Staying active with low-impact exercise such as cycling helps strengthen muscles and improve joint stability. – 123rf.com
WEAR and tear of the joints – this is a simple, yet accurate description of osteoarthritis (OA). It is one of the most common musculoskeletal disorders among older adults and the older we get, the more likely we suffer from it.
Sunway Medical Centre Velocity (SMCV) consultant orthopaedic, trauma and arthroplasty surgeon Dr Yuen Jin Chuan says that OA is the most common type of arthritis and a leading cause of disability in the elderly worldwide.
“Knee OA affects 10–20% of adults over 55, particularly older women,” notes Dr Yuen.
“OA results from the gradual breakdown of cartilage in joints, leading to joint pain, stiffness and disability. Increasing age is the strongest risk factor for OA. The incidence of the most common type, knee OA, is around 10-20% for those above 55, with more older women being affected.”
“We also see patients as young as their 30s or 40s developing significant knee OA and that’s due to risk factors such as obesity, a history of knee injuries, repetitive strain from certain occupations or sports and family history,” observes Dr Yuen.
By 2040, it is projected that 14.5% of Malaysians will be aged 65 and above (Department of Statistics Malaysia), making us an “aged nation” rather than an “ageing” one. This also points to a significant increase in the number of OA cases in the country. This puts pressure not only on individuals and families but also on healthcare systems. The burden includes escalating costs of long-term treatment, physiotherapy and the need for surgical interventions.
Worldwide, it is estimated that by 2050, cases of knee OA alone are expected to rise by 74%, driven by longer lifespans and higher obesity rates (Global Burden of Disease study 2021, published in The Lancet Rheumatology).
Early symptoms of OA may include morning stiffness and mild pain after activity, notes Dr Yuen. As the disease progresses, the knee may swell and pain can become constant, limiting walking, climbing stairs, or even standing. “Diagnosis typically involves a physical examination and X-rays. MRI scans to assess cartilage damage are rarely done,” adds Dr Yuen.
In the early stages of knee OA, doctors usually recommend non-surgical treatments. Dr Yuen says that lifestyle changes such as weight management, low-impact exercise and even joint supplements. “A weight loss of just 10% can make a difference to onset of symptoms,” he notes.
For those whose pain is not debilitating, medications like anti-inflammatory drugs or pain relievers are helpful, while injections to the knee to temporarily relieve pain are also available.
When these measures no longer provide relief and quality of life is severely affected, surgery becomes an option.
A traditional total knee replacement (TKR) involves removing damaged portions of bone and cartilage and replacing them with artificial implants made of metal and other synthetic material. It is considered one of the most effective procedures for reducing pain and restoring mobility. “About 95% of such implants can last about 10 to 15 years, while about 85% last 20 to 25 years,” says Dr Yuen.
However, robotic-assisted total knee replacement (TKR) is transforming how doctors treat severe cases of knee OA. It is a highly precise tool guided entirely by the orthopaedic surgeon. “During robotic-assisted TKR, detailed 3D imaging helps in mapping out the procedure to each patient’s knee joint. The robotic arm then assists in executing the surgical plan,” says Dr Yuen.
Robotic-assisted TKR leads to greater precision in aligning and positioning the implant, improved implant fit, which may reduce wear and extend its lifespan, less trauma to surrounding tissues and potentially better long-term outcomes, with more natural knee movement.
“In general, some patients may need revision surgery when the implant breaks down over time. “With robotic-assisted TKR, the revision rate is drastically reduced, around 36-40%,” explains Dr Yuen. “Robotic TKR ensures greater consistency and accuracy.”
While robotic-assisted TKR represents a major leap forward, prevention remains the best strategy, advises Dr Yuen. Maintaining a healthy weight, exercising regularly, protecting the joints from injury and seeking early medical advice for knee pain can all help delay or reduce the severity of osteoarthritis. “For those suffering from severe knee OA, specialists try to treat it non-surgically until there’s no choice left. Then surgery becomes the last option,” says Dr Yuen.
As we grow older, living with joint pain caused by wear and tear should not be seen as something we simply have to endure, as effective treatment options are available. Yes, it can be burdensome, especially financially, for the elderly and family members. For patients needing assistance with surgery costs, many hospitals and healthcare centers offers financial support initiatives. This includes Sunway Medical Centre Velocity, which has its own “Golden Hands for Golden Care” programme as part of its corporate social responsibility initiative, designed to support elderly patients (KKLIU 2911/ EXP: Dec 31, 2027). For more information, visit the hospital’s website or reach out to the hospital’s customer service.
