The cartilage and natural padding between joints deteriorate in a condition termed Osteoarthritis (OA), commonly known as wear-and-tear arthritis. When this happens, the joint's bones grind more closely against one another, decreasing cartilage's ability to absorb shock. The results of rubbing include discomfort, edema, stiffness, a loss in range of motion and possibly the emergence of bone spurs [1].

OA, the most common disease of the joints that affects joints all over the world, most usually affects the knee. The primary cause of knee osteoarthritis is ageing. The condition osteoarthritis is one that practically everyone experiences at some point. The likelihood of developing severe arthritis at a younger age is increased by a number of factors, including weight, heredity, femininity, frequent stress injuries, sports, weak knee muscles and other conditions like rheumatoid arthritis, among others [1,2].

Osteoarthritis typically progresses over time and becomes a disabling condition. Clinical symptoms can appear in various ways and to different degrees in every person. But over time, they typically deteriorate, occur more frequently and worsen in severity. The rate of development is also different for each person [2]. 

For someone with knee arthritis, many daily tasks, such as walking and climbing stairs, might be difficult. It is a substantial source of wasted work time and a significant impediment for many people [3]. 

Numerous researches carried done in various regions of India show that people are generally unaware of osteoarthritis in the knee. In order to affect a behavioural change when the populace is most receptive, the proper information at the right time is crucial because this disease is mainly preventable. The purpose of this study was to evaluate the awareness of risk and preventative variables for osteoarthritis knee among ortho OPD patients at Regional Hospital, Keylong in the Himachal Pradesh’s district of Lahaul and Spiti.

Objectives of the Study

To evaluate the knowledge of patients attending Ortho OPD towards risk and preventive factors for osteoarthritis Knee in Regional Hospital, Keylong in district Lahaul and Spiti of Himachal Pradesh.

• Research Approach: Descriptive

• Research Design: Cross Sectional Hospital Based Survey

• Setting of the Study: Ortho OPD of Regional Hospital, Keylong in District Lahaul and Spiti of Himachal Pradesh

• Study Duration: July 2022 to September 2022

• Study Population: Ortho OPD patients in Regional Hospital, Keylong in District Lahaul and Spiti of Himachal Pradesh

Sample Size

About 400 assuming 50% adults have adequate knowledge of risk and preventive factors for osteoarthritis Knee, 5% absolute error, 95% confidence level and 5% non response rate:

• Sampling Technique: Convenience Sampling Technique

• Sampling Criteria: First five patients attending the Ortho OPD of Regional Hospital, Keylong everyday were selected till the completion of sample size after explaining the purpose of the study. Informed consent/assent was taken from them and confidentiality of the selected participants was also maintained 

• Inclusive Criteria: Patients selected during the day of data collection in study setting and who were willing to participate in the study.

• Exclusion Criteria: Patients who were not willing to participate in the study 

Development of Tool

Knowledge related questionnaires description of tool:

• Section A: Socio-demographic characteristics of the patients (Age, Gender etc.)

• Sections B: Questions regarding knowledge of risk and preventive factors for osteoarthritis Knee

• Validity of Tool: By the experts in this field

• Permission: Obtained from the concerned head of the Regional Hospital, Keylong

Data collection by the researcher themselves and patients were given 5 minutes time to complete that questionnaire and collected at the end of the prescribed time.

Data Analysis

Data was collected and entered in Microsoft excel spread sheet, cleaned for errors and analysed with Epi Info V7 Software with appropriate statistical test in terms of frequencies, percentage, mean standard deviation etc.

The present study was Non-experimental descriptive study carried out to evaluate knowledge of risk and preventive factors for osteoarthritis Knee at Regional Hospital, Keylong in District Lahaul and Spiti of Himachal Pradesh.

In the present study 31.5% (126) of the Patients fall were below 40 years of age while 68.5% (274) were above 40 years. 51.25% (205) of patients were male and 48.75% (195) were female.

Among the total patients, 58(14.5%) didn’t know about any risk factor of osteoarthritis Knee. 309 (77.25%) respondents told that Inadequate amounts of dietary calcium and vitamin D is the risk factor of osteoarthritis Knee, followed by Bad posture and poor gait by 160(40%), Repeated stress on the joint by103(25.75%), Lack of physical activity by 91(22.75%), Obesity by 88(22%), Unhealthy diet by 49(12.25%), Joint injury by 47 (11.75%), Muscle weakness by 23(5.75%) and Bone deformity/Malpositioning of the joint e.g. valgus/varus posture by 21 (5.25%) respondents (Table 1).

