Knee Osteoarthritis in Postmenopausal Women. Research Paper

Knee Osteoarthritis in Women Above 60 Years
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Knee Osteoarthritis in Postmenopausal Women
Several health conditions set in with old age, including functional, cognitive, increased susceptibility to chronic diseases like cancer, diabetes mellitus, hypertension, osteoporosis, and other aging factors that weaken the patients' physiology. Osteoarthritis is one of the most prevalent chronic conditions associated with old, although other contributory factors exist in different forms depending on the site. The other contributory risk factors to osteoarthritis include obesity, prior injury, and lack of exercise. Data from the WHO shows that women above the age of 60 are more susceptible to osteoarthritis with 18% vs. 9.6% men in global statistics (Davis et al., 2014). The National Institute on Aging (2017) noted various osteoarthritis types, categorized based on their location, including hands, knees, hips, and spine. Knee osteoarthritis (KOA) is the most prevalent musculoskeletal disorder ranked among the 11th highest causes of disability globally (Tiulpin et al., 2018). KOA is one of the most common forms of arthritis, close to the hip and back, affecting close to a third of the population above 60 years of higher prevalence among women than men due to osteocalcin (Chen et al., 2019). The commonality of knee osteoarthritis among postmenopausal women, gender as a non-modifiable risk factor, necessitates extensive research on managing the disease and how preventing through multiple approaches directed programs towards risk populations. Health practitioners can implement comprehensive measures to reduce knee osteoarthritis to establish both pharmacological and nonpharmacological care programs to reduce the prevalence of the disease.
This report concentrates on the prevalence of knee osteoarthritis (KOA) among menopausal women in Canada and analyses Manitoba's care programs' efficiency mechanisms. It also highlights the role of physical activity as the main nonpharmacological care program and its effectiveness in preventing and managing the disease. The other aspect of the illness covered in the report is the use and applicability of different treatment methods and care programs for managing osteoarthritis.
Physiology Description of the Knee osteoarthritis
The knee is joint comprises various tissues and cells that, when their joinery and lubrication is affected, causing pain, stiffness, and swelling due to the tear and wear of the cartilage. The knee's main components include osseous structures, cartilage, ligaments, and a synovial membrane (Mora et al., 2018). Osteoarthritis is caused by the tear and wear of tissue and cartilage that cushion joints causing pain, swelling, tenderness, and stiffness to the affected areas (NIA, 2017). Peat et al. (2001) describe knee osteoarthritis as an active disease that destroys the cartilage and thickens the subchondral bone, leading to new bone structures in the knees. The tear and wear are usually a result of obesity, genetics, injury, or continued stress on joints due to sports activities or heavy lifting.
Lespasio et al. (2017) also identify diabetes, synovitis, systemic inflammatory mediators, innate immunity, joint shape, inflammation from metabolic syndromes, and lower limb alignment. This combination of genetics, joint mechanics, inflammation, and cellular processes makes KOA one of the multifactorial chronic conditions indicated by the multiple approaches to its treatment. The trauma, inflammation, mechanical, biochemical reactions, and metabolic imbalance change to the non-cartilaginous cells like synovium membrane, subchondral bone, joint capsule, ligaments, periarticular muscles, which are the cause of the pain (Mora et al., 2018). This is because the cartilaginous tissue lacks innervation and vasculature, making it incapable of inducing pain on its own. Regardless of the cause, KOA involves the protective cartilage damage, which exposes the subchondral bone leading to osteophytes and sclerosis (Ashkavand et al., 2013). In menopausal women, the prevalence of KOA is facilitated by the osteocalcin hormone and bone resorption, which lowers the thawed away cartilage (Ashkavand et al., 2013).
The wear and tear of cartilages are mainly due to inflammation caused by synovitis and other pro-inflammatory mediators and enzymes in the knees (McAlindon et al., 2017). Synovitis refers to the infiltration of inflammatory cells into the synovium membrane resulting in the synovial fluid. The cartilage's incapability to cause pain is the main reason for knee osteoarthritis to be linked to inflammations. The synovial fluid contains plasma proteins, leukotrienes, cytokines, nitric oxide, prostaglandins, and growth factors, which are inflammatory mediators contributing to cartilage breakdown (Mora et al., 2018).
Knee Osteoarthritis prevalence in Postmenopausal Women in Canada
Globally, women above 60 years are more susceptible to knee osteoarthritis, with 18% of the population suffering from the condition (Davis et al.,2014). In Canada, for the years 2013-2014, the same picture is reflected as 60% of the prevalent cases were women with 15.4% women and an incidence occurrence of 10.2 women per every 1,000 points (Public Agency of Canada, 2017). For the fiscal year 2016-17, the same picture is realized as 16.1% of all women (against 11.1% men) above 20 years are susceptible to osteoarthritis (Government of Canada, 2020). For the postmenopausal women (60+), the susceptibility increases to 25.0%, while for the women above seventy, 39.7% have been diagnosed with osteoarthritis. Data by the Canadian Community Health Survey (CCHS) shows that close to 45% of aged 60-64 have osteoarthritis, and approximately 630 people in every 1,000 people suffer from the condition (Badley et al., 2019). The numbers rise with age as the 70-79 bracket almost has 60% prevalence and more than 800 conditions per 1000 persons.
The Role of Physical Activity in preventing and Managing Knee Osteoarthritis
Nonpharmacological interventions should always be the first direction towards managing and preventing osteoarthritis due to the adversity of inactivity to cartilage degeneration, thinning and softening, and impaired joint mechanics and flexibility (Mora, 2018). Physical exercise is the most important and widely applied nonpharmacological therapy for knee osteoarthritis (Chen et al., 2019). This widely adopted physical therapy recommendation is due to its categorization as a safe, cheap delay of progression and enhances joint function, especially in early detection. Obesity is one of the modifiable risk factors targeted in the treatment of KOA using physical exercises due to its effect on diminished activity and loss of protective muscle strength (Lespasio et al., 2017). Combining weight loss exercises with individualized physical programs like low-impact exercises helps reduce the stress on the knees and improve the flexibility and functionality of knees (Lespasio et al., 2017). The adoption of low-impact exercises helps knee osteoarthritis patients improve their mechanical and functional abilities, risk reduction of other chronic conditions like hypertension and diabetes, disability, emotional wellness, and self-efficacy (Mora et al., 2018).
Other Treatments for Knee Osteoarthritis
Due to its lack of a definitive cure, the treatment approaches to KOA are meant to manage its progression, improve quality of life, limit disability, and relieve pain (Lespasio et al., 2017). This is because of the degenerative and progressive nature of osteoarthritis, which only calls for symptom control (Mora et al., 2018). The choice of treatment depends on the stag...