Osteoarthritis is the most common type of knee arthritis. Also called wear-and-tear arthritis or degenerative joint disease, osteoarthritis is characterized by progressive wearing away of the cartilage of the joint. As the protective cartilage is worn away by knee arthritis, bone is exposed, the knee becomes swollen and painful, and activities become increasingly difficult.
Knee arthritis typically affects patients over 50 years of age. It is more common in patients who are overweight, and weight loss tends to reduce the symptoms associated with knee arthritis. There is also a genetic predisposition to this condition, meaning knee arthritis tends to run in families. Other factors that can contribute to developing knee arthritis include trauma to the knee, meniscus tears or ligament damage, and fractures to the bone around the joint.
Symptoms of Knee Arthritis?Knee arthritis symptoms tend to progress as the condition worsens, however, symptoms often don't progess as a setady decline. Rather, many patients report long episodes of mild symptoms, with sudden changes that increase their symptoms. Often patients report good months and bad months, or symptoms that fluctuate with the weather. This is important to understand because comparing the symptoms of arthritis on one particular day may not accurately represent the overall progression of the condition. Since there is not a cure for arthritis, learning ways to slow the progression is important for all patients with this condition.
The most common symptoms of knee arthritis include:
- Pain with activities
- Limited range of motion
- Stiffness of the knee
- Swelling of the joint
- Tenderness along the joint
- A feeling the joint may "give out"
- Deformity of the joint (knock-knees or bow-legs)
Evaluation of a patient with knee arthritis should begin with a physical examination and X-rays. These can serve as a baseline to evaluate later examinations and determine progression of the condition.
Treatment of Knee ArthritisTreatment should begin with the most basic steps and progress to the more involved, possibly including surgery. Not all treatments are appropriate for every patient, and you should have a discussion with your doctor to determine which treatments are appropriate for your particular situation. The range of options:
- Weight Loss
Probably one of the most important, yet least commonly performed treatments. The less weight the joint has to carry, the less painful activities will be.
- Activity Modification
Limiting certain activities may be necessary, and learning new exercise methods may be helpful.
- Walking Aids
Use of a cane or a single crutch is the hand opposite the affected knee will help decrease the demand placed on the arthritic joint.
- Physical Therapy
Strengthening of the muscles around the knee joint may help decrease the burden on the knee. Preventing atrophy of the muscles is an important part of maintaining functional use of the knee.
- Anti-Inflammatory Medications
Anti-inflammatory pain medications (NSAIDs) are prescription and nonprescription drugs that help treat pain and inflammation.
- Cortisone Injections
Cortisone injections may help decrease inflammation and reduce pain within a joint.
Synvisc may be effective against pain in some patients with knee arthritis and may delay the need for knee replacement surgery.
- Knee Arthroscopy
Exactly how effective knee arthroscopy is for treatment of arthritis is debatable. For some specific symptoms, it may be helpful.
- Knee Osteotomy
While most patients are not good candidates for this alternative to knee replacement, it can be effective for young patients with limited arthritis.
- Total Knee Replacement Surgery
In this procedure, the cartilage is removed and a metal & plastic implant is placed in the knee.
- Partial Knee Replacement Surgery
Also called a unicompartmental knee replacement, this is replacement of one part of the knee. It is a surgical option for the treatment of limited knee arthritis.
BJ Cole and CD Harner "Degenerative arthritis of the knee in active patients: evaluation and management" J. Am. Acad. Ortho. Surg., Nov 1999; 7: 389 - 402.