Sebelum kemalangan hari tu, lutut aku dah mula sakit sikit-sikit. Aku dah ke doktor dan dikesan mengidap OA. Tak kisah lah sebab biasa la dengan keadaan umur yang macam ni dan dengan berat badan yang lebih dari biasa, aku terpaksa terima hakikat dan dalam usaha untuk mengurangkan berat badan. Belum sempat berat badan berkurang, aku ditimpa kemalangan dan secara kebetulan kedua-dua belah lutut aku terlanggar dashboard dengan kuat dan akhirnya memberi kecederaan serius. Lama juga aku tak boleh membengkokkan lutut.
Bila keadaan dah hampir reda dan baru sja bagitau babah aku nak solat macam biasa selepas habis period hari tu, belum sempat habis lagi aku jatuh katil yang tinggi dengan kuat sekali dan kedua-dua lututku sekali lagi tersepit dicelah meja.Sakit balik semula. Kebetulan juga lututku yang tersangkut dicelah meja tersebut.
Seronok tengok orang yang sihat dan tak sakit lutut. Bebas melakukan aktiviti sendiri seperti berjoging dan terutamanya solat dengan teratur. tapi aku sedar, semuanya kuasa tuhan Aku terima dan sedang cuba berusaha untuk pulih seperti biasa.
Kadang-kadang tak tahan, tengah rancak berjalan, tiba-tiba boleh tersentap kesakitan. namun apa pun jua, kesakitan itu cuma sedikit sebagai peringatan dan tetap kuingat, INGAT 5 PERKARA SEBELUM 5 PERKARA dan aku dah menerima satu darinya. Sihat sebelum sakit.
Osteoarthritis of the knee
How does a normal joint work?
A joint is where two or more bones meet. The joint allows the bones to move freely but within limits. The knee is the largest joint in the body, and also one of the most complicated. It needs to be strong enough to take our weight and must lock into position so we can stand upright. But it also has to act as a hinge so we can walk and must withstand extreme stresses, twists and turns, such as when we run or play sports.
The knee joint is where the thigh bone (femur) and shin bone (tibia) meet. The end of each bone is covered with cartilage which has a smooth, slippery surface which allows the ends of the bones to move against each other almost without friction. The knees have two additional rings of cartilage between the bones. These are called menisci – they act a bit like shock absorbers to spread the load more evenly across the joint.
The kneecap (patella) is attached to the thigh muscles by a large tendon and is attached to the bone just below the knee joint at the front of the tibia. The underneath of the kneecap is also covered with cartilage.
The joint is surrounded by a membrane (the synovium) which produces a small amount of thick fluid (synovial fluid) which helps to nourish the cartilage and lubricate the joint. The synovium has a tough outer layer called the capsule which helps hold the knee in place.
The tendons are strong connecting tissues which attach the muscles to the bones on either side of the joint. They also help to keep the joint in place. When a muscle contracts it shortens, and this pulls on the tendon attached to the bone and makes the joint move.
The knee joint is held in place by four large ligaments. These are thick, strong bands which run within or just outside the joint capsule. Together with the capsule, the ligaments prevent the bones moving in the wrong directions or dislocating. The thigh muscles (quadriceps) also help to hold the knee joint in place.
What is osteoarthritis?
Osteoarthritis is a disease that affects the body’s joints. The condition is sometimes called arthrosis, osteoarthrosis or degenerative joint disease. When a joint develops osteoarthritis, the surfaces of the joint are damaged so the joint doesn’t move as smoothly as it should. The cartilage covering the ends of the bones gradually roughens and becomes thin. This happens over the main surface of the knee joint or in the cartilage underneath the patella. The bone beneath the cartilage reacts by growing thicker. All the tissues within the joint are more active than normal – as if the body is trying to repair the damage:
The bone at the edge of the joint grows outwards forming bony spurs called osteophytes. This can affect the thigh bone, the shin bone or the patella.
•The synovium may swell and produce extra fluid, causing the joint to swell. This is sometimes called ‘water on the knee’.
•The capsule and ligaments slowly thicken and contract – as if they were trying to push the joint back into shape.
In some joints the body’s ‘repairs’ are quite successful and the changes inside the joint won’t cause much pain. But in osteoarthritis of the knee the repair doesn’t usually work very well.
Symptoms of osteoarthritis
The main symptoms are pain and sometimes stiffness. Your knee may feel stiff at certain times, often in the mornings or after a period of rest, and walking for a few minutes usually eases the stiffness. Osteoarthritis can affect both knees or just one knee.
You may have pain all around the joint or just in a particular place, most likely at the front and sides of the knee, and it may be worse after a particular movement, such as climbing stairs. The pain is usually better when you rest. It’s unusual to have pain in the knee which wakes you up at night, although this sometimes happens with severe osteoarthritis. You’ll probably find that your pain will vary and that you have good days and bad days – sometimes depending on how active you’ve been but sometimes for no obvious reason.
