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‘Why Females are More Prone to Degenerative Joint Disease’
Date Posted: 22/Aug/2017
The knee is described as the weight bearing joint but when osteoarthritis (OA) sets in, it becomes an excruciating experience for those affected. Knee osteoarthritis also referred to as wear and tear arthritis or degenerative joint disease is a debilitating condition which affects many worldwide. 
In Sokoto, findings of a local study on osteoarthritis of the knee have shown a higher female preponderance.
Surgeons at the Usmanu Danfodyo University Teaching Hospital (UDUTH) Sokoto found out that females are not only at  higher risk  of  the disease  than  men,  but they  are  also prone  to  have  severe OA. The surgeons have also successfully conducted knee and hip replacement surgeries.
Following the difficulty and expensive nature of seeking treatment here and abroad, the authorities of UDUTH sent an arthroplasty team to India led by a Consultant Orthopaedic Surgeon, Dr. Muhammad Oboirien, and has now successfully carried out these replacement surgeries with 100 percent local input. 
Speaking on the study conducted, the lead surgeon, Dr.   Oboirien, who described knee osteoarthritis as a degenerative condition of the structures that form a joint, said it was common with ageing population and presents with pains, stiffness, deformity as well as difficulty in walking. 
“Our study indicated a higher female preponderance as is the case in most studies worldwide,” he said. On the reason for the greater female preponderance, he said it could be in the risk factors, adding “Obesity and sedentary lifestyle could be blamed.”
He explained that the study examined risk factors associated with degenerative knee osteoarthritis in the environment. The medical expert pointed out that various risks factors including age, genetics, lifestyle and obesity have been implicated in the development of the disease. 
He said  multiple studies had suggested a strong relationship between OA and both overweight and obesity. 
“Elevated Body Mass Index (BMI) is both a systemic and local risk factor for development and progression of knee OA. Increased body weight is believed to increase joint reaction force, which in turn increases wear on cartilage, the so-called intuitive biomechanical theory,” he said. 
This observation, he asserted, supports the link between obesity and osteoarthritis.
“The obesity gene and its product leptin may have important implications for the onset and progression of OA,” he added.
 Dr. Oboirien also noted that history of previous joint injuries leads to early joint degeneration. The surgeon said available therapies aim to ensure adequate joint function and mobility, adding that the goal of treatment is to relieve pain and restore joint motion. 
“Pain medication and physiotherapy ensures the integrity of the joint capsules (structures). Surgery may be required to correct joint deformity (corrective osteotomy) or replace the damaged cartilage (total knee replacement). 
“In advanced societies, cartilage transplant can be done to damaged parts replaced through genetic tissue engineering. This advanced procedure is useful in patients that present early. People who seek treatment early would reduce the chances of or delay a knee replacement,” he said.
The consultant pointed out that  weight reduction should be considered as part of management protocol.
 In Sokoto, he said knee replacement is relatively new - under one year.
“We are still gathering data. We have had two years’ experience with total hip replacement and they have all done well. We have done few knees and some hips. The numbers are still small and follow up should be at least two years,” he added.
He however stressed that people in Sokoto do not have to go outside the state to seek care as they have the full complement of staff from surgeons to anaesthetics, and physiotherapy for rehabilitation.
“With increasing awareness and governments’ campaign to discourage medical tourism, we hope to have more surgeries. We have also noted a trend of intra national medical tourism as patients from other regions are coming to Sokoto not only in the field of orthopaedics, but neurosurgery and others,” he said. 
To reduce the incidence, the medical expert advised that people should avoid being overweight, engage in regular exercise and maintain a general healthy lifestyle. He harped on the need to seek timely medical care from onset of symptoms.
By: Rakiya A. Muhammad, Sokoto
Daily Trust News

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