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Knee Arthritis (Osteoarthritis of the Knee)

  • What is knee arthritis?

    Knee arthritis

    Knee arthritis is caused by thinning of the cartilage of the knee joint, usually due to injury or ‘wear and tear’ over time.

    While there are many kinds of arthritis, the main types affecting the knee are:

    • Osteoarthritis is the most common and occurs with age. This degenerative condition, which causes the joint cartilage to wear down, is more common with age.
    • Rheumatoid arthritis, an autoimmune disease characterised by inflammation, can affect the joints as well as other parts of the body.
    • Post-trauma arthritis refers to arthritis that develops after a knee injury such as a torn meniscus, ligament injury or fracture.
  • There are many risk factors for knee arthritis and some of them can be managed with changes to your lifestyle, by helping to prevent the symptoms from getting worse.

    These are risk factors you can change:

    • Being overweight or obese, which places additional stress on the knee joints
    • High impact activities, repetitive actions or overuse of the knee joint, which all contribute to excessive wear and tear of the joint
    • Smoking

    Other risk factors which cannot be modified include:

    • Ageing, which increases the risk of developing arthritis
    • Gender, as several types of arthritis are more common in women
    • Genetics or family history which increase your likelihood of developing arthritis
    • Past knee injury which may have lasting impact on the knee joint
  • The most common symptom of knee arthritis is knee pain. In most cases it develops gradually over time, though it can also appear suddenly.

    Other symptoms include:

    • Stiffness or swelling that makes it difficult to bend or straighten the knee
    • Worsening of pain or swelling after a period of inactivity, such as after sitting and resting, or when waking in the morning
    • Worsening of pain after being physically active
    • Sensation of the knee joint ‘locking’ or ‘sticking’ during movement, sometimes accompanied by a cracking or grinding sound known as crepitus

    Feeling of weakness or the knee giving way and being unable to support weight, sometimes referred to as ‘joint instability’.

  • A physical examination will be conducted to detect joint swelling, warmth, redness and tenderness and to test for range of movement, stability and strength.

    Several tests will help to confirm the diagnosis and type of knee arthritis that you are experiencing. These include:

    • Imaging tests such as X-rays, magnetic resonance imaging (MRI), computed tomography (CT) scan or bone scan to provide a detailed picture of the knee joint. This will allow your doctor to look for narrowing of the joint space, changes in the bone or the formation of bone spurs that are causing your symptoms.
    • Blood tests can help to support your doctor’s diagnosis for certain types of knee arthritis, such as rheumatoid arthritis
  • Treatment of knee arthritis includes non-surgical and surgical options.

    Non-surgical methods aim to relieve pain and improve mobility. These include:

    • Exercise, which plays a role in reducing weight and therefore pressure on the knee joints. Low-impact exercises such as cycling or swimming are preferable. Studies also show that individuals who exercise regularly experience less pain.
    • Physiotherapy is important to improve strength to reduce pressure on the knees and to improve range of motion.
    • Home-based aids such as a compression sleeve or knee brace can help support the knee joint
    • Pain-relief medication including over-the-counter medicines and prescription painkillers. All medications should be taken with care and according to your doctor’s instruction.
    • Corticosteroid, hyaluronic acid or platelet-rich plasma injections are injected directly into the knee and may reduce pain for a limited period of time.

    Surgery for knee arthritis may be recommended to repair or remove damaged portions of the knee joint to relieve pain, if non-surgical options are unsuccessful. Procedures include:

    • Arthroscopy to treat a torn meniscus
    • Cartilage grafting to replace damaged cartilage
    • Synovectomy to remove joint lining damaged by rheumatoid arthritis
    • Osteotomy to reshape the thighbone or shinbone to relieve pressure on the knee joint
    • Arthroplasty (partial or total knee replacement) removes damaged cartilage and bone, inserting a metal or plastic piece to replace it

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  • Complications of knee arthritis depends on the type of arthritis that is causing the pain.

    • In knee osteoarthritis, the degenerative nature of the disease means it is likely the pain and condition of the joint will worsen.
    • In septic arthritis, which is caused by infection in the knee joint, swelling, pain and redness can cause extensive damage to the knee cartilage.
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