knee to knee osteoarthritis directs the knee radiography enough to confirm, said the P r Pascal Richette, rheumatologist Lariboisière Hospital (Paris). A swollen knee, painful at night and in the morning, which then improves, points to an inflammatory pathology (rheumatoid arthritis, gout, etc.) which will be confirmed by the analysis of the puncture of the synovial fluid. " An unstable knee without real pain rather indicates ligament pathology.

Main risk factors for knee osteoarthritis, aging, past trauma to the knee, but above all overweight. According to a recent meta-analysis, excess weight multiplies by 2 the risk of knee osteoarthritis, obesity by 2.5. We are now even talking about metabolic osteoarthritis. “Aside from the mechanical stress of overweight on the knee, an effect of low noise inflammation associated with obesity is suspected. Thus, the more overweight increases, the more the incidence of osteoarthritis of the hands increases despite the absence of mechanical stress, specifies P rJérémie Sellam, rheumatologist at Cochin hospital (Paris). In addition, the metabolic diseases associated with obesity (diabetes, hypertension, metabolic syndrome, etc.) confer a risk of knee osteoarthritis added to that of obesity alone. ” This hypothesis remains debated, however, mechanical stress remaining for some the main detriment of overweight.

When the pain appears, it is already very late: the destruction of the cartilage, poorly vascularized, poorly innervated and which regenerates little, has already begun. “Some seriously affected patients will need a prosthesis in five to ten years. Others will have moderate pain all the time. Others will have a very bad time, then the pain will decrease ... But the intensity of the pain is worsening quickly marker, "says P r Richette.

If there is overweight or obesity, weight loss is an essential part of treatment, as is the fight against sedentary lifestyle. “A 10% weight loss already has a noticeable effect on pain and possibly on the breakdown of cartilage. Bariatric surgery may be considered, for example if a person with severe obesity has knee pain such that they no longer leave their home, insists Prof. Sellam. Painful osteoarthritis not only impairs the quality of life, but also its duration due to metabolic diseases associated with a sedentary lifestyle resulting in pain. ”

When this pain becomes too much, the fitting of a prosthesis may be necessary. In France, 80,000 to 90,000 knee prostheses are implanted each year. According to a recent study, the number of those placed in the United States should double by 2030, quadruple by 2040. A trend that is likely to be global ... The prosthesis can be partial (only the injured part is removed) or total. “With the partial prosthesis, the intervention and recovery are faster, the risk of complications lower. But the gesture is more delicate and the risk of failure greater: 10% of them must be reoperated within ten years, against 5% of total prostheses, explains Prof. Jean-Yves Jenny, orthopedic surgeon at Strasbourg University Hospital. The partial prosthesis also better preserves the ligaments, which participate in the proprioception of the knee. ”