The joint may not move as freely or as far as normal, and it may creak or crunch as you move. If the osteoarthritis is severe the knees may become bent and bowed. Sometimes the joint gives way either because the muscles have become weak or because the ligaments are damaged. Exercises to strengthen the muscles can often help to prevent the knee giving way.
What causes osteoarthritis?
There are many factors that can increase the risk of osteoarthritis, and it’s often a combination of these factors that leads to osteoarthritis:
•Age – Osteoarthritis usually starts from the late 40s onwards. We don’t fully understand why it’s more common in older people but it’s probably due to factors like weakening of the muscles and the body being less able to heal itself.
•Sex – Osteoarthritis of the knee is twice as common in women as in men. It’s most common in women over the age of 50 although there’s no strong evidence that it is directly linked to the menopause. It is often associated with mild arthritis of the joints at the ends of the fingers (nodal osteoarthritis) which is also more common in women.
•Obesity – Being overweight is an important factor in causing osteoarthritis generally, but especially in the knee. It also increases the chances of osteoarthritis becoming progressively worse.
•Joint injury – Normal activity and exercise don’t cause osteoarthritis, but very hard, repetitive activity or physically demanding jobs can increase the risk. Injuries to the knee joint often lead to osteoarthritis in later life. A common cause is a torn meniscus or ligament which can result from a twisting injury. This is a common injury in footballers, and an operation to remove the torn cartilage (meniscectomy) also increases the risk of osteoarthritis.
•Genetic factors – Genetic factors play a part in osteoarthritis of the knee. The genes we inherit may affect collagen, one of the important components of cartilage, or the way the bone reacts and repairs itself, or even the inflammatory process.
•Other types of joint disease – Sometimes osteoarthritis is a result of damage from a different kind of joint disease, such as rheumatoid arthritis, that occurred years before.
What is the outlook?
It’s impossible to predict how osteoarthritis will develop for any one person.
Usually, osteoarthritis is a slow process that develops over many years and results in fairly small changes in just part of the joint. This doesn’t mean it won’t be painful but it’s less likely to cause severe deformity or disability.
Osteoarthritis can sometimes develop more quickly and cause a lot of damage to a joint, which may cause some deformity or disability. This is more likely to affect older people with a severe form of the disease. The pain can increase with a reduction in mobility within a few weeks or months. But this is rare and occurs in less than 1 in 20 people with osteoarthritis.
In severe osteoarthritis the cartilage can become so thin that it no longer covers the ends of the bones. The bones start to rub against each other, and eventually to wear away. The loss of cartilage, the wearing of bone, and the bony spurs can alter the shape of the joint, forcing the bones out of their normal alignment and causing deformity.
In addition, the muscles that move the joint gradually weaken and become thin or wasted. This can make the joint unstable so that your knee gives way when you put weight on it.
Changes in your lifestyle can greatly reduce the risk of osteoarthritis of the knee progressing. Regular exercise, protecting the joint from further injury and keeping to a healthy weight will all help.
Osteoarthritis doesn’t lead to rheumatoid arthritis or other types of joint disease and won’t spread through the body. Nor is osteoarthritis linked with cancer or other serious illnesses, although some people with osteoarthritis will develop other illnesses purely by chance.
Complications of osteoarthritis
There can sometimes be complications with osteoarthritis of the knee, including deposits of calcium crystals in the cartilage and the formation of cysts at the back of the knee.
Osteoarthritis with crystals
A fairly common complication is where chalky deposits of calcium crystals form in the cartilage. This is called calcification or chondrocalcinosis. It can happen in any joint, with or without osteoarthritis, but it’s most likely to occur in a knee that’s already affected by osteoarthritis, especially in older people. It can cause a sudden flare-up of pain and noticeable swelling of the joint. The crystals will show up in x-rays and they can also be seen in samples of fluid taken from the joint.
Osteoarthritis tends to become more severe, and more quickly, when there are crystals present. And sometimes the crystals can shake loose from the cartilage, causing a sudden attack of very painful swelling called acute calcium pyrophosphate crystal arthritis (pseudogout).
Baker’s cysts (popliteal cysts)
Baker’s cysts can form when the joint has been damaged by arthritis. They are often painless, but you may be able to feel a soft lump at the back of the knee. Sometimes a cyst can cause aching or tenderness when exercising, or the knee may give way. Occasionally a cyst can press on a blood vessel, which can lead to swelling in the leg, or the cyst may burst (rupture), which can be very painful. Cysts can generally be treated by drawing off the extra fluid from the knee joint using a syringe (this is called aspiration) and injecting a steroid solution.