A simple Google search for “knee arthritis” yields more results than a person can read in a lifetime. With information overload, it can be difficult to decipher what is true and applicable in your situation. While much of what is found on the internet is true regarding arthritis, some pieces of information are not. Hopefully these explanations will dispel some common arthritis myths.
Myth #1: I have arthritis in multiple joints and/or one of my parents had arthritis, so I must have Rheumatoid Arthritis.
Rheumatoid Arthritis (RA) is a condition that affects more than just the joints and is considered an “inflammatory arthritis”. This differs from osteoarthritis in that RA is caused by an autoimmune reaction that leads to destruction of the joints by one’s own immune system. While we don’t fully understand what causes osteoarthritis, it is more of a wearing down of the cartilage in the affected joint. Although the end result for the joint is similar between these two forms of arthritis (bone-on-bone rubbing with resulting pain and dysfunction), these are actually two different processes going on within the joint.
Myth #2: I shouldn’t exercise because it will make my arthritis worse.
When it comes to joint pain and arthritis, nearly everyone can benefit from therapy and exercise. Maintaining strength and a good range of motion are critical for non-operative management of arthritic pain. Regular low-impact aerobic exercise (i.e. elliptical, exercise bike, water aerobics, etc.) along with lower extremity strength and motion exercises have led to improved function and decreased pain in patients with hip and knee arthritis. Further, regular exercise can help with weight loss and improve cardiovascular fitness, promoting overall health and decreasing the risk of perioperative complications. For patients undergoing a total knee replacement, the single biggest predictor of long-term range of motion after surgery is their range of motion before surgery. Therefore, working on motion and strength before surgery can help set you up to have the best possible outcome.
Myth #3: Can’t we just do a scope and “clean up” the arthritis?
Arthritis is a wearing down of the joint. An arthroscopic (scope) debridement is a procedure where a few small holes are made around the knee and a camera and special tools are used to shave off bumps and irregularities of the bone, meniscus, and other soft tissue. Unfortunately, this procedure has no way of generating new cartilage or reversing the arthritis. To use an analogy, the loss of cartilage in arthritis is similar to treads wearing out on a car tire. The treads don’t magically grow back while the car sits in the garage, and we can’t just glue on new treads to a worn out tire. An arthroscopic debridement for general arthritic pain is equivalent to shaving off a little more of the treads from the tire. It doesn’t really help the problem, and studies have shown that it does not lead to much sustained pain relief. There are certain situations where a scope can be helpful in the setting of arthritis. Having a discussion with your surgeon about your symptoms is the best way to determine which treatment is right for you.