Overview of Knee Osteoarthritis

Osteoarthritis (OA) is a disease that causes pain and stiffness in your joints. Your knee is a large load-bearing joint, and therefore it is one of the joints that’s most commonly affected.

It is a degenerative, wear-and-tear type of arthritis that occurs most often in people 50 and older, although it may occur in younger people, too.

Over time, the protective cartilage cushions the knee joints and wears down, leading to pain, stiffness, and reduced mobility. Understanding the causes, symptoms, and treatment options for knee osteoarthritis is essential for managing the condition effectively and improving the quality of life.

Causes of Knee OA

As part of normal life, your joints are exposed to constant low level stress and strain. In most cases, your body repairs the damage itself and you do not experience any symptoms. However in osteoarthritis, the protective cartilage on the surface of your bones slowly breaks down, causing pain, swelling and problems moving the joint. Bony growths can sometimes also develop (bone spurs), and the area can become swollen and red.

While the exact cause of OA is not fully known, there are several things are thought to increase your risk of developing osteoarthritis, including:

• Age: The risk of knee OA increases with age, as the cartilage naturally undergoes wear and tear over time.
• Genetics: Family history may play a role in the development of knee osteoarthritis, suggesting a genetic predisposition.
• Obesity: Excess weight places additional stress on the knee joints, accelerating the breakdown of cartilage.
• Joint Injuries: Previous knee injuries or trauma can increase the likelihood of developing osteoarthritis.
• Repetitive Stress: Certain occupations or activities that involve repetitive stress on the knees may contribute to OA.

Symptoms of Knee OA

The symptoms of knee osteoarthritis can vary in severity and can often come and go (known as arthritic flare ups). Sometimes symptoms can increase after doing a certain activity. As it is a progressive condition, overtime symptoms will usually become wors and more frequent.

Common symptoms of knee OA may include:

• Pain: Persistent pain in the knee joint, particularly during movement or weight-bearing activities.
• Stiffness: Difficulty moving the knee, especially after periods of rest or inactivity.
• Swelling: The knee joint may become swollen and feel warm to the touch.
• Decreased Range of Motion: It may become challenging to fully bend or straighten the knee.
• Joint Instability: The knee may feel unstable or give out during movement.

How is osteoarthritis of the knee diagnosed?

Arthritis of the knee can be initially diagnosed during a consultation with a knee specialist, who will carry out a full clinical examination. This diagnosis is usually confirmed with an x-ray that assesses the knee bones and joint, and can visualise the severity of the arthritis. Occasionally, a magnetic resonance imaging (MRI) scan or a computerised tomography (CT) scan may be needed to determine the condition of your knee’s bone and soft tissues.

Physical Examination:

• Joint swelling, warmth, or redness
• Tenderness around the knee
• Range of passive (assisted) and active (self-directed) motion
• Instability of the joint
• Crepitus (a grating sensation inside the joint) with movement
• Pain when weight is placed on the knee
• Problems with your gait (the way you walk)
• Any signs of injury to the muscles, tendons, and ligaments surrounding the knee
• Involvement of other joints (an indication of rheumatoid arthritis)

Treatment Options for Knee OA

The treatment of knee osteoarthritis aims to alleviate pain, improve joint function, and slow down the progression of the disease. Treatment options include:

• Lifestyle Modifications: Weight management, regular low-impact exercise, and avoiding activities that exacerbate knee pain.
• Physiotherapy: Specific exercises to strengthen the muscles around the knee, improve flexibility, and enhance joint stability.
• Pain Management: Over-the-counter pain relievers, such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), can help manage pain.
• Corticosteroid Injections: These can provide temporary relief by reducing inflammation in the knee joint.
• Viscosupplementation: Hyaluronic acid injections to improve joint lubrication and reduce pain.
• Bracing: The use of knee braces to provide support and reduce stress on the affected joint.

Surgical Options and Outcomes for Knee OA

When conservative treatments fail to provide adequate relief, surgical options may be considered:

• Knee Arthroscopy: A minimally invasive procedure where the surgeon examines and treats the joint using small incisions and a camera. It is most suitable for mild to moderate cases but may not be effective for advanced knee osteoarthritis.
• Knee Osteotomy: Involves realigning the bones around the knee joint to shift weight away from the damaged area, suitable for younger, active patients.
• Partial Knee Replacement (Unicompartmental Knee Replacement): Replaces only the damaged part of the knee joint with metal or plastic components, preserving healthy tissue.
• Total Knee Replacement (TKR): Artificial components replace The damaged joint entirely. TKR is most effective for severe cases of knee osteoarthritis, providing significant pain relief and improved function.

Q & As:

Can knee osteoarthritis be prevented?
While some risk factors like age and genetics cannot be changed, maintaining a healthy weight, staying physically active, and avoiding excessive knee stress can reduce the risk of developing knee osteoarthritis.

Can knee osteoarthritis be cured with surgery?
Knee osteoarthritis is a chronic condition, and while surgery can provide significant pain relief and improve function, it does not cure the disease. Surgery aims to manage symptoms and enhance the quality of life.

How long does it take to recover from knee replacement surgery?
The recovery period can vary depending on the individual and the type of surgery performed. Generally, patients may require several weeks of physical therapy and rehabilitation after knee replacement surgery before resuming normal activities.

Is exercise safe for knee osteoarthritis?
Yes, regular low-impact exercises like walking, swimming, and cycling can be beneficial for knee osteoarthritis. Exercise helps strengthen the muscles around the knee joint, improve joint flexibility, and reduce pain.

Are there any alternative treatments for knee osteoarthritis?
Some alternative treatments, such as acupuncture or glucosamine supplements, have shown promise in relieving knee osteoarthritis symptoms for some individuals. However, it’s essential to consult with a healthcare professional before trying any alternative therapies to ensure their safety and effectiveness.