Among the total patients, maximum 307(76.75%) told that Calcium and Vitamin D supplements helps in Prevention of osteoarthritis Knee, followed by calcium-rich foods 221(55.25%), Good posture and gait by 171(42.75%), Greece capsule(glucosamine) by 156 (39%), Exercise and yoga by 152(38%), Knee cap/Knee bracing by 101(25.25%), Maintenance of ideal weight by 98(24.5%), Prevention of injury and stress to knee joint by 53(13.25%) and healthily and balanced diet by 47(11.75%) respondents. In our survey, 63 (15.75%) respondents didn’t know about any preventive factor of osteoarthritis Knee (Table 2).

Table 1: Knowledge About Risk Factors of Osteoarthritis Knee Among Participants

Table 2: Knowledge of Participants Towards Prevention of Osteoarthritis Knee

The cartilage that lines the bones of the joint eventually deteriorates in OA of the knee. The bones rubbing against one another over time may result in bone spurs. The pain and stiffness will get worse and there can even be a loss of movement [4].

In the present study, among the total patients, 58(14.5%) didn’t know about any risk factor of osteoarthritis Knee. 309 (77.25%) respondents said that Inadequate amounts of dietary calcium and vitamin D is the risk factor of osteoarthritis Knee, followed by Bad posture and poor gait by 160(40%). Among the total patients, maximum 307(76.75%) told that Calcium and Vitamin D supplements helps in Prevention of osteoarthritis Knee, followed by calcium-rich foods 221(55.25%) and good posture and gait by 171(42.75%). In our survey, 63 (15.75%) respondents didn’t know about any preventive factor of osteoarthritis Knee.

Being overweight can add to the stress already placed on the joints and having too much body fat can make inflammation worse. Maintaining a healthy weight may help to minimise the symptoms of osteoarthritis. If necessary, even a small amount of weight loss could significantly alleviate knee pain brought on by osteoarthritis [5,6].

Exercise has been proved to improve physical performance and to be a powerful painkiller. The muscles surrounding the knee can be strengthened to help with stability and discomfort. Stretching exercises for the knees' surrounding muscles keep them supple and flexible. You must exercise frequently to keep your joints healthy. If you have osteoarthritis in your knees, being active is essential. Exercise can aid in weight loss, knee muscle strengthening and posture improvement, all of which can minimise osteoarthritis symptoms and pain [7,8].

A well-balanced, nutrient-rich diet will give persons who have osteoarthritis the body's tools to resist further joint degradation. Since some foods have been shown to stop inflammatory processes in the body, an anti-inflammatory diet can help symptoms. Antioxidants like vitamins A, C and E should be consumed in sufficient amounts to prevent further joint damage [9,10].

Natural amino monosaccharide glucosamine has the ability to boost cartilage cells' capacity for repair, promote the repair and reconstruction of cartilage matrix and postpone the start of cartilage degradation. Glucosamine can be used to treat osteoarthritis, a degenerative condition, in several parts of the body, including the knee joint [11].

Additionally, getting enough shut-eye at night can help manage knee discomfort more effectively. Examples of assistive devices that help ease joint stress include knee caps and braces. Pressure on the knee or hip is relieved by walking [13].

The risk and preventive variables for knee osteoarthritis are still unknown to many of the respondents. Knee, calcium-rich foods, proper posture and gait, the Greece (glucosamine) capsule, yoga and exercise are all recommended. Osteoarthritis in the knees can be avoided by wearing knee braces, eating a balanced, healthy diet, keeping a healthy weight and preserving the knee joint from harm and stress.

Ethical Approval

Participants confidentiality and anonymity was maintained.

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2. Physio-pedia. “Knee Osteoarthritis.” Physio-pedia, https://www.physio-pedia.com/Knee_Osteoarthritis. Accessed 15 July 2022.

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10. BactMed. “What Is the Best Diet for Osteoarthritis?” BactMed, https://bactmed.bacttraining.com/what-is-the-best-diet-for-osteoarthritis/. Accessed 25 Sept. 2022.

11. Medical Trend. “Glucosamine Plus Calcium Can Treat Knee Pain.” Medical Trend, 26 Jan. 2021, https://medicaltrend.org/2021/01/26/glucosamine-plus-calcium-can-treat-knee-pain/. Accessed 27 Sept. 2022.

12. Healthline. “How to Sleep Better with Knee Pain.” Healthline, https://www.healthline.com/health/osteoarthritis/sleep-better-knee-pain. Accessed 29 Sept. 2022.

13. Keeogo. “Walking Aids for Leg Weakness or Knee Problems.” Keeogo, https://keeogo.com/walking-aids-for-leg-weakness-or-knee-problems. Accessed 31 Sept. 2022.