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19 March 2024

Arab knee: Here's what's wrong with it

Published
By Majorie van Leijen

The occurrence of knee injuries among UAE nationals is significantly higher than among westerners, claim specialists.

"It has taken on almost epidemic proportions," said William Murrell, Consultant Orthopaedic Sports Medicine.

According to the American doctor, knee injuries and lower back pain share first place when it comes to musculoskeletal problems in the UAE, and UAE nationals  are greatly affected.

“A common injury -anterior cruciate ligament- occurs 6 times more often among UAE nationals than among Europeans and North Americans," he claimed.

Murrell is not alone in making these conclusions.

Several specialists have come across the high occurrence of these injuries and have referred to the problem as the 'Arab knee', a term now used by doctors around the world.

What is wrong with the Arab knee?

One theory is that the knee of people in the Arab world is different in structure.
“The soft tissue of the knee among the Arab population seems to be more flexible, which means that it is easier to suffer an injury.

"The shape of the shinbone is also different from that of other populations; the shinbone has a higher slope, and as a result the ligament is more prone to tearing."

“Further, there is a higher occurrence of bow-leggedness in many parts of Asia, which results in a different alignment of the knee," Murrell explained.

Apart from these factors there are certain activities that can contribute to the high occurrence of knee injuries in the region.

"Soccer is one of the sports where knee injuries are common, because the player is required to change direction fast and often. This is a popular sport here. The incidence of ACL injuries among players is high," said Murrell.

Although the problem is known among doctors, very little has been done to put the problem on the agenda, the doctor believes.

“The population should be more aware of the high occurrence of knee injuries and the options they have to treat these injuries.”

Anas Daher is a 30-year-old Syrian resident in Dubai, suffering from osteochondritis dissecans, a form of knee injury that resulted in the breaking off of a part of the knee many years ago, and ever since the quality of the knee is on a decline.

He has had three operations so far, every time introducing a new technology that is supposed to alleviate his suffering, but the pain has never ceased to exist, he narrates.

“I cannot walk for longer than an hour, and even when I do not engage in any physical activity I feel the pain. I am taking two painkillers a day, every day so I can deal with the pain.”

According to Murell, the lack of proper diagnosis and treatment often leads to further damage to the knee.

“An unstable knee can lead to osteoarthritis if not treated effectively, as the cartilage structure will be damaged over time. I see this quite a bit here,” noted.

“Early diagnosis and treatment is becoming increasingly important for various reasons, the most significant of which is the fact that the damage to surrounding ligaments and bones is negligible at during the early stages.

“Long term damage to the knee or other joints also leads to subsequent damage of connected areas which makes treatment at a later stage much more complicated, and with less satisfactory results,” said Pangal Sripathi Rao, Specialist Orthopeadics Surgeon.

A general misconception is that knee replacement is suitable only for older patients, leaving the young with few options that do not always make a difference.

“I would love to have a knee replacement, but I was told that this is only done for older people,” said Anas.

“The popular belief that knee replacement surgery should be considered only when the pain and trauma is unbearable is grossly incorrect,” said Vijayamohan S, Consultant-Orthopaedics and Head of Division for Adult Hip and Knee Reconstruction at Aster Medcity, India.

“It is important for patients to be aware that surgery needn’t wait till later years of life. The best results of joint replacement are achieved when the person is in the initial stages of osteoporosis or arthritis and begins to experience difficulties in carrying out daily chores,” he said.

“For me, this would solve the problem,” said Anas. Even if a knee replacement would only be effective for 10 years or so, as it is claimed, this is fine with me because it will at least stop the pain and I would be able to do things again. Not any of the surgeries I have done so far have helped.”