a tooth[인터뷰] Baek Seok-ho, orthopedic surgeon
a toothDegenerative arthritis, a chronic disease, management is the most important
a toothAt the end of the disease, there are not many options, consider surgical treatment
In 2016, as a result of a survey carried out by the Health Insurance Review and Assessment Service on the topic ‘Diseases I worry about,’ the opinion that ‘degenerative arthritis is scary’ was the second highest after cancer, at 10.2%. It means that many people are aware of this uninvited guest that suddenly comes along with aging.
As Korean society enters an elderly society, the number of patients with degenerative arthritis in Korea is increasing rapidly. According to the data published by Shimpyeongwon in 2022, the number of patients who visited hospitals for degenerative arthritis in Korea in 2019 was more than 4 million (4,042,159).
Although the number of patients with degenerative arthritis is increasing rapidly, there are many unfortunate cases where degenerative arthritis is mistakenly recognized as a natural process of aging and left unattended to develop the disease. The problem is that once damaged cartilage does not heal or regenerate naturally, and as the disease progresses, various symptoms cause major difficulties in daily life. Therefore, it is important to take measures such as correcting an active lifestyle, regular examinations, and treatment with the help of a specialist in the early stages of disease with little cartilage damage. Learn more about degenerative arthritis with orthopedic specialist Seok-ho Baek (Madiesang Hospital).
Director Baek Seok-ho｜Source: Madisesang Hospital
Q. Why do the elderly fear degenerative arthritis?
The cartilage of the knee reduces the friction between the femur and the tibia, facilitating joint movement and protecting the subchondral bone. If this structure is damaged, bones constantly collide with each other, resulting in pain and swelling. If left untreated, symptoms can worsen and the shape of the legs can be deformed. That is, degenerative arthritis occurs.
Many people know that degenerative arthritis is just a disease that causes pain due to damage and wear and tear of the knee cartilage. However, in reality, it is a chronic disease that causes problems not only in the cartilage but also in the knee joint, such as the meniscus, the synovial membrane, and the subchondral bone. In general, the number of cases tends to increase with age, and among many degenerative diseases, it is a disease with so many patients that it is the fifth most expensive disease.
Recently, with the movement craze blowing, arthritis is often seen even at a relatively young age. Cartilage does not heal on its own once it has been damaged, so it is important to manage the condition so that it does not deteriorate through regular checkups and early treatment.
Q. I wonder why ‘aging’ is the biggest risk factor for degenerative arthritis. Also, aside from aging, what are some lifestyle habits that accelerate degenerative arthritis?
As we age, degenerative changes in the meniscus occur and the synovial membrane becomes inflamed. As a result, the shock absorption function of the meniscus decreases, and the effect applied directly to the cartilage increases. Eventually, the cartilage begins to be damaged, and the cartilage damage is further accelerated by the inflammatory response of the surrounding soft tissue.
In addition, △weight gain △weakness in the muscles around the knee △sedentary lifestyle △women are considered representative risk factors for deterioration of knee health. In the past, degenerative arthritis was often overlooked as an inevitable phenomenon of aging. However, if you take good care of your knee health from a young age, you can have strong knees in old age.
C. Degenerative arthritis can be divided into early, middle and late stages depending on the stage of progression. How does the treatment method vary by stage?
Degenerative arthritis is classified into early, middle and late stages according to ‘joint gap’ and ‘grade of osteophyte formation’ based on X-ray imaging results and the Kellegren-Lawrence Grade (KL Grade).
Fully automatic knee osteoarthritis severity rating using deep neural networks with a novel hierarchical loss published in Europe PMC by
In the early stages of arthritis, non-surgical and conservative treatment is sufficient. Systematic and consistent management such as ‘exercise to strengthen the muscles around the knee’, ‘weight control’, and ‘lifestyle change’ can effectively slow down the progress of the disease. However, if there is swelling and effusion in the synovial membrane of the knee, drug therapy and injection therapy can be considered to improve it.
Even in the medium term, there are many treatment options available. You still need to manage your knee health through exercise, weight management, and lifestyle changes. Here, if you have knee pain, you can treat what is causing your symptoms. For pain treatment, ‘arthroscope surgery’, ‘cartilage regeneration’, and ‘osteotomy’ are used. However, at the end of the disease, there are few treatment options. You may need to have a knee arthroplasty.
In the early stages of arthritis, there are often no symptoms. However, if the disease progresses without proper treatment, the knee becomes sore, stiff, and symptoms of swelling begin to appear. At the end of the disease, the knee is not fully extended or bent, and walking on stairs or flat ground becomes difficult. Therefore, the most important thing is to control degenerative arthritis from the beginning so that it does not progress to a later stage. However, if the disease has already progressed to the end, appropriate measures such as surgery are required before bone deformity and stiffness of the knee occurs.
Q. Do I have to get an artificial joint replacement at the end of arthritis?
Arthroplasty is an operation that replaces a joint with an artificial joint after removing damaged articular cartilage and bone. However, even if the results of the X-ray examination show that arthritis is severe, it does not necessarily mean that joint replacement surgery is necessary. Arthroplasty is best considered when a patient has:
1. If it is difficult to walk on level ground or go up and down stairs
2. Knee pain that makes everyday life difficult
3. When bending and straightening becomes increasingly difficult due to pain or stiffness in the knee
4. Pain that is not controlled by medicines or injections
5. Severe knee deformity
As arthritis progresses to a terminal stage, there are cases along with bone deformity. The more severe the deformity, the more bone to resect during surgery, and the contraction and relaxation of surrounding ligaments can change the long-term outcome of the surgery. Therefore, surgery should be avoided unconditionally, but it is also important to receive surgical treatment at the right time so that it is not too late.
*Continued from Part 2.
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