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Estrogen Levels and Knee Osteoarthritis

Lowered Estrogen Levels in Premenopausal Women Linked to Knee Osteoarthritis

June 04, 2007   By: Jean Johnson for Knee1

Part Two Part One

Knee Osteoarthritis and Weight

One of the comments that jumps out of the literature on knee osteoarthritis is weight. Indeed, as Marcus Laux, MD, author of Natural Women, Natural Menopause wrote, “In overweight women, osteoarthritis of the knee is fairly common.

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The Center for Human Performance and Joint Restoration in the University of Southern Alabama Health System lists the following as the main focus in current treatment for knee osteoarthritis:
  • Weight loss
  • Anti-inflammatory medications
  • Steroids or synthetic joint fluid injections
  • Physical therapy
  • Surgical options include knee arthroscopy or a partial or total joint replacement

“Excess pounds also may have a direct metabolic effect on cartilage beyond the effects of increase joint stress,” Laux added. “Obese people also often have more dense bones. Research has shown that dense bones may provide less shock-absorbing function than thinner bones, allowing more direct trauma to the cartilage.”

The Center for Human Performance and Joint Restoration in the University of Southern Alabama Health System concurs with Laux. “Obesity appears to strongly affect females more than males in weight-bearing joints” (hip and knee).

Osteoarthritis Primer

Osteoarthritis arises when loss of surface cartilage at the end of the bone gives rise to joint inflammation, swelling, stiffness, tenderness, redness, or warmth. The weight-bearing joints of the hips and knees are usually the ones affected. The shoulder, elbow, and ankle generally don’t present problems.

Laux explains that the exact cause of osteoarthritis remains unknown. “Researchers know aging doesn’t appear to cause osteoarthritis. Cartilage in people with the disease show many destructive changes not seen in older persons without the disease.”

Laux does say that certain conditions seem to trigger osteoarthritis. “Some families seem to have a lot of osteoarthritis, pointing to a genetic factor, although this is most commonly seen in osteoarthritis of the hands.”

He also points out that repeated trauma can sometimes be associated with knee osteoarthritis. “Athletes, extremely active people, and individuals with physically demanding jobs often develop the disease.”

The Toll of Osteoarthritis

“Arthritis negatively impacts an individual's overall well being,” states the Center for Human Performance and Joint Restoration. “It bears a physical, psychological, social and economic toll on a person.”

In addition to common physical effects, the Center points out that osteoarthritis also can give rise to “psychological effects such as depression, anxiety, feelings of helplessness, and reduced self-esteem. Embarrassment and discomfort in public due to physical changes can reduce community involvement.”

That doesn’t surprise Anderson.

“Why, of course,” she said. “Just look at these old ladies when they start hobbling around. They know they’re starting to become a burden on their children and their friends. Many of them are alone since the men seem to die off early. So it’s just a mess.

“I hope this estrogen research proves to be on target. Women suffer enough without their knees going, so if taking hormone replacement therapy would help, they’d probably go for it.

“And as far as the weight goes,” Anderson added, “most of us ladies do put on pounds when we age. It’s just tough all the way around, especially because once you’ve reached a certain age, they don’t even like to do a knee replacement on you.”

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