Osteoarthritis of Knee

“Long-term relief from knee arthritis — from conservative care to advanced joint replacement.”

Overview: What is Osteoarthritis?

Osteoarthritis of the knee happens when the cartilage of the knee joint breaks down, resulting in the rubbing of the bones. Such friction causes pain and swelling in the knee, leading to stiffness. The condition is a degenerative joint disease and may develop over time.

This long-term progressive condition doesn’t have a cure. However, many treatment options are available and you can use them to manage the pain and discomfort and improve your quality of life. The healthcare provider will monitor your condition upon discussing symptoms and then provide a sought-after treatment option.

Symptoms

The symptoms of osteoarthritis develop slowly and may worsen over time. They include the following:

• Pain in the affected joints during or after movement
• Immense stiffness in the joints
• Tender joints when you apply light pressure on them
• Grating sensation experienced while using the joint
• Bone spurs or extra bits of bone that may feel like hard lumps and may form around the affected joint
• Swelling caused by soft tissue inflammation around the joint.

Causes of Osteoarthritis

Osteoarthritis occurs when the cartilage that cushions the ends of the bones in the joints wears out. Cartilage refers to a firm and slippery tissue that allows frictionless joint motion. Although this condition develops over time as cartilage wears and tears, certain external factors may also contribute to its progression. The external causes of osteoarthritis include extra stress on the knees, injury, accident, or a sedentary lifestyle. Certain conditions increase the risk of developing osteoarthritis in the knees.

• Individuals with a BMI of 30 or more are at an increased risk of osteoarthritis.
• Any kind of old knee injury may result in osteoarthritis.
• Putting a lot of stress on the knees causes osteoarthritis.
• In some cases, heredity is also a risk factor.
• Any other bone deformity, including crooked bones or joints, or knock knees, increases the chances of developing osteoarthritis.

Diagnosis

Your healthcare provider will discuss your health history along with your symptoms. They will examine your knee in the following ways.

• If the knee is discoloured, swollen, or sore
• If you feel pain in a specific location of the knee
• If there is any sign that you may have injured your knee
• If your knee is moving properly
• If your knee joint feels loose or unstable
• If you have an abnormal gait or walk.

In addition, they may order a few imaging tests to confirm the diagnosis of the condition. A knee X-ray will be carried out. In some cases, they may as well order a CT scan or MRI to take a closer look at your joints to confirm the diagnosis.

Treatment

The treatment of osteoarthritis of the knees depends on the severity of your condition. The healthcare provider begins with conservative treatment options and may recommend surgery if they don’t work.

Non-Surgical Treatment Options

Medication

• Acetaminophen may help individuals with osteoarthritis who experience mild to moderate pain.
• Nonsteroidal anti-inflammatory drugs, such as ibuprofen and naproxen, should be taken at recommended doses. These medicines are known to relieve the pain. However, do not take more than what is prescribed.
• Duloxetine, a drug usually used as an antidepressant, is also approved to treat chronic pain, including pain resulting from osteoarthritis.

Therapy

• Physical Therapy: The healthcare provider will suggest that you work with a physiotherapist who will train you for exercises to strengthen the muscles around your joint, increase flexibility, and reduce pain. Regular gentle exercises are proven to be effective.
• Occupational Therapy: The healthcare provider will connect you with an occupational therapist, who will help you find ways to do everyday tasks without putting extra stress on the affected joint.
• Transcutaneous Electrical Nerve Stimulation: Also known as TENS, this procedure uses a low-voltage electrical current to relieve pain. It offers short-term relief for patients with knee and hip osteoarthritis.
• Cortisone Injections: Injecting a corticosteroid into the joint may relieve pain for a few weeks. The healthcare provider will recommend their use every year. It is generally limited to 3 or 4 per year.
• Lubrication Injections: The use of hyaluronic acid injections may relieve pain by offering cushioning to the knee. This component acts similarly to the component found in the joint fluid.

Surgical Treatment Options

Osteotomy

If your condition has damaged one side of your knee more than the other, the surgeon may perform an osteotomy to relieve you of pain and discomfort. The procedure includes cutting across the bone either above or below the knee and removing or adding a wedge of bone. It shifts your body weight away from the worn-out part of the knee.

Knee Replacement Surgery

Under this procedure, the surgeon removes the damaged joint surface and replaces it with plastic and metal implants. It is vital to choose implants of good quality, or they wear out or come loose, requiring a revision surgery from time to time. Knee Replacement Surgery may be total or partial.

1. Partial Knee Replacement: The surgeon replaces the part of the knee joint with an implant. This type of procedure is called arthroplasty. Only the damaged sections of the knees are removed and replaced with artificial joints.
2. Total Knee Replacement: It is the most common type of knee replacement. The surgeon replaces all three areas of the knee joint, including the inside, outside, and under the kneecap. This procedure is called a total knee arthroplasty.

Recovery

Recovery after an osteoarthritis knee replacement may be a long process in the case of surgery. The healthcare provider or their care team will give you instructions to follow for a smooth and speedy recovery.

• Low-impact exercise may increase your endurance and strengthen muscles around the joint, making them more stable.
• You will be advised to lose weight as carrying extra weight increases stress on the weight-bearing joints, including knees and hips.
• The healthcare provider will put you on physiotherapy for rehabilitation. Your physical therapist may also include exercises, like Tai chi and yoga, with deep breathing. These movements may reduce osteoarthritis pain and improve movement.
• Head and cold compression are good ways to relieve pain and swelling in the joints. You may use them upon the advice of the healthcare provider.
• For pain management, they will prescribe you medication, including oral medicines and topical nonsteroidal anti-inflammatory gels. Apply it to the affected joint for relief.
• You may be advised to wear braces, shoe inserts, and other assistive devices to help relieve stress on the joints.

Prevention

There is no single cause of osteoarthritis in the knee, so you may not entirely prevent it. However, you can always reduce the risk of this condition by reducing stress and strain on the knee.

• Include exercise in your routine to strengthen your knees.
• If you run or jog, seek out soft surfaces.
• Consume a healthy diet and avoid smoking.
• Do not skip follow-up visits to your healthcare provider, as these visits help monitor your progress.

FAQs

Looking for expert care? Consult Dr. Ashwani Maichand today for a personalised assessment and tailored treatment plan.