“Walking around is difficult”
“Climbing stairs seems impossible”
“The pain started in one knee, and now the other knee hurts even more”
“Doctor why are my legs curved like a bow?”
Do these words sound relatable? Don’t worry, you are not alone, and you aren’t suffering from anything incurable.
Chronic or acute-on-chronic knee pain are an exceedingly common occurrence in the elderly. The culprit is, more often than not, a condition called Osteoarthritis. I’m fairly certain that the term is familiar to you, and also that it scares most of the people who are diagnosed to be having it. So what IS osteoarthritis? Why is it such a scary condition? Is it curable? Does it always require a surgery? Is the patient bedridden after the surgery? How to prevent this? Let’s find out.

Osteoarthritis of any joint is essentially a condition in which the normal joint cartilage (the articular cartilage) wears off and the underlying bare bone is exposed. The bone, unlike the articular cartilage, is not smooth and frictionless. So naturally, the bare bone surfaces grind against each other during movements or weight bearing, causing pain.

There are two major types of osteoarthritis.

1. Primary (due to natural ageing process)

2. Secondary (due to an underlying condition like a type of inflammatory arthritis or an improperly healed fracture)

To summarize, primary osteoarthritis of the knee is an age-related degeneration of the knees. In varying proportions, it’s as inevitable as the greying of hair, balding or wrinkling of skin that occurs with age. Timely consultation and treatment can slow down the progression of the condition to the late stages, and may perhaps totally avoid an extensive surgery. So consult your orthopedic today !

Dr. Hrishikesh Patkar is a consultant orthopedic and joint replacement surgeon based in Pune. He has extensive experience in all orthopedic trauma and primary and revision/complex joint replacement surgeries of the knee, hip, shoulder and elbow. He performs conventional, navigation-based and robotic joint replacement surgeries across multiple hospitals in and around Pune.

Building healthy bones is extremely important. Minerals are incorporated into your bones during childhood, adolescence, and early adulthood. Once you reach 30 years of age, you have achieved peak bone mass. If not enough bone mass is created during this time or bone loss occurs later in life, you have an increased risk of developing fragile bones that break easily. Fortunately, many nutrition and lifestyle habits can help you build strong bones and maintain them as you age. Here are 10 natural ways to build healthy bones.

1. Eat Lots of Vegetables

Vegetables are great for your bones. They’re one of the best sources of vitamin C, which stimulates the production of bone-forming cells. In addition, some studies suggest that vitamin C’s antioxidant effects may protect bone cells from damage. Vegetables also seem to increase bone mineral density, also known as bone density. Bone density is a measurement of the amount of calcium and other minerals found in your bones. Both osteopenia (low bone mass) and osteoporosis (brittle bones) are conditions characterized by low bone density. A high intake of green and yellow vegetables has been linked to increased bone mineralization during childhood and the maintenance of bone mass in young adults. Eating lots of vegetables has also been found to benefit older women. A study on women over 50 found those who consumed onions most frequently had a 20% lower risk of osteoporosis, compared to women who rarely ate them. One major risk factor for osteoporosis in older adults has increased bone turnover or the process of breaking down and forming new bone. In a three-month study, women who consumed more than nine servings of broccoli, cabbage, parsley, or other plants high in bone-protective antioxidants had a decrease in bone turnover.

2. Perform Strength Training and Weight-Bearing Exercises

Engaging in specific types of exercise can help you build and maintain strong bones. One of the best types of activity for bone health is weight-bearing or high-impact exercise, which promotes the formation of new bones. Studies in children, including those with type 1 diabetes, have found that this type of activity increases the amount of bone created during the years of peak bone growth. In addition, it can be extremely beneficial for preventing bone loss in older adults. Studies in older men and women who performed weight-bearing exercises showed increases in bone mineral density, bone strength, and bone size, as well as reductions in markers of bone turnover and inflammation. However, one study found little improvement in bone density among older men who performed the highest level of weight-bearing exercise over nine months. Strength-training exercise is not only beneficial for increasing muscle mass. It may also help protect against bone loss in younger and older women, including those with osteoporosis, osteopenia, or breast cancer. One study in men with low bone mass found that although both resistance training and weight-bearing exercise increased bone density in several areas of the body, only resistance training had this effect on the hip.

3. Consume Enough Protein

Getting enough protein is important for healthy bones. About 50% of bone is made of protein. Researchers have reported that low protein intake decreases calcium absorption and may also affect rates of bone formation and breakdown. However, concerns have also been raised that high-protein diets leach calcium from bones to counteract increased acidity in the blood. Nevertheless, studies have found that this doesn’t occur in people who consume up to 100 grams of protein daily, as long as this is balanced with plenty of plant foods and adequate calcium intake. Research suggests that older women, in particular, appear to have better bone density when they consume higher amounts of protein. In a large, six-year observational study of over 144,000 postmenopausal women, higher protein intake was linked to a lower risk of forearm fractures and significantly higher bone density in the hip, spine, and total body. What’s more, diets containing a greater percentage of calories from protein may help preserve bone mass during weight loss. In a one-year study, women who consumed 86 grams of protein daily on a calorie-restricted diet lost less bone mass from their arm, spine, hip, and leg areas than women who consumed 60 grams of protein per day.

4. Eat High-Calcium Foods Throughout the Day

Calcium is the most important mineral for bone health, and it’s the main mineral found in your bones. Because old bone cells are constantly broken down and replaced by new ones, it’s important to consume calcium daily to protect bone structure and strength. The RDI for calcium is 1,000 mg per day for most people, although teens need 1,300 mg and older women require 1,200 mg. However, the amount of calcium your body absorbs can vary greatly. Interestingly, if you eat a meal containing more than 500 mg of calcium, your body will absorb much less of it than if you consume a lower amount. Therefore, it’s best to spread your calcium intake throughout the day by including one high-calcium food from this list at each meal. It’s also best to get calcium from foods rather than supplements. A recent 10-year study of 1,567 people found that although high calcium intake from foods decreased the risk of heart disease overall, those who took calcium supplements had a 22% greater risk of heart disease.

5. Get Plenty of Vitamin D and Vitamin K

Vitamin D and vitamin K are extremely important for building strong bones. Vitamin D plays several roles in bone health, including helping your body absorb calcium. Achieving a blood level of at least 30 ng/ml (75 nmol/l) is recommended for protecting against osteopenia, osteoporosis, and other bone diseases. Indeed, studies have shown that children and adults with low vitamin D levels tend to have lower bone density and are more at risk for bone loss than people who get enough. Unfortunately, vitamin D deficiency is very common, affecting about one billion people worldwide. You may be able to get enough vitamin D through sun exposure and food sources such as fatty fish, liver, and cheese. However, many people need to supplement with up to 2,000 IU of vitamin D daily to maintain optimal levels. Vitamin K2 supports bone health by modifying osteocalcin, a protein involved in bone formation. This modification enables osteocalcin to bind to minerals in bones and helps prevent the loss of calcium from bones. The two most common forms of vitamin K2 are MK-4 and MK-7. MK-4 exists in small amounts in liver, eggs, and meat. Fermented foods like cheese, sauerkraut, and a soybean product called natto contain MK-7. A small study in healthy young women found that MK-7 supplements raised vitamin K2 blood levels more than MK-4. Nevertheless, other studies have shown that supplementing with either form of vitamin K2 supports osteocalcin modification and increases bone density in children and postmenopausal women. In a study of women 50–65 years of age, those who took MK-4 maintained bone density, whereas the group that received a placebo showed a significant decrease in bone density after 12 months. However, another 12-month study found no significant difference in bone loss between women whose diets were supplemented with natto and those who did not take natto.

Anatomy of a Joint

Joints are the areas where 2 or more bones meet. Most joints are mobile, allowing the bones to move. Joints consist of the following:

Cartilage. This is a type of tissue that covers the surface of a bone at a joint. Cartilage helps reduce the friction of movement within a joint.

Synovial membrane. A tissue called the synovial membrane lines the joint and seals it into a joint capsule. The synovial membrane secretes a clear, sticky fluid (synovial fluid) around the joint to lubricate it.

Ligaments. Strong ligaments (tough, elastic bands of connective tissue) surround the joint to give support and limit the joint’s movement. Ligaments connect bones.

Tendons. Tendons (another type of tough connective tissue) on each side of a joint attach to muscles that control the movement of the joint. Tendons connect muscles to bones.

Bursas. Fluid-filled sacs, called bursas, are between bones, ligaments, or other nearby structures. They help cushion the friction in a joint.

Synovial fluid. A clear, sticky fluid secreted by the synovial membrane.

Meniscus. This is a curved part of cartilage in the knees and other joints.

What are the different types of joints?

There are many types of joints, including joints that don’t move in adults, such as the suture joints in the skull. Joints that don’t move are called fixed. Other joints may move a little, such as the vertebrae. Examples of mobile joints include the following:

Ball-and-socket joints. Ball-and-socket joints, such as the shoulder and hip joints, allow backward, forward, sideways, and rotating movements.

