To understand Arthritis, we must look at the structure of the knee joint. It is the  junction at which the upper limb with the femur bone and the lower limb with the  tibia bone meet. The end of these bones have cartilages, which facilitate a nice,  smooth and elastic structure, helping us in movements during our day to day life.  This joint is supported by two rope like ligaments, on each side to help the knee  to be stable. Increased wear and tear of the bone endings and cartilage gives  rise to arthritis. As the bone ends rub on each other, it produces pain and fluid  accumulation. Usually one of the joint is affected earlier than the other half,  resulting in bending of the limb. The accompanying muscles also become weak and stiff, with advancement of arthritis, making activities like walking difficult.

Arthritis can be divided into two, they include:

• Osteo-arthritis afflicts people in their 50’s or 60’s and both the knee joints  commonly.
• Rheumatoid – arthritis afflicts people in their 30’s or 40’s, characterized by pain  in multiple joints and morning stiffness.

Commonly osteo-arthritis is caused by genetic predisposition, overweight, long  distance running, significant injury to the joint, etc. Gentle walking and mild  overweight do not by itself cause osteo-arthritis. The rate of progression of  osteo- arthritis is also unpredictable.

Rheumatoid – arthritis is caused by a process in which the whole body’s defence mechanism produces a toxin, which effects the joint covering, gradually destroying the surroundings and joint also. It is progressive and can be controlled in the early stages by medication, but once the joint structure gets involved then surgery is usually required.

The Treatment methods can be divided into two, they are as follows:

• Early arthritis
• Late /advanced arthritis

Osteo-arthritis at an early stage causes pain on activity, like running, walking, etc.Rest from the particular activity , hot water fermentation, weight reduction and general exercises help one to overcome the problem. Keyhole surgery also helps in certain cases of early arthritis.

The early stages of rheumatoid arthritis is characterized by pain and swelling in multiple joints like knees, shoulders, hips and ankles. This may vary in degrees and the pain may come and go. To control arthritis at this early stage quite a few modern medicines are available, apart from hot water fermentation and physiotherapy, help in providing relief.

Alternative systems of medicine like ayurveda and siddha also offer excellent remedies during the early stages of arthritis.

 When the pain becomes severe and painkillers don’t work, then surgery should be  resorted to without further delay, to provide permanent relief. Knee joint  replacement surgery has a high degree of success rate and has come as a blessing  to the millions afflicted with arthritis. About a week before the actual surgery, the  patient is thoroughly checked by an anesthesian, general physician and a dentist.  The patients are also checked for hypertension, diabetes and heart problems,  since; commonly most people who undergo this surgery are elderly. The body is  checked for any infection and then the date of surgery is confirmed.

 The surgery consists of initially cleaning the knee region. The patient is administered antibiotics to avoid infection. During the surgery, the damaged cartilage and ligaments are cut and removed and the size of bones is measured after the bone cuts. An appropriately sized artificial knee joint is then placed and joined with the bones using bone cement, which takes about ten minutes to solidify. The excess bone cement is carefully removed and the knee joint is connected to a vacuum container with two tubes. These tubes drain out the oozing blood from the joint cavity. The cut muscles are then sutured and the veins are sealed. The entire process takes place after the patient is administered an epidural injection, so that they remain pain free as well as conscious during the entire process of the surgery.

After the process of surgery is over for a period of 3-4 days the patients are  under complete bed rest and gradually take up breathing and leg exercises. Once  the bandage is changed the patients can stand up with support and after about  10 days of physiotherapy they can walk comfortably. Once the sutures are  removed at the end of this period, the patients can walk comfortably, without  any pain. Infact, in three months time, they can walk independently upto half a  kilometer and climb stairs.