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Orthopedic surgeon Lukes believes that knee pain doesn’t mean it’s useless. Frequent moderate activity and walking can nourish cartilage, improve metabolism and reduce inflammation, which is key to fighting arthritis.
「Washington Post A series of stories on the treatment of “knee joint” was published in October. China Post columnist Gretchen Reynolds interviewed the 63-year-old manBone Doctor Howard Lukes talks about the most common mistakes knee pain patients make. Dr. Lukes built his medical practice on the belief that with some basic care and nutrition, our joints can remain strong and functional throughout life.
“Bone on bone” (bone on bone, meaning that the joint cartilage has been completely worn away and the bone hits directly). Luke wants the term removed from medical discussions, saying it causes too much unnecessary harm.
He frequently writes and lectures about how knee pain, stiffness, tissue breakdown and even bone-grinding osteoarthritis “don’t necessarily limit your mobility,” he said. These symptoms “do not automatically mean you have to give up” activities you enjoy or need, nor do they mean you are simply older or older.
He said these symptoms may be a sign that it is time to re-examine certain aspects of life and health. For example: It’s time to go for a walk.
The author asked him, “Why don’t you like the term ‘grinding bone on bone’?” Lukes said many patients come in for consultations or second opinions with X-ray or magnetic resonance imaging (MRI) images, and are told they have “bone grinding on bone” arthritis. So they feel that their knee is dead, has stopped working and they should stop using it. They are ready to give up running, playing tennis, climbing stairs or even walking.
He often tells everyone: “You are not the same as your imaging report.” Just because they have a meniscal tear (i.e., damage to the cartilage that supports the bones of the knee joint) does not mean they will definitely develop arthritis. Even if you have a little bit of arthritis, it doesn’t necessarily have to get worse to the point of “bone grinding bone.” To take a step back, even if it gets to that point, does not mean that activities should be restricted. His patients also include runners suffering from bone-grinding osteoarthritis who still run.
Doesn’t running or other high-impact exercise, or even walking, wear down cartilage? We’ve all heard this, Lukes said, but it’s a myth. Moving and using your knees does not cause cartilage wear; Movement actually nourishes the cartilage.
Cartilage has no vascular supply, he said, so it can’t get nutrients from the blood. Its only source of nutrition is synovial fluid (the sticky fluid that fills the knee joint). When you step, bend, and put weight on your knee, it encourages synovial fluid to spread around and into the cartilage, providing nutrients. The same action triggers a cellular response that causes the cartilage to synthesize new collagen and begin repairing itself. Using your knee will keep it in good shape, and the biggest mistake people with knee pain make is “not moving.” “Rest” is not a panacea for knees.
He said most cases of knee arthritis are not caused by “wear and tear.” There are some, such as knee injuries (such as rupture of the anterior cruciate ligament) that can alter a person’s walking posture, leading to wear and tear and eventually arthritis. Genes also play a role, although studies show that their effect is usually small. In fact, being overweight is not the main cause of arthritis.
He said that according to the latest scientific literature, osteoarthritis is primarily a metabolic disease. Remember, cartilage is nourished by synovial fluid. We now know that joint synovial fluid reflects your metabolic status. If you have metabolic problems (such as diabetes or other chronic diseases), inflammatory molecules will be present in your blood. Some of these molecules enter the joint fluid and then into the cartilage, causing an inflammatory response there.
They also change specific cells in the lining of the joints. In a healthy knee, these cells release substances that help regenerate the cartilage; But in an inflamed knee, they change their nature and start secreting large amounts of substances making it difficult for the cartilage to repair. At this point, your knees enter a condition that is at risk of worsening and developing into arthritis. However, this process does not begin within the knee, but rather results from systemic metabolic problems.