Hinge joints. Hinge joints, such as in the fingers, knees, elbows, and toes, allow only bending and straightening movements.

Pivot joints. Pivot joints, such as the neck joints, allow limited rotating movements.

Ellipsoidal joints. Ellipsoidal joints, such as the wrist joint, allow all types of movement except pivotal movements.

What Are Bones and What Do They Do?

Bones provide support for our bodies and help form our shape. Although they’re very light, bones are strong enough to support our entire weight.

Bones also protect the organs in our bodies. The skull protects thebrain and forms the shape of the face. The spinal cord, a pathway for messages between the brain and the body, is protected by the backbone, or spinal column. The ribs form a cage that shelters theheart andlungs, and the pelvis helps protect the bladder, part of the intestines, and in women, thereproductive organs.

Bones are made up of a framework of a protein called collagen, with a mineral called calcium phosphate that makes the framework hard and strong. Bones store calcium and release some into the bloodstream when it’s needed by other parts of the body. The amounts of certain vitamins and minerals that you eat, especially vitamin D and calcium, directly affect how muchcalcium is stored in the bones.

Bones are made up of two types of bone tissues:

1. Compact bone is the solid, hard outside part of the bone. It looks like ivory and is extremely strong. Holes and channels run through it, carrying blood vessels and nerves.

2. Cancellous(pronounced: KAN-suh-lus) bone, which looks like a sponge, is inside compact bone. It is made up of a mesh-like network of tiny pieces of bone called trabeculae (pronounced: truth-BEH-kyoo-lee). This is where bone marrow is found.

This soft bone is where most of the body’s blood cells are made. The bone marrow contains stem cells, which produce the body’s red blood cells and platelets, and some types of white blood cells. Red blood cells carry oxygen to the body’s tissues, and platelets help with blood clotting when someone has a cut or wound. White blood cells help the body fight infection.

Bones are fastened to other bones by long, fibrous straps called ligaments (pronounced: LIG-uh-Mentz). Cartilage (pronounced: KAR-tul-ij), a flexible, rubbery substance in our joints, supports bones and protects them where they rub against each other.

How Do Bones Grow?

The bones of kids and young teens are smaller than those of adults and contain “growing zones” called growth plates. These plates consist of multiplying cartilage cells that grow in length, and then change into hard, mineralized bone. These growth plates are easy to spot on an X-ray. Because girls mature at an earlier age than boys, their growth plates change into hard bone at an earlier age.

Bone-building continues throughout life, as a body constantly renews and reshapes the bones’ living tissue. Bone contains three types of cells:

1. osteoblasts (pronounced: AHS-tee-uh-blastz), which make new bone and help repair damage

2. osteocytes (pronounced: AHS-tee-o-sites), mature bone cells which help continue new born formation

3. osteoclasts (pronounced: AHS-tee-o-klasts), which break down bone and help to sculpt and shape it

Functions Of Bones

Bones are a key part of your skeletal system. They’re lightweight structures that are incredibly strong. A normal adult has around 206 bones in their body.

Your bones serve five main functions in your body, including:

Supporting your body and helping you move. Your bones hold up your body and keep it from collapsing to the ground. Your posture depends on your bones. You also need to be able to coordinate your bones and shift your weight around them to move.

Protecting your internal organs. Your bones keep your organs safe from hard impacts, punctures, and other forms of injury. For example, your ribs protect your heart and lungs, and your skull protects your brain.

Producing your blood cells. Certain types of bones make your platelets, red blood cells, and white blood cells. These cells are made inside of your bones. Platelets help your blood clot, red blood cells deliver oxygen to your organs, and white blood cells help fight off infections.

Storing and releasing fat. Certain types of bones store fat and then release it when your body needs energy.

Storing and releasing minerals. Bones can also store necessary minerals when their levels are too high in your blood. Then, your bones will release the minerals when your body needs them. Examples of these minerals include calcium, phosphorus, and vitamin D.

What Is Your Skeletal System?

Your bones join together to make your skeleton: the structure that your entire body is built around — part of your musculoskeletal system.

Your skeletal system functions as a structural lattice that the rest of your body is built around and depends on for support.

Besides bones, other parts of your skeletal system include:

Ligaments. These are strong tissues that connect your bones to one another.

Cartilage. This is a semi-rigid tissue that covers bones where they touch one another. It provides a flexible and smooth surface for movement.

Tendons. These connect your bones to your muscles.