Intake of caffeinated drinks, unhealthy lifestyle, obesity, and substance abuse are main reasons
New Delhi : Healthcare experts across the country are reporting a sharp increase in knee Osteoarthritis in the younger population, a condition typically associated with ageing. While joint pain at any age is known to negatively affect the overall well-being and productivity, early onset is bringing an altogether different set of challenges to deal with.
“Of late I have been receiving patients as young as 40-41, complaining of severe knee pain and work absenteeism. Unlike elderly knee osteoarthritis patients, who are more into pain management, this young working lot is focussed on complete and quick recovery so that they could resume work as soon as possible. In cut-throat competition, they cannot afford low productivity in their working age,” says Dr L. Tomar, Director , Dept. of Orthopaedics, Max Super Speciality Hospital, New Delhi.
In younger age, knee pain is reported to cause loss of productivity and a poor career growth at the prime of career1, it also increases apprehension concerning financial obligations and makes it difficult for the patients to sustain a normal family and social life.
Rise in knee osteoarthritis in the younger population is surprising as it is a condition which develops due to wear and tear of weight bearing joints, mostly due to ageing.
According to the doctors, Knee Osteoarthritis triggers due to some morphological and biochemical changes in the knee joints, creating a gap between the joints that leads to abrasion and joint degeneration, a classical symptom of ageing. And even in the older age, doctors believe that regulating certain modifiable risk factors, like increasing physical activity, maintaining a healthy weight, ensuring an optimum sun exposure and refraining from substance abuse, like tobacco and alcohol, could help delay or completely eliminate the chances of knee pain.
So a rise in knee osteoarthritis at an unusual age seeks explanation, Dr Tomar says, “An early onset of degenerative joint disease simply means that factors like unhealthy lifestyle, obesity, lack of sun exposure and substance abuse played their part way too well.”
According to the American Journal of Clinical Nutrition, another reason for weak bones in young age is an excessive intake of caffeinated drinks, especially in childhood and adolescence2. According to a study published in PubMed3 more than ninety percent of total bone mineral content (BMC) is generated before the age of 17 years, so technically the stage for weaker joints is set at an early age.
Clearly, we are falling short in ensuring bone health at almost every front, leading to a sharp rise in knee arthritis in working age.
As far the treatment of knee osteoarthritis in younger patients, it depends entirely on the stage of the disease, explains Dr Tomar, “At an early stage we prefer medication and lifestyle modification. Usually attaining a healthy body weight, ensuring doctor-assisted physical activity and improving bone density by diet and supplements helps with pain, and sometimes even stops joint degeneration. However, for the patients with chronic pain and advanced osteoarthritis, when such interventions are late to work, knee replacement surgery offers a sustainable solution.”
With advanced technologies like computer navigated knee arthroplasty and customised surgical plan for knee replacement, the procedure has become very safe and long lasting. An article published in PubMed states that KA is remarkably effective, with a mere 1% of annual failure and revision rates and a whopping 85% rate in symptom relief4.
However, despite all its benefits, knee replacement is still considered an optional procedure in India. It is always up to the patients whether they want to go on with the severe pain and its effects on their wellbeing or seek a permanent solution.
Dr Tomar says, “We need to understand that unlike the heart or other vital organ surgery, joint replacement at any stage is never a lifesaving procedure. Knee osteoarthritis, despite being disabling in most sense, is not a life-threatening condition in itself. It is the health issues rising due to immobility, like obesity, heart disease, hypertension, bed sores and kidney problems due to prolonged use of analgesics etc. which eventually proves fatal. Patients especially in their working age, opt for Knee Replacement to remove pain, ensure mobility and to restore normal routine, productivity, overall health and of course to save treatment cost in the long-term.”
