Osteoarthritis of the Knee

Arthritis is inflammation of one or more of your joints. Pain, swelling, and stiffness are the main symptoms of arthritis. The knee is commonly affected, although any joint in your body can be affected. You might struggle with even routine activities such as walking or climbing stairs.

The most common types of arthritis are osteoarthritis and rheumatoid arthritis, but there are more than 100 different forms. While arthritis is predominantly an adult disease, some forms affect children.

Although there is no cure for arthritis, there are many treatment options available to help manage pain and keep people staying active.

Anatomy

The knee is the largest and strongest joint in your body. It is made up of the lower end of the femur (thighbone), the upper end of the tibia (shinbone), and the patella (kneecap). The ends of the three bones where they touch are covered with articular cartilage, a smooth, slippery substance that protects and cushions the bones as you bend and straighten your knee.

Two C-shaped pieces of cartilage called meniscus act as “shock absorbers” between your thighbone and shinbone. They help to cushion the joint and keep it stable.

The knee joint is surrounded by a thin lining called the synovial membrane. This membrane releases a fluid that lubricates the cartilage and reduces friction.

Symptoms

If your knee joint affected by arthritis it may become painful and inflamed. Generally, the pain develops gradually over time, although sudden onset is also possible. There are other symptoms, as well:

• The joint may become stiff and swollen, making it difficult to bend and straighten the knee.
• Pain and swelling may be worse in the morning, or after sitting or resting.
• Vigorous activity may cause pain to flare up.
• Loose fragments of cartilage and other tissue can interfere with the smooth motion of joints. The knee may “lock” or “stick” during movement. It may creak, click, snap or make a grinding noise (crepitus).
• Pain may cause a feeling of weakness or buckling in the knee.
• Many people with arthritis note increased joint pain with rainy weather.

Treatment

There is no cure for arthritis but there are a number of treatments that may help relieve the pain and disability it can cause.

Nonsurgical Treatment

As with other arthritic conditions, initial treatment of arthritis of the knee is nonsurgical. Your surgeon at Surrey Total health may recommend a range of treatment options.

Lifestyle modifications

Some changes in your daily life can protect your knee joint and slow the progress of arthritis.

• Minimise activities that aggravate the condition, such as climbing stairs.
• Switching from high impact activities (like jogging or tennis) to lower impact activities (like swimming or cycling) will put less stress on your knee
• Losing weight can reduce stress on the knee joint, resulting in less pain and increased function.

Physiotherapy

Specific exercises can help increase range of motion and flexibility, as well as help strengthen the muscles in your leg. Your surgeon at Surrey Total health can help develop an individualised exercise program that meets your needs and lifestyle.

Assistive devices

Using devices such as a cane, wearing shock-absorbing shoes or inserts, or wearing a brace or knee sleeve can be helpful. A brace assists with stability and function, and may be especially helpful if the arthritis is centred on one side of the knee. There are two types of braces that are often used for knee arthritis: An “off-loader” brace shifts weight away from the affected portion of the knee, while a “support” brace helps support the entire knee load.

Other remedies

Applying heat or ice, using pain-relieving ointments or creams, or wearing elastic bandages to provide support to the knee may provide some relief from pain.

Medications

Several types of drugs are useful in treating arthritis of the knee. Because people respond differently to medications, your surgeon at Surrey Total Health will work closely with you to determine the medications and dosages that are safe and effective for you.

Surgical Treatment

Your surgeon at Surrey Total Health may recommend surgery if your pain from arthritis causes disability and is not relieved with nonsurgical treatment. As with all surgical interventions, there are some risks and possible complications with different knee procedures. Your surgeon will discuss the possible complications with you before your operation.

Arthroscopy

During arthroscopy, surgeons use small incisions and thin instruments to diagnose and treat joint problems.

Arthroscopic surgery is not often used to treat arthritis of the knee. In cases where osteoarthritis is accompanied by a degenerative meniscal tear, arthroscopic surgery may be very rarely be recommended to treat the torn meniscus.

Osteotomy

In a knee osteotomy, either the tibia (shinbone) or femur (thighbone) is cut and then reshaped to relieve pressure on the knee joint. Knee osteotomy is used when you have early-stage osteoarthritis that has damaged just one side of the knee joint. By transferring your weight off the damaged side of the joint, an osteotomy can relieve pain and significantly improve function in your arthritic knee.

Total or partial knee replacement (arthroplasty)

Your surgeon will remove the damaged cartilage and bone, and then position new metal or plastic joint surfaces to restore the function of your knee.