WHAT CAUSES THE DISEASE?
Primary osteoarthritis is produced by unknown causes.  The cells inside the cartilage called chondrocytes are altered resulting in a decrease in elasticity and properties of the cartilage which ends up deteriorating.

Another type of arthritis in which the damage occurs from some type of mechanical cartilage injury such as trauma.  It can also cause internal structures after lesions in the knee and meniscus, ligaments, synovial membrane alterations, etc


ANATOMY OF INJURY
A joint is a very special structure that allows one bone against another move smoothly and painlessly.  This is thanks to the lining of the hyaline cartilage surfaces.  The cartilage is that glossy coating that surrounds the ends of bones (chicken, lamb, veal).  This tissue has the ability to withstand great pressure without crushing or breaking.  The hyaline cartilage is a living tissue.  Within it are cells called chondrocytes which are continuously making proteins that keep you healthy.

Sometimes the cartilage begins to lose biomechanical properties which make it useful.  No one knows where the problem originates, whether in the chondrocyte or bone where the cartilage rests, but the fact is that the cartilage begins to deteriorate.  It can not stand the pressure.  It starts to thin out and break.  Sometimes revealing the bone to which it is located.  The articulation does not fit perfectly as before.  It is as if sand has entered in a bearing.  What was once smooth movements is now friction and stiffness.


WHAT ARE THE SYMPTOMS
Lnee osteoarthritis is manifested initially with pain after prolonged periods of standing or walking.  Especially painful activities such as climbing stairs, walking over rough terrain or standing up from a chair.  This pain is accentuated with advancing age.  It is as if the knees were stiff and require heating to be able to walk again.  It is a mechanical pain that improves with rest.  Sometimes the knee becomes swollen and warm.  These are episodes of inflammation due to the lining inside the knee which produces excess fluid.  The knee swells.  It is different from the swelling of the legs and ankles of people who retain liquids or have a cardiopulmonary illness.

Over time, it alters the alignment of the knee, turning legs inwards or outwards, upsetting the axis of the limb.


DIAGNOSIS
Osteoarthritis is diagnosed by going to the doctor and performing a detailed history, an exploration of the patient and x-rays.  Sometimes it is necessary to analyze the joint fluid to rule out other diseases.


WHAT INFLUENCES IN THE PROCESS?
Obesity is a major risk factor.
Physical activities that require running or jumping can accelerate the destruction of articular cartilage.
There is no special diet to improve osteoarthritis of the knee.  It is recommended to control caloric intake and diet balance.


HOW IS IT TREATED?
There is no treatment to cure knee osteoarthritis.  But there are hygiene measures that help to have an acceptable quality of life.  Patients with osteoarthritis of the knee should get used to living with the disease and adapt their activity to the manifestation.

RECOMMENDATIONS:

• General mesasures:

Avoid prolonged periods of standing or walking.  It is more convenient to take various short walks than a long walk.  When pain appears you should rest.  Ideal weight should be reached.  Rest is helpful in relieving pain that occurs after physical activity.

• Aids to daily living:

Avoid climbing stairs.  Use ramps and elevators.  It is advisable to use a cane in the opposite hand to the knee which has arthritis to relieve pressure.

• Physical treatment:

You should have good muscle tone and fitness.  Recommended activities are exercises that do not load pressure on the knee such as the stationary bike and swimming.  The application of dry heat with a hot water bottle to relieve pain and stiffness.

• Pharmaceutical treatment:

Analgesics and non steroid anti-inflammatory drugs reduce pain and swelling.  There are a group of drugs that can slow the progression of the disease, both symptomatic and deterioration of hyaline cartilage.  These drugs include glucosamin sulfate, chondroitin sulfate and diacerein.

• Local treatments:

The intra-articular administration of corticosteroids and hyaluronic acid, can produce prolonged symptomatic relief.