Draft:Primary Osteoarthritis of the Knee

Title - Primary Osteoarthritis of the knee: its cause pathogenesis and specific treatment.
Source - The matter is based on a published research article vide - Agrawal RC: Primary Osteoarthritis Knee: establishing its cause, pathogenesis and treatment. Orthopedic JMPC 2022; 28(1): 36-43. Available from https://ojmpc.com/index.php/ojmpc/article/view/142.

Introduction - Osteoarthritis (OA) is also called Degenerative Arthritis.

Cause - The cause is prolonged deficient full flexion (DFF) / deficient full extension (DFE) or both combined in a knee. The first is found in those working standing e.g. surgeons, teachers and conductors; second in those sitting cross legged. eg. some shopkeepers and home confined elderly and third working sitting on chairs, eg. clerks.

Pathogenesis- It is contracture formation in the capsule. The anterior part of capsule is most elastic and longest during full knee flexion. When DFF is present for years its elasticity and length reduce (contracture formation in anterior part of capsule) In the same way DFE produces contracture in posterior part and combined DFF and DFE in both aspects.

Articular cartilage damage is secondary to capsule contracture through reduced synovial fluid transportation to them. Synovial fluid is the only means to supply oxygen and nutrients.

Stretch on contracture gives rise to pain.

Treatment- it consists of passive flexion of knee in case of DFF, passive extension in case of DFE and both flexion and extension separately in case of combined defect. The aim is to correction of the contracture and hence name of therapy - ‘Contracture corrector therapy (CCT)’. There are five body postures designed for passive flexion and three for passive extension. Each posture is maintained for ten slow counts (10-15 seconds), 1-4 times a day with a motto of providing intermittent sustained passive flexion/extension.













The full article can be downloaded from the website https://ojmpc.com/index.php/ojmpc/article/view/142. It is desirable to obtain its printout also to study the time